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Medicina
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Meta-Research in the Medico-Scientific Field
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Meta-Research in the Medico-Scientific Field

A special issue of Medicina (ISSN 1648-9144).

Deadline for manuscript submissions: closed (31 December 2020) | Viewed by 57583

Special Issue Editors

Prof. Dr. Jae Il Shin

E-Mail Website
Guest Editor
Department of Pediatrics, Yonsei University College of Medicine, Seoul 03722, Korea
Interests: evidence-based medicine; meta-analysis; meta-research; reproducibility crisis; bias
Special Issues, Collections and Topics in MDPI journals
Dr. Andreas Kronbichler

E-Mail Website
Guest Editor
Department of Internal Medicine IV (Nephrology and Hypertension), Anichstrasse 35, 6020 Innsbruck, Austria
Interests: vasculitis; nephrotic syndrome; glomerular disease; contrast-associated acute kidney injury; systemic lupus erythematosus
Special Issues, Collections and Topics in MDPI journals
Dr. Marco Solmi

E-Mail Website
Guest Editor
Neuroscience Department, Psychiatry Unit, Padua Neuroscience Center, University of Padua, Padua, Italy
Interests: evidence-based medicine; meta-analysis; meta-research; epidemiology; neuroscience

Special Issue Information

Dear Colleagues,

Meta-research, which is also called meta-science, is a recent field of research that studies science itself and research practices with the aim of finding evidence-based improvements. Meta-research has grown as a reaction to the replication crisis and concerns about waste in research in various fields, e.g., biomedical research . Therefore, meta-research seeks to increase the quality of scientific research while reducing waste. Any effort to improve this is included in the field of meta-research.

The purpose of this Special Issue is to discuss various kinds of topics associated with meta-research and ultimately improve the quality and reliability of scientific research. The scope of the issue is broad to encourage coverage of a wide range of topics and perspectives (all medico-scientific fields) related to meta-research. This includes not only systematic reviews and meta-analyses but also umbrella reviews, field synopses, and any topics related to meta-research. for patients or healthcare professionals.

In summary, we are happy to host this Special Issue and welcome solicited and unsolicited submissions that will contribute to its success.

With kind regards,

Prof. Jae Il Shin
Dr. Andreas Kronbichler
Dr. Marco Solmi
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Medicina is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1800 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Meta-research
  • Systematic review
  • Meta-analysis
  • Umbrella review
  • Field-synopsis

Published Papers (18 papers)

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Research

Jump to: Review, Other

10 pages, 1088 KiB  
Article
A Comparison of Clinical Outcomes between Endoscopic Resection and Surgical Resection in Ampullary Tumors
by Jung-Soo Pyo, Byoung Kwan Son, Hyo Young Lee, Il Hwan Oh and Kwang Hyun Chung
Medicina 2020, 56(10), 546; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina56100546 - 18 Oct 2020
Cited by 4 | Viewed by 1887
Abstract
Background and objectives: This study aimed to elucidate the clinical outcomes of endoscopic resection (ER) through comparison with surgical resection (SR) through a meta-analysis. Materials and Methods: This meta-analysis was performed using 32 studies. The complete resection and recurrence rates of treatment for [...] Read more.
Background and objectives: This study aimed to elucidate the clinical outcomes of endoscopic resection (ER) through comparison with surgical resection (SR) through a meta-analysis. Materials and Methods: This meta-analysis was performed using 32 studies. The complete resection and recurrence rates of treatment for ampullary tumors were investigated and compared between ER and SR. In addition, complications, including pancreatitis, cholangitis, cholecystitis, perforation, and papillary stenosis, and mortality of ER and SR, respectively, were estimated. Results: The rates of complete resection were 0.812 (95% confidence interval, CI, 0.758–0.856) and 0.929 (95% CI 0.739–0.984) in ER and SR, respectively. Recurrence rates were 0.145 (95% CI 0.107–0.193) and 0.126 (95% CI 0.057–0.257) in ER and SR, respectively. There were no significant differences in complete resection and recurrence rates between ER and SR in the meta-regression tests (p = 0.164 and p = 0.844, respectively). The estimated rates of pancreatitis, cholangitis/cholecystitis, perforation, and papillary stenosis were 12.8%, 4.4%, 5.2%, and 4.3% in ER and 9.9%, 5.6%, 2.3%, and 5.6% in SR, respectively. There was no significant difference in complications between ER and SR. The mortality rate of SR was slightly higher than that of ER (0.041, 95% CI 0.015–0.107 vs. 0.031, 95% CI 0.005–0.162). Our results show that ER had no significant differences in terms of complete resection and recurrence rates compared to SR, regardless of tumor behaviors. Conclusions: By comparing the complication and mortality rates between ER and SR, the safety of ER was proven. Full article
(This article belongs to the Special Issue Meta-Research in the Medico-Scientific Field)
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13 pages, 608 KiB  
Article
Clinicopathological Significance of EBV-Infected Gastric Carcinomas: A Meta-Analysis
by Jung-Soo Pyo, Nae-Yu Kim and Dong-Wook Kang
Medicina 2020, 56(7), 345; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina56070345 - 13 Jul 2020
Cited by 14 | Viewed by 2324
Abstract
Background and objectives: The present study aims to elucidate the clinicopathologic significance of Epstein–Barr virus (EBV) infection in gastric carcinomas (GCs) through a meta-analysis. Materials and Methods: Sixty-one eligible studies were included in the present meta-analysis. The included patients, with and [...] Read more.
Background and objectives: The present study aims to elucidate the clinicopathologic significance of Epstein–Barr virus (EBV) infection in gastric carcinomas (GCs) through a meta-analysis. Materials and Methods: Sixty-one eligible studies were included in the present meta-analysis. The included patients, with and without EBV infection, were 2063 and 17,684, respectively. We investigated the clinicopathologic characteristics and various biomarkers, including programmed death-ligand 1 (PD-L1) expression and tumor-infiltrating lymphocytes (TILs). Results: The estimated EBV-infected rate of GCs was 0.113 (95% confidence interval (CI): 0.088–0.143). The EBV infection rates in GC cells were 0.138 (95% CI: 0.096–0.194), 0.103 (95% CI: 0.077–0.137), 0.080 (95% CI: 0.061–0.106), and 0.042 (95% CI: 0.016–0.106) in the population of Asia, America, Europe, and Africa, respectively. There was a significant difference between EBV-infected and noninfected GCs in the male: female ratio, but not other clinicopathological characteristics. EBV infection rates were higher in GC with lymphoid stroma (0.573, 95% CI: 0.428–0.706) than other histologic types of GCs. There were significant differences in high AT-rich interactive domain-containing protein 1A (ARID1A) and PD-L1 expressions, and high CD8+ TILs between EBV-infected and noninfected GCs. Conclusions: Our results showed that EBV infection of GCs was frequently found in male patients and GCs with lymphoid stroma. EBV infection was significantly correlated with ARID1A and PD-L1 expressions and CD8+ TILs in GCs. Full article
(This article belongs to the Special Issue Meta-Research in the Medico-Scientific Field)
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Review

