Clinical interventions in aging
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Review Meta Analysis
Comprehensive geriatric assessment prediction of postoperative complications in gastrointestinal cancer patients: a meta-analysis.
Gastrointestinal cancer is an age-associated disease, and geriatric patients are mostly likely to suffer from postoperative complications. Some studies indicated that comprehensive geriatric assessment (CGA) could predict postoperative complications in gastrointestinal cancer patients. However, the evidence is mixed. ⋯ Comorbidity (CCI ≥3), polypharmacy (≥5 drugs/day) and ADL dependency were predictive factors for postoperative complications in gastrointestinal cancer patients; the results of other geriatric instruments were not conclusive, pointing to insufficient studies and requirement of more original investigations.
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Meta Analysis
Association between apolipoprotein E gene polymorphism and mild cognitive impairment: a meta-analysis.
A number of published case-control studies reported that the apolipoprotein E (ApoE) gene polymorphism was associated with the mild cognitive impairment (MCI). However, previous reports still remain conflicting. To estimate the association between ApoE polymorphism and MCI susceptibility, we searched the electronic databases including PubMed, Wanfang, CNKI (China National Knowledge Infrastructure), VIP, and EMBASE to retrieve all available studies. ⋯ In the stratified analysis based on ethnicity, similar results were also observed in Chinese population (significant risk: ε4 vs ε3: OR =2.52, 95% CI: 2.19-2.90; ε4/ε4 vs ε3/ε3: OR =5.45, 95% CI: 3.41-8.70; ε2/ε4 vs ε3/ε3: OR =2.59, 95% CI: 1.74-3.86; ε3/ε4 vs ε3/ε3: OR =2.34, 95% CI: 1.97-2.79; slight protection: ε2/ε3 vs ε3/ε3: OR =0.79, 95% CI: 0.64-0.98; no association: ε2 vs ε3: OR =0.92, 95% CI: 0.78-1.09; and ε2/ε2 vs ε3/ε3: OR =1.04, 95% CI: 0.55-1.99). In summary, this meta-analysis of 5,709 subjects suggested that ApoE ε4 allele was associated with an increased risk of MCI. In addition, ApoE ε2/ε3 genotype provided a slight protection for MCI.
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Deep brain stimulation (DBS) is the surgical procedure for patients with advanced Parkinson's disease. Globus pallidus internus (GPi) and subthalamic nucleus (STN) are the most targeted locations for the procedure. To investigate the variable efficiencies for the two different locations, we conducted a meta-analysis to compare both stimulation sites. ⋯ GPi and STN DBS significantly improve advanced Parkinson's patients' symptoms, functionality, and QOL. Variable therapeutic efficiencies were observed in both procedures, GPi and STN DBS. GPi DBS allowed greater recovery of verbal fluency and provided greater relief of depression symptoms. Better QOL was also obtained using GPi DBS. Meanwhile, GPi DBS was also associated with increased dosage of levodopa equivalent doses. The question regarding which target is superior remained open for discussion. An understanding of the target selection still depends on individual symptoms, neurocognitive/mood status, therapeutic goals of DBS (eg, levodopa reduction), and surgical expertise.
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Review Meta Analysis
The role of perioperative oral nutritional supplementation in elderly patients after hip surgery.
The effect of perioperative oral nutritional supplementation (ONS) on elderly patients after hip surgery remains controversial. This study intended to ascertain whether perioperative ONS is beneficial for the rehabilitation of elderly patients after hip surgery. ⋯ Based on the evidence available, this meta-analysis is consistent with the hypothesis that perioperative ONS can help elderly patients recover after hip surgery and reduce complications.