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Dexmedetomidine has been demonstrated to be effective in the management of pain in total knee replacement (TKA). Nevertheless, a combination of a local anaesthetic and a dose of dexmedetomidine might be a better choice for post‐operative pain management of TKA. The aim of this research is to determine if the combination of a local anaesthetic with dexmedetomidine during a knee replacement operation can decrease the post‐operation pain. Furthermore, the effectiveness and security of dexmedetomidine combined with topical anaesthetic were evaluated for the management of post‐operative TKA. Based on the research results, the author made a research on the basis of four big databases. The Cochrane Handbook on Intervention Systems Evaluation has also evaluated the quality of the literature. Seven randomized controlled trials have been established from this. It was found that the combination of local anaesthesia and dexmedetomidine had a greater effect on postoperative pain in 4 h (mean difference [MD], −0.9; 95% CI, −1.71, −0.09; p = 0.03), 8 h (MD, −0.52; 95% CI, −0.66, −0.38; p < 0.0001), 12 h (MD, −0.72; 95% CI, −1.04, −0.40; p < 0.0001), 24 h (MD, −0.49; 95% CI, −0.83, −0.14; p = 0.006), 48 h (MD, −0.51; 95% CI, −0.92, −0.11; p = 0.01). Nevertheless, because of the limited number of randomized controlled trials covered by this meta‐analysis, caution should be exercised with regard to data treatment. More high quality research will be required to confirm the results. [ABSTRACT FROM AUTHOR]

The effects of screen time on depression have always been a bone of contention. This meta-analysis aimed to determine whether increased screen time is associated with an increased risk of depression in adolescents. Prospective cohort studies were identified from searches of five databases from inception to May 2024: PubMed, Web of Science, Embase, PsycINFO, and Scopus. We included nine prospective cohort studies on screen time and the risk of depression in adolescents. A random-effects meta-analysis was adopted to calculate the odds ratio (OR, 95 % confidence interval; CI). Overall, baseline screen time had a significant effect on the incidence of depression at follow-up (OR = 1.20, 95 % CI: 1.12–1.28, I2 = 81.0 %). Compared with >3 h/ day of screen time in the exposure group, >2 h/ day of screen time in the exposure group had a more significant effect on the incidence of depression at follow-up. We recommend that screen time for adolescents should meet the recommendation of the American Academy of Pediatrics. According to the deficiencies in the current research, future research should conduct high-quality longitudinal in-depth research on the relationship between different screen types, screen content, screen forms, and the risk of depression in adolescents, to better guide the rational use of electronic screens. [ABSTRACT FROM AUTHOR]

Background: Hemostatic agents (HAs) are used to achieve hemostasis and prevent postoperative complications in multiple surgeries, but the role of HAs is ambiguous during partial nephrectomy (PN), so this study aimed to assess the role of HAs in PN. Methods: PubMed, Embase, CENTRAL and ClinicalTrials.gov were searched for randomized controlled trials and cohort studies regarding the comparison of HA use alone and standard suturing during PN on January 17, 2020. RevMan 5.3 was used to conduct meta-analysis. Sensitivity analyses and subgroup analyses were performed based on surgical procedures and HA types. Results: Six studies involving 1,066 patients were included. The quality of studies was moderate to high. There were significant reductions in warm ischemia time (mean difference [MD] = −6.30 min, 95% confidence interval [CI] −7.70 to −4.90, p < 0.00001), operative time (MD = −19.81 min, 95% CI −27.54 to −12.08, p < 0.00001), and estimated blood loss (MD = −108.62 mL, 95% CI −177.27 to −39.9, p = 0.002) in the HA group, and HA use alone did not increase postoperative complications. The results were similar in the subgroup analyses and sensitivity analyses. Conclusion: HA may be an effective and safe surgical material in PN, which can improve postoperative outcomes. High-quality and randomly designed