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10 pages, 291 KiB  
Review
Transradial Embolization, an Underused Type of Uterine Artery Embolization Approach: A Systematic Review
by Loredana Maria Himiniuc, Mara Murarasu, Bogdan Toma, Razvan Popovici, Ana-Maria Grigore, Ioana-Sadiye Scripcariu, Mihaela Oancea and Mihaela Grigore
Medicina 2021, 57(2), 83; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina57020083 - 20 Jan 2021
Cited by 8 | Viewed by 1707
Abstract
Background and Objectives: The most utilized approach for the embolization of uterine arteries is the transfemoral path. However, the transradial approach (TRA) has been gaining popularity among cardiologic interventions in the last years but only few studies have shown its applicability in uterine [...] Read more.
Background and Objectives: The most utilized approach for the embolization of uterine arteries is the transfemoral path. However, the transradial approach (TRA) has been gaining popularity among cardiologic interventions in the last years but only few studies have shown its applicability in uterine myoma treatment. The objective of this paper is to assess the feasibility, safety and efficacy of TRA when compared with the transbrachial, transulnar or transfemoral approach (TFA) for uterine arteries embolization (UAE). Materials and methods: A systematic review of the literature that analyzes the TRA for UAE it was carried out, in order to assess its safety and effectiveness. It was systematically searched the literature (Google Scholar, PubMed/MEDLINE, Cochrane Library and Embase) using the words “uterine artery embolization”/“uterine embolization” and “transradial”/“radial”. All the relevant papers published until March 2020 were retrieved and analyzed. Results: Ten studies were considered eligible for this topic. TRA is a comparable method with TFA for uterine artery embolization. Conclusions: These studies allowed us to conclude that TRA is as safe and efficient as TFA. Its advantages include few complications, shorter hospitalization period, and rapid mobilization but a steeper learning curve has the disadvantage of a longer learning curve compared to TFA. Yet, these findings are built on few reports and more research is needed. Full article
(This article belongs to the Special Issue Meta-Research in the Medico-Scientific Field)
9 pages, 2500 KiB  
Review
Laparoscopic versus Open Transverse-Incision Approach for Right Hemicolectomy: A Systematic Review and Meta-Analysis
by Claudio F. Feo, Panagiotis Paliogiannis, Alessandro Fancellu, Angelo Zinellu, Giorgio C. Ginesu, Carlo V. Feo and Alberto Porcu
Medicina 2021, 57(1), 80; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina57010080 - 19 Jan 2021
Cited by 2 | Viewed by 2468
Abstract
Background and Objectives: There is general agreement on the benefits of laparoscopy for treatment of rectal and left colon cancers, whereas findings regarding the comparison of laparoscopic and open right colonic resections are discordant. The aim of this systematic review and meta-analysis was [...] Read more.
Background and Objectives: There is general agreement on the benefits of laparoscopy for treatment of rectal and left colon cancers, whereas findings regarding the comparison of laparoscopic and open right colonic resections are discordant. The aim of this systematic review and meta-analysis was to assess the outcomes and advantages of laparoscopic versus transverse-incision open surgery for management of right colon cancer. Materials and Methods: A systematic review was performed according to the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. Comparative studies evaluating the results of laparoscopic and transverse-incision open right hemicolectomies were analyzed. The measured outcomes were mean operative time, time to feeding, duration of hospital stay, and number of lymph nodes harvested. Results: A total of 5 studies including 318 patients met the inclusion criteria. Meta-analysis revealed no differences in time to resume oral feeding, hospital stay, and number of lymph nodes harvested in between groups, but mean length of surgery was significantly longer in the laparoscopic group. Conclusion: These data confirm that the preferred approach to right hemicolectomy is yet unclear. Laparoscopy has a longer operative time than transverse-incision open surgery, and no significant short-term benefits were observed for the studied parameters. Well-designed randomized control trials (RCTs) might help to identify the differences between these two techniques for the surgical treatment of right colon cancer. Full article
(This article belongs to the Special Issue Meta-Research in the Medico-Scientific Field)
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18 pages, 623 KiB  
Review
A Systematic Review of the Legal Considerations Surrounding Medicines Management
by Mojtaba Vaismoradi, Sue Jordan, Patricia A. Logan, Sara Amaniyan and Manela Glarcher
Medicina 2021, 57(1), 65; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina57010065 - 13 Jan 2021
Cited by 4 | Viewed by 4459
Abstract
Background and Objectives: There is a paucity of integrated knowledge regarding legal considerations required to ensure patient safety through safe medicines management. This study explores the legal considerations surrounding medicines management, providing a synthesis of existing knowledge. An integrative systematic review of [...] Read more.
