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This meta-analysis systematically evaluates the impact of rapid rehabilitation nursing interventions on wound infections and postoperative complications in patients undergoing thoracoscopic lung cancer surgery. A comprehensive literature search was conducted, from database inception to November 2023, using databases including PubMed, Embase, Google Scholar, Cochrane Library, China National Knowledge Infrastructure, and Wanfang databases to identify randomized controlled trials (RCTs) that focused on the application of rapid rehabilitation nursing in the perioperative period of thoracoscopic lung cancer surgery. Two researchers independently screened the literature, extracted data, and assessed the quality based on inclusion and exclusion criteria. Data analysis was performed using Stata 17.0 software. A total of 22 RCTs involving 2319 patients were included in the analysis. The results indicated that the application of rapid rehabilitation nursing in thoracoscopic lung cancer surgery significantly reduced the incidence of wound infections (OR = 0.32, 95% CI: 0.20–0.54, p < 0.001) and postoperative complications (OR = 0.24, 95% CI: 0.18–0.31, p < 0.001). This study demonstrates that implementing rapid rehabilitation nursing interventions during the perioperative period for patients undergoing thoracoscopic lung cancer surgery can significantly decrease the occurrence of wound infections and complications, thereby facilitating rapid patient recovery.
More and more meta-analyses have been conducted to compare the effects of intramedullary fixation (IF) and plate fixation (PF) on the outcome of midshaft clavicle fractures. It can affect the doctors' treatment decisions. A number of studies have been conducted in order to assist surgeons in selecting optimal operative procedures and to recommend operative treatment of clavicle fractures in accordance with the best available research. Our analysis of the IF and PF of clavicle fractures was done through a search for PubMed, Emabase, Web of Science, and Cochrane Library. Two different researchers analysed the research literature for quality of analysis and data extraction. The analysis of the data was done with RevMan 5.3. The 95% CI and OR models have been computed by means of either fixed-dose or randomize. In addition, RCT in 114 references have been reviewed and added for further analysis. It is concluded that the application of plate and intramedullary fixation in the middle clavicle operation has remarkable influence on the outcome of post-operation. There was a lower risk of postoperative wound infection in IF (OR, 5.92; 95% CI, 2.46, 14.27 p < 0.0001), smaller surgical incisions (MD, 6.57; 95% CI, 4.90, 8.25 p < 0.0001), and shorter operative time (MD, 17.09; 95% CI 10.42, 23.77 p < 0.0001), less blood loss (MD, 63.62; 95% CI, 55.84, 71.39 p < 0.0001) and shorter hospital stay (MD, 1.05; 95% CI, 0.84, 1.25 p < 0.0001). However, there is no statistical significance in the incidence of wound dehiscence. Thus, the effect of IF on the incidence of injury is better than that of the inner plate in the middle of the clavicle.
by Zixin Cai, Bilian Liu
ObjectiveIn December 2019, a novel pneumonia associated with the 2019 coronavirus emerged unexpectedly. However, limited data exist on the effects of COVID-19 on ACTH and cortisol levels. To address this gap in knowledge, we conducted a meta-analysis of published studies on the relationship between COVID-19 patients and their ACTH and cortisol levels.
MethodsWe conducted a thorough search of the PubMed, Embase, Cochrane Library, and Web of Science databases up until May 2023. We assessed the relevance of each study we found, specifically looking for studies that reported on ACTH and cortisol levels in COVID-19 patients. We calculated weighted mean differences (WMD) and 95% confidence intervals (CI) to investigate the relationship between ACTH and cortisol levels in COVID-19 patients. We evaluated the quality of each study using the Newcastle Ottawa scale (NOS), and we assessed publication bias using Begg’s rank correlation test, Egger’s test, and funnel plot. We conducted our meta-analysis using the Stata 12.0 (Stata Corporation, TX).
ResultsOur search yielded nine studies that met our inclusion criteria, which included a total of 440 COVID-19 patients and 474 controls, with data up to May 2023. Seven of these studies reported on ACTH levels, and six studies reported on cortisol levels. Our findings revealed that COVID-19 patients had significantly higher levels of cortisol compared to controls (WMD 3.46 (95% CI 2.29 to 4.62)). However, there was no significant difference in ACTH levels between COVID-19 patients and controls (WMD 1.58 (95% CI -5.79 to 8.94)).
ConclusionsThis meta-analysis indicates a potential relationship between elevated cortisol levels and COVID-19 infection. However, more well-designed, adequately powered, randomized controlled trial will be needed to assess the use of cortisol in patients with COVID-19 infection.
Currently, there are two methods of treating subtrochanteric femur fractures: intramedullary nailing and extramedullary plate fixation. However, it remains to be seen whether internal or external fixation is the primary treatment for subrotator femur fractures in adults. In this meta-analysis, we reviewed the effects of internal and external fixation on the treatment of subrotator and subrotator fractures. Until July 2023, the researchers have been researching the Cochrane Library, Embase, Web of Science and PubMed, with English as their only language. The aims of the study are as follows: (1) to assess the efficacy of internal and external fixation for the treatment of postoperative wound infections in adult patients with subrotator femur fractures; (2) to assess the efficacy of various types of internal fixation for the treatment of adult patients with subrotator femur fractures, including postoperative complications, infections, and operative time. Meta-analysis showed that there was no significant difference in the treatment of subrotator fracture with internal versus external fixation in terms of wound infections, intra-operative bleeding, length of incision, and operative time were not significantly different. Therefore, more research is needed to support these findings with a number of large, high-quality randomized studies.
The objective of this research is to evaluate the risk of postoperative infection and other risks associated with robotic radical hysterectomy (RRH) compared with laparoscopic radical hysterectomy (LRH). Recent studies on RRH versus LRH have not been conclusive for cervical carcinoma. Our group attempted to use meta-analyses to evaluate the effects of both RRH and LRH on postoperative outcomes in order to make sure that the best operative method was used to prevent wound infections. We looked up Cochrane Library and published databases for this research and found 594 findings. Articles were screened by title and abstract and then carefully examined for inclusion and exclusion criteria. Data extraction was performed independently by two researchers. Comparison studies were used to describe the incidence of wound complications after surgery. The publication bias was assessed using Egger regression correlation analysis. There were six trials eligible for inclusion, of which 491 RRH and 807 LRH. Depending on surgery for cervical carcinoma, it is true that there is a difference in the way that surgery affects the postoperative complications. Our analysis demonstrated that the use of robotic operation can decrease the amount of blood loss during operation as compared with routine laparoscopy (MD, −77.69; 95% CI, −132.08, −23.30; p = 0.005). However, there were no statistical differences in the incidence of postoperative wound infections (OR, 0.54; 95% CI, 0.25, 1.19; p = 0.13) and intraoperative operative time (MD, 13.01; 95% CI, −41.38, 67.41; p = 0.64) among the two procedures. There was no statistically significant difference between these two groups of patients with severe postoperative complications. Unlike other research, the findings of this meta-analysis are not consistent with the findings of the present study, which suggest that robotic operations cannot lower the rate of postoperative wound infections. However, because of the limitations and the retrospective character of the trials covered, these findings should be interpreted with care and more extensive research is required.
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