Background and Objectives: There is a paucity of integrated knowledge regarding legal considerations required to ensure patient safety through safe medicines management. This study explores the legal considerations surrounding medicines management, providing a synthesis of existing knowledge. An integrative systematic review of the current international knowledge was performed. Materials and Methods: The search encompassed the online databases of PubMed (including Medline), Scopus, CINAHL, and Web of Science using MeSH terms and relevant keywords relating to the legal considerations of medicines management in healthcare settings. Results: The search process led to the identification of 6051 studies published between 2010 and 2020, of which six articles were found to be appropriate for data analysis and synthesis based on inclusion criteria. Research methods were varied and included qualitative interviews, mixed-methods designs, retrospective case reports and cross-sectional interrupted time-series analysis. Their foci were on the delegation of medicines management, pharmacovigilance and reporting of adverse drug reactions (ADRs) before and after legislation by nurses, physicians and pharmacists, medico-legal litigation, use of forced medication and the prescription monitoring program. Given the heterogenicity of the studies in terms of aims and research methods, a meta-analysis could not be performed and, therefore, our review findings are presented narratively under the categories of ‘healthcare providers’ education and monitoring tasks’, ‘individual and shared responsibility’, and ‘patients’ rights’. Conclusion: This review identifies legal aspects surrounding medicines management, including supervision and monitoring of the effects of medicines; healthcare providers’ knowledge and attitudes; support and standardised tools for monitoring and reporting medicines’ adverse side effects/ADRs; electronic health record systems; individual and shared perceptions of responsibility; recognition of nurses’ roles; detection of sentinel medication errors; covert or non-voluntary administration of medication, and patient participation. Full article
(This article belongs to the Special Issue Meta-Research in the Medico-Scientific Field)
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11 pages, 2735 KiB  
Review
A Systematic Review to Identify the Effects of Biologics in the Feet of Patients with Rheumatoid Arthritis
by Laura Ramos-Petersen, Christopher James Nester, Andres Reinoso-Cobo, Pilar Nieto-Gil, Ana Belen Ortega-Avila and Gabriel Gijon-Nogueron
Medicina 2021, 57(1), 23; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina57010023 - 29 Dec 2020
Cited by 3 | Viewed by 2244
Abstract
Background and Objective: Ninety percent of patients with rheumatoid arthritis (RA) feel foot pain during the disease process. Pharmacological treatment of RA has a systematic effect on the body and includes: Nonsteroidal anti-inflammatory drugs, disease-modifying antirheumatic drugs (DMARDs) and biologics. The objective of [...] Read more.
Background and Objective: Ninety percent of patients with rheumatoid arthritis (RA) feel foot pain during the disease process. Pharmacological treatment of RA has a systematic effect on the body and includes: Nonsteroidal anti-inflammatory drugs, disease-modifying antirheumatic drugs (DMARDs) and biologics. The objective of our review was to examine the impact of biologics on patients with RA ‘foot. Methods and Material: A systematic review of randomized control trials and observational studies that evaluated the efficacy of biologics against other pharmacological treatment, and included a foot outcome measure. The search covered MEDLINE Ovid, Pubmed, CINAHL, Cochrane Library, Evidence Search, and Web of Science. Risk of bias was evaluated using Cochrane guidance and the Newcastle Ottawa Scale adapted version. Results: A total of eight studies fully met the inclusion criteria: Three randomized control trials, and five observational studies were the basis of our review. A total sample of 1856 RA patients with RA treatment participated. The use of biologics was not associated as a risk factor for post-operative surgical site infection or delayed wound healing. The benefits of biologics, in terms of the disease evolution, were assessed using X-ray. Conclusion: Evidence suggests that the use of biologics is not a risk factor for post-operative surgical site infection or delayed wound healing. The use of biologics presents benefits in terms of the disease evolution assessed through X-ray. Full article
(This article belongs to the Special Issue Meta-Research in the Medico-Scientific Field)
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9 pages, 1097 KiB  
Review
The Effect of Heat Shock Protein 90 Inhibitor on Pain in Cancer Patients: A Systematic Review and Meta-Analysis
by Victoria N. Miles, Roma K. Patel, Amanda G. Smith, Ryan P. McCall, Jun Wu and Wei Lei
Medicina 2021, 57(1), 5; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina57010005 - 23 Dec 2020
Cited by 2 | Viewed by 2116
Abstract
Background and objectives: Heat shock protein 90 (Hsp90) is a molecular chaperone that plays an essential role in tumor growth. Numerous Hsp90 inhibitors have been discovered and tested in preclinical and clinical trials. Recently, several preclinical studies have demonstrated that Hsp90 inhibitors [...] Read more.
Background and objectives: Heat shock protein 90 (Hsp90) is a molecular chaperone that plays an essential role in tumor growth. Numerous Hsp90 inhibitors have been discovered and tested in preclinical and clinical trials. Recently, several preclinical studies have demonstrated that Hsp90 inhibitors could modulate pain sensitization. However, no studies have evaluated the impact of Hsp90 inhibitors on pain in the patients. This study aims to summarize the pain events reported in clinical trials assessing Hsp90 inhibitors and to determine the effect of Hsp90 inhibitors on pain in patients. Materials and Methods: We searched PubMed, EBSCOhost, and clinicaltrials.gov for Hsp90 inhibitor clinical trials. The pain-related adverse events were summarized. Meta-analysis was performed using the data reported in randomized controlled trials. Results: We identified 90 clinical trials that reported pain as an adverse effect, including 5 randomized controlled trials. The most common types of pain reported in all trials included headache, abdominal pain, and back pain. The meta-analysis showed that Hsp90 inhibitors increased the risk of abdominal pain significantly and appeared to increase the risk for back pain. Conclusions: In conclusion, Hsp90 inhibitor treatment could potentially increase the risk of pain. However, the meta-analysis demonstrated only moderate evidence for the connection between Hsp90 inhibitor and pain. Full article
(This article belongs to the Special Issue Meta-Research in the Medico-Scientific Field)
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18 pages, 733 KiB  
Review
Relationship between Night Shifts and Risk of Breast Cancer among Nurses: A Systematic Review
by Javier Fagundo-Rivera, Juan Gómez-Salgado, Juan Jesús García-Iglesias, Carlos Gómez-Salgado, Selena Camacho-Martín and Carlos Ruiz-Frutos
Medicina 2020, 56(12), 680; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina56120680 - 10 Dec 2020
Cited by 21 | Viewed by 6079
Abstract
Background and objectives: The incidence of breast cancer worldwide has increased in recent decades, accounting for 1 in 3 neoplasms in women. Besides, nurses are mainly represented by the female collective, most of them, undertaking working conditions with intensive rotative and night shifts [...] Read more.
Background and objectives: The incidence of breast cancer worldwide has increased in recent decades, accounting for 1 in 3 neoplasms in women. Besides, nurses are mainly represented by the female collective, most of them, undertaking working conditions with intensive rotative and night shifts due to the 24-h pace of work of this profession. The objective of this study was to assess the possible relationship between shift work, especially night-time work, and the development of breast cancer among nurses. Materials and Methods: A systematic review of the literature was carried out through the consultation of the following databases: Cochrane Plus Library, PubMed, CINAHL (Cumulative Index to Nursing and Allied Health Literature), Web of Science, ScienceDirect, Scopus, and Dialnet. Records were selected between 2010 and 2020, in Spanish and English, which covered the association between breast cancer diagnosed among nursing professionals and rotating night shifts. Results: A total of 12 studies were identified after critical reading. Most of the studies found an association between breast cancer and consecutive rotating night shifts prolonged over time. Among the associated factors, the alteration of the circadian rhythm influenced the expression of peripheral clock genes, which was the same as reproductive hormones. The risk of breast cancer in nurses increased during early adulthood and after 5 or more years with 6 or more consecutive nights. Conclusions: The different studies of this review show significant associations between breast cancer and prolonged rotating night shifts. Similarly, there is a relationship between the alterations in certain circadian rhythm markers (such as melatonin), epigenetic markers (such as telomeres), and breast cancer that would require more studies in order to corroborate these findings. Full article
(This article belongs to the Special Issue Meta-Research in the Medico-Scientific Field)
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10 pages, 1040 KiB  
Review
Spontaneous Heterotopic Pregnancy with Unaffected Intrauterine Pregnancy: Systematic Review of Clinical Outcomes
by Mihaela Oancea, Razvan Ciortea, Doru Diculescu, Alexandra-Andreea Poienar, Mihaela Grigore, Roxana-Adelina Lupean, Renata Nicula, Diana Chira, Stefan Strilciuc and Dan Mihu
Medicina 2020, 56(12), 665; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina56120665 - 30 Nov 2020
Cited by 10 | Viewed by 2461
Abstract
Background and objective: Spontaneous heterotopic pregnancy (SHP) is a rare condition represented by the synchronous coexistence of an intrauterine and an ectopic pregnancy. It rarely occurs with natural conception and is usually a consequence of assisted reproductive techniques. Diagnosis of SHP can [...] Read more.
Background and objective: Spontaneous heterotopic pregnancy (SHP) is a rare condition represented by the synchronous coexistence of an intrauterine and an ectopic pregnancy. It rarely occurs with natural conception and is usually a consequence of assisted reproductive techniques. Diagnosis of SHP can be a challenge for the clinician. The evolution of the intrauterine pregnancy is dependent on many factors, such as the location of the heterotopic pregnancy, gestational age at the time of diagnosis, the surgical procedure, the presence of other risk factors, early or delayed management. The aim of this systematic review of the literature was to extract existing evidence on spontaneous heterotopic pregnancy with otherwise unaffected intrauterine pregnancy. Materials and Methods: From a total of 1907 database entries identified in PubMed, EMBASE and Cochrane reviews, we selected 18 papers for narrative synthesis, for which we explored the diagnostic options, treatment, and outcome of these extremely rare epidemiologic occurrences. Manuscripts were assessed using the CARE guidelines for reporting case reports. Results: The main symptom was abdominal pain, and the preferred treatment approach was surgical, more precisely, using a laparoscopic approach. Most cases presented no risk factors, and the diagnosis was mostly made in the first semester. Conclusions: Normal follow-up and evolution of intrauterine pregnancy have been observed regardless of surgical approach (open or laparoscopic). Early diagnosis and treatment are advised, as they impact maternal and fetal outcomes. Evidence on this topic is scarce, predominantly comprised of case reports with variable degrees of adherence to dissemination guidelines. More studies on this topic are required to optimize care protocols for this type of pregnancy. Full article
(This article belongs to the Special Issue Meta-Research in the Medico-Scientific Field)
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10 pages, 1168 KiB  
Review
Early vs. Delayed Feeding after Endoscopic Submucosal Dissection for Gastric Cancer: A Systematic Review and Meta-Analysis
by Jun Watanabe, Joji Watanabe and Kazuhiko Kotani
Medicina 2020, 56(12), 653; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina56120653 - 27 Nov 2020
Viewed by 1930
Abstract
Background: Endoscopic submucosal dissection (ESD) for gastric cancer is increasingly performed worldwide due to its efficacy and safety. This study aimed to assess the evidence of the impact of early vs. delayed feeding after ESD on quality of care, which remains to [...] Read more.
Background: Endoscopic submucosal dissection (ESD) for gastric cancer is increasingly performed worldwide due to its efficacy and safety. This study aimed to assess the evidence of the impact of early vs. delayed feeding after ESD on quality of care, which remains to be fully determined. Methods: Electronic databases (PubMed, the Cochrane Central Register of Controlled Trials, EMBASE) and the trial registries (the World Health Organization International Clinical Trials Platform Search Portal and ClinicalTrials.gov) were searched for studies performed prior to September 2020. Study selection, data abstraction, and quality assessment were independently performed using the Grading of Recommendations Assessment, Development, and Evaluation approach. Self-rated satisfaction and hospital stay were chiefly analyzed. Results: Two randomized controlled trials (239 patients) were included. The early and delayed post-ESD feeding groups had similar rates of post-ESD bleeding (risk ratio 1.90, 95% CI 0.42 to 8.63; I2 = 0%). Early post-ESD feeding resulted in increased patients’ satisfaction in comparison to delayed post-ESD feeding (standard mean difference (MD) 0.54, 95% CI 0.27 to 0.81; I2 = 0%) and reduced the length of hospital stay (MD −0.83, 95% CI −1.01 to −0.65; I2 = 0%). Conclusion: Early post-ESD feeding was associated with increased patients’ satisfaction and reduced hospital stay in comparison to delayed feeding, while the rate of complications did not differ to a statistically significant extent. As we must acknowledge the limited number of reviewed studies, various trials regarding the quality of care are further needed to determine the benefits of early feeding after ESD. Full article
(This article belongs to the Special Issue Meta-Research in the Medico-Scientific Field)
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11 pages, 317 KiB  
Review
Energy Based Vessel Sealing Devices in Thyroid Surgery: A Systematic Review to Clarify the Relationship with Recurrent Laryngeal Nerve Injuries
by Mario Pacilli, Nicola Tartaglia, Alberto Gerundo, Giovanna Pavone, Alberto Fersini and Antonio Ambrosi
Medicina 2020, 56(12), 651; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina56120651 - 27 Nov 2020
Cited by 17 | Viewed by 2297
Abstract
Background and objectives: The principal complications associated with thyroid surgery consist in postoperative recurrent laryngeal nerve (RLN) palsy, hypoparathyroidism, intra-operative and post-operative hemorrhage. In this paper, structured as a literature review, we describe the current knowledge and the technical improvements currently employed in [...] Read more.
Background and objectives: The principal complications associated with thyroid surgery consist in postoperative recurrent laryngeal nerve (RLN) palsy, hypoparathyroidism, intra-operative and post-operative hemorrhage. In this paper, structured as a literature review, we describe the current knowledge and the technical improvements currently employed in the field of thyroid surgery, focusing on the contribution of energy based devices in relation with the reduction of the operating time and the odds of possible complication. Materials and methods: a relevant systematic literature search on Pubmed was carried out including works from 2004 through 2019, selecting studies providing information on the energy based devices employed in surgeries and statistic data concerning RNL (transient and permanent) injury and operative time. Results: Nineteen studies were reviewed, dealing with 4468 patients in total. The operative variables considered in this study are: employed device, number of patients, pathological conditions affecting the patients, surgical treatment, RNL injury percentage and the operating time, offering an insight on different patient conditions and their relative operative outcomes. A total of 1843 patients, accounting to the 41.2% of the total pool, underwent the traditional technique operation, while 2605 patients (58.3%) were treated employing the energy based devices techniques. Thyroidectomy performed by approaches different from traditional (for example robotic, MIVAT (Mini Invasive Video Assisted thyroidectomy)) were excluded from this study. Conclusions: The energy-based vessel sealing devices in study, represent a safe and efficient alternative to the traditional clamp-and-tie hand technique in the thyroidal surgery scenario, granting a reduction in operating time while not increasing RNL injury rates. According to this information, a preference for energy based devices techniques might be expressed, furthermore, a progressively higher usage rate for these devices is expected in the near future. Full article
(This article belongs to the Special Issue Meta-Research in the Medico-Scientific Field)
10 pages, 449 KiB  
Review
Primary Melanoma of the Lung: A Systematic Review
by Panagiotis Paliogiannis, Antonella M. Fara, Gianfranco Pintus, Wael M. Abdel-Rahman, Maria Colombino, Milena Casula, Giuseppe Palmieri and Antonio Cossu
Medicina 2020, 56(11), 576; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina56110576 - 30 Oct 2020
Cited by 11 | Viewed by 2552
Abstract
Background and Objectives: The respiratory apparatus, generally affected by highly aggressive tumors like lung cancer and mesothelioma, is rarely affected by primary malignant melanoma. The aim of this review was to identify cases of primary malignant melanoma of the lung (PMML) published [...] Read more.
Background and Objectives: The respiratory apparatus, generally affected by highly aggressive tumors like lung cancer and mesothelioma, is rarely affected by primary malignant melanoma. The aim of this review was to identify cases of primary malignant melanoma of the lung (PMML) published in the modern scientific literature, and to describe their main clinical, pathological and therapeutic features. Materials and Methods: A systematic search of publications in the electronic database PubMed has been performed using keywords, and the references of the selected articles were checked to identify additional missing studies. Results: Globally 52 papers reporting on 76 cases were identified. Among them there were 47 reports of a single case, three papers reporting on two cases each, and two larger case series published in 1997 and 2005 including eight and 15 cases, respectively. Conclusions: PMML was generally diagnosed in middle-aged males, without any apparent correlation with cigarette smoking. It was more frequently found in the lower lobes and the left lung. The tumors were generally pigmented, composed by epithelial and/or spindle cells with large nuclei and prominent nucleoli, nuclear atypia, and numerous mitotic figures; they commonly showed immunostaining for S-100, HMB 45 and Melan-A. Early detection and surgical resection were the main determinants of survival from this rare malignancy. Full article
(This article belongs to the Special Issue Meta-Research in the Medico-Scientific Field)
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20 pages, 1594 KiB  
Review
Long-Term Prognosis of Endodontic Microsurgery—A Systematic Review and Meta-Analysis
by Diogo Pinto, Andréa Marques, Joana F. Pereira, Paulo J. Palma and João Miguel Santos
Medicina 2020, 56(9), 447; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina56090447 - 03 Sep 2020
Cited by 39 | Viewed by 6057
Abstract
Background and objectives: The long-term outcome of endodontic microsurgery (EMS) performed on root-filled teeth affected by post-treatment apical periodontitis (AP) has been a matter of debate, re-launched by the introduction of novel root-end filling materials which have been proven to improve the short-term [...] Read more.
Background and objectives: The long-term outcome of endodontic microsurgery (EMS) performed on root-filled teeth affected by post-treatment apical periodontitis (AP) has been a matter of debate, re-launched by the introduction of novel root-end filling materials which have been proven to improve the short-term outcome of EMS. The purpose of this systematic review and meta-analysis is to evaluate the clinical and radiographic long-term outcome of endodontic microsurgery in teeth diagnosed with secondary AP through radiographic evaluation. Materials and Methods: This systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Inclusion and exclusion criteria were defined a priori to select the best longitudinal evidence. Only randomized clinical trials (RCT) and prospective clinical studies (PCS), with a follow-up ≥ 2-year, and exhibiting well-established clinical and radiographic outcome criteria, were selected. Results: A total of 573 articles were obtained, from which 10 fulfill inclusion criteria: 6 PCS and 4 RCT. Meta-analysis showed a pooled proportion of success rate of 91.3%, from an overall amount of 453 treated teeth included in RCT; from overall 839 included teeth in PCS, a pooled success rate of 78.4% was observed, with the follow-up time ranging from 2 to 13-years. Survival rate outcomes varied from 79 to 100% for the same follow-up period. Five prognostic factors with influence on the outcome were disclosed: smoking habits, tooth location and type, absence/presence of dentinal defects, interproximal bone level, and root-end filling material. Conclusions: High success rates and predictable results can be expected when EMS is performed by trained endodontists, allowing good prognosis and preservation of teeth affected by secondary AP. Full article
(This article belongs to the Special Issue Meta-Research in the Medico-Scientific Field)
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14 pages, 1554 KiB  
Systematic Review
Accuracy of Contrast Extravasation on Computed Tomography for Diagnosing Severe Pelvic Hemorrhage in Pelvic Trauma Patients: A Meta-Analysis
by Sung Nam Moon, Jung-Soo Pyo and Wu Seong Kang
Medicina 2021, 57(1), 63; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina57010063 - 12 Jan 2021
Cited by 4 | Viewed by 1859
Abstract
Background and objective: The early detection of underlying hemorrhage of pelvic trauma has been a critical issue. The aim of this study was to systematically determine the diagnostic accuracy of computed tomography (CT) for detecting severe pelvic hemorrhage. Materials and Methods: [...] Read more.
Background and objective: The early detection of underlying hemorrhage of pelvic trauma has been a critical issue. The aim of this study was to systematically determine the diagnostic accuracy of computed tomography (CT) for detecting severe pelvic hemorrhage. Materials and Methods: Relevant articles were obtained by searching PubMed, EMBASE, and Cochrane databases through 28 November 2020. Diagnostic test accuracy results were reviewed to obtain the sensitivity, specificity, diagnostic odds ratio, and summary receiver operating characteristic curve of CT for the diagnosis in pelvic trauma patients. The positive finding on CT was defined as the contrast extravasation. As the reference standard, severe pelvic hemorrhage was defined as an identification of bleeding at angiography or by direct inspection using laparotomy that required hemostasis by angioembolization or surgery. A subgroup analysis was performed according to the CT modality that is divided by the number of detector rows. Result: Thirteen eligible studies (29 subsets) were included in the present meta-analysis. Pooled sensitivity of CT was 0.786 [95% confidence interval (CI), 0.574–0.909], and pooled specificity was 0.944 (95% CI, 0.900–0.970). Pooled sensitivity of the 1–4 detector row group and 16–64 detector row group was 0.487 (95% CI, 0.215–0.767) and 0.915 (95% CI, 0.848–0.953), respectively. Pooled specificity of the 1–4 and 16–64 detector row groups was 0.956 (95% CI, 0.876–0.985) and 0.906 (95% CI, 0.828–0.951), respectively. Conclusion: Multi-detector CT with 16 or more detector rows has acceptable high sensitivity and specificity. Extravasation on CT indicates severe hemorrhage in patients with pelvic trauma. Full article
(This article belongs to the Special Issue Meta-Research in the Medico-Scientific Field)
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23 pages, 2798 KiB  
Systematic Review
Effectiveness of Percutaneous Nephrolithotomy, Retrograde Intrarenal Surgery, and Extracorporeal Shock Wave Lithotripsy for Treatment of Renal Stones: A Systematic Review and Meta-Analysis
by Chan Hee Kim, Doo Yong Chung, Koon Ho Rha, Joo Yong Lee and Seon Heui Lee
Medicina 2021, 57(1), 26; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina57010026 - 30 Dec 2020
Cited by 17 | Viewed by 3765
Abstract
Background and objectives: To perform a updated systematic review and meta-analysis comparing effectiveness of percutaneous nephrolithotomy (PCNL), retrograde intrarenal surgery (RIRS), and extracorporeal shock wave lithotripsy (ESWL) for treatment of renal stones (RS). Materials and Methods: A total of 37 studies [...] Read more.
Background and objectives: To perform a updated systematic review and meta-analysis comparing effectiveness of percutaneous nephrolithotomy (PCNL), retrograde intrarenal surgery (RIRS), and extracorporeal shock wave lithotripsy (ESWL) for treatment of renal stones (RS). Materials and Methods: A total of 37 studies were included in this systematic review and meta-analysis about effectiveness to treat RS. Endpoints were stone-free rates (SFR), incidence of auxiliary procedure, retreatment, and complications. We also conducted a sub-analysis of ≥2 cm stones. Results: First, PCNL had the highest SFR than others regardless of stone sizes and RIRS showed a higher SFR than ESWL in <2 cm stones. Second, auxiliary procedures were higher in ESWL than others, and it did not differ between PCNL and RIRS. Finally, in <2 cm stones, the retreatment rate of ESWL was higher than others. RIRS required significantly more retreatment procedures than PCNL in ≥2 cm stones. Complication was higher in PCNL than others, but there was no statistically significant difference in complications between RIRS and PCNL in ≥2 cm stones. For ≥2 cm stones, PCNL had the highest SFR, and auxiliary procedures and retreatment rates were significantly lower than others. Conclusions: We suggest that PCNL is a safe and effective treatment, especially for large RS. Full article
(This article belongs to the Special Issue Meta-Research in the Medico-Scientific Field)
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13 pages, 617 KiB  
Systematic Review
Gastric Calcifying Fibrous Tumor: An Easy Misdiagnosis as Gastrointestinal Stromal Tumor–A Systemic Review
by Meng-Ko Tsai, Hung-Yi Chen, Ming-Lung Chuang, Chun-Wen Chen and Gwo-Ping Jong
Medicina 2020, 56(10), 541; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina56100541 - 14 Oct 2020
Cited by 6 | Viewed by 2218
Abstract
Background and Objectives: Calcifying fibrous tumor (CFT) in the stomach is extremely rare and is easily misdiagnosed as a gastrointestinal stromal tumor (GIST). This study aims to determine the best method to differentiate between gastric CFT and GIST after a systemic review and [...] Read more.
Background and Objectives: Calcifying fibrous tumor (CFT) in the stomach is extremely rare and is easily misdiagnosed as a gastrointestinal stromal tumor (GIST). This study aims to determine the best method to differentiate between gastric CFT and GIST after a systemic review and meta-analysis. Materials and Methods: A systematic search of articles using electronic databases (MEDLINE, EMBASE, and LILACS) was conducted and resulted in 162 articles with 272 CFT cases published from January 1988 to September 2019. Results: Of these cases, 272 patients, 60 patients with gastric CFT (32 men and 28 women, mean age 49.2 years) were analyzed. The mean tumor size was 2.4 cm in patients with gastric CFT. Both endoscopic ultrasound (EUS) and computed tomography (CT) findings revealed well-defined (100% vs. 77.8%), heterogeneous (100% vs. 77.8%), iso-hypoechoic (71.4% vs. 33.3%), and calcified (85.7% vs. 77.8%) lesions, respectively. The majority of patients (53.3%) were symptomatic, with the most common symptom being abdominal discomfort (55.6%). None of the patients with gastric CFT showed recurrence after treatment, and most patients received nonendoscopic treatment (56%, n = 28/50). Both age and tumor size were statistically significant in patients with gastric CFT than GIST (49.2 vs. 65.0 years and 2.4 vs. 6.0 cm; both p < 0.001). The ratio of children among patients with CFT (5%) and GIST (0.05%) was also significantly different (p = 0.037). The calcification rates of gastric CFT had significantly higher calcification rates than GIST on images of EUS and CT (85.7% vs. 3.6% and 77.8% vs. 3.6%; both p < 0.001). Conclusions: Compared with patients with GIST, patients with gastric CFT were younger, had smaller tumor size, and were symptomatic. Furthermore, gastric CFT was well-defined, heterogeneous in the third layer, and had high calcification rates on the images. Full article
(This article belongs to the Special Issue Meta-Research in the Medico-Scientific Field)
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17 pages, 3085 KiB  
Systematic Review
Hypnotics and Risk of Cancer: A Meta-Analysis of Observational Studies
by Tzu-Rong Peng, Li-Jou Yang, Ta-Wei Wu and You-Chen Chao
Medicina 2020, 56(10), 513; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina56100513 - 01 Oct 2020
Cited by 5 | Viewed by 5457
Abstract
Background and objectives: The association between hypnotic drugs and risk of cancer remains controversial. Therefore, we performed a meta-analysis to investigate this association. Materials and Methods: Pubmed and Embase were searched systematically to identify publications up to April 2020. The Newcastle-Ottawa [...] Read more.
Background and objectives: The association between hypnotic drugs and risk of cancer remains controversial. Therefore, we performed a meta-analysis to investigate this association. Materials and Methods: Pubmed and Embase were searched systematically to identify publications up to April 2020. The Newcastle-Ottawa scale for observational studies was used to assess the quality of studies. All included studies were evaluated by two reviewers independently; any discrepancies were resolved through discussion. Results: Twenty-eight studies including 22 case-control studies and 6 cohort studies with 340,614 hypnotics users and 1,828,057 non-users were included in the final analyses. Hypnotics (benzodiazepines and Z-drugs) use was significantly associated with an increased risk of cancer (odds ratio [OR] or relative risk [RR] 1.17; 95% confidence interval 1.09–1.26) in a random-effects meta-analysis of all studies. Subgroup meta-analysis by anxiolytics/sedatives effect (anxiolytics benzodiazepines vs. sedatives group (include sedatives benzodiazepines and Z-drugs)) revealed that a significant association in sedatives group (pooled OR/RR 1.26, 95% CI, 1.10–1.45), whereas no significant relationship was observed in anxiolytics benzodiazepines (pooled OR/RR 1.09, 95% CI, 0.95–1.26). Moreover, a significant dose–response relationship was observed between the use of hypnotics and the risk of cancer. Conclusions: This meta-analysis revealed association between use of hypnotics drugs and risk of cancer. However, the use of lower dose hypnotics and shorter duration exposed to hypnotics seemed to be not associated with an increased risk of cancer. Moreover, the use of anxiolytics effect benzodiazepines seemed to be lower risk than sedatives benzodiazepines. A high heterogeneity was observed among identified studies, and results were inconsistent in some subgroups. Randomized control trials are needed to confirm the findings in the future. Full article
(This article belongs to the Special Issue Meta-Research in the Medico-Scientific Field)
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14 pages, 468 KiB  
Systematic Review
Clinical Characteristics of Asymptomatic and Symptomatic Pediatric Coronavirus Disease 2019 (COVID-19): A Systematic Review
by Sojung Yoon, Han Li, Keum Hwa Lee, Sung Hwi Hong, Dohoon Kim, Hyunjoon Im, Woongchan Rah, Eunseol Kim, Seungyeon Cha, Jinho Yang, Andreas Kronbichler, Daniela Kresse, Ai Koyanagi, Louis Jacob, Ramy Abou Ghayda, Jae Il Shin and Lee Smith
Medicina 2020, 56(9), 474; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina56090474 - 15 Sep 2020
Cited by 17 | Viewed by 4785
Abstract
Background and objectives: Characterization of pediatric coronavirus disease 2019 (COVID-19) is necessary to control the pandemic, as asymptomatic or mildly infected children may act as carriers. To date, there are limited reports describing differences in clinical, laboratory, and radiological characteristics between asymptomatic and [...] Read more.
Background and objectives: Characterization of pediatric coronavirus disease 2019 (COVID-19) is necessary to control the pandemic, as asymptomatic or mildly infected children may act as carriers. To date, there are limited reports describing differences in clinical, laboratory, and radiological characteristics between asymptomatic and symptomatic infection, and between younger and older pediatric patients. The objective of this study is to compare characteristics among: (1) asymptomatic versus symptomatic and (2) less than 10 versus greater or equal to 10 years old pediatric COVID-19 patients. Materials and Methods: We searched for all terms related to pediatric COVID-19 in electronic databases (Embase, Medline, PubMed, and Web of Science) for articles from January 2020. This protocol followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Results: Eligible study designs included case reports and series, while we excluded comments/letters, reviews, and literature not written in English. Initially, 817 articles were identified. Forty-three articles encompassing 158 confirmed pediatric COVID-19 cases were included in the final analyses. Lymphocytosis and high CRP were associated with symptomatic infection. Abnormal chest CT more accurately detected asymptomatic COVID-19 in older patients than in younger ones, but clinical characteristics were similar between older and younger patients. Conclusions: Chest CT scan findings are untrustworthy in younger children with COVID-19 as compared with clinical findings, or significant differences in findings between asymptomatic to symptomatic children. Further studies evaluating pediatric COVID-19 could contribute to potential therapeutic interventions and preventive strategies to limit spreading. Full article
(This article belongs to the Special Issue Meta-Research in the Medico-Scientific Field)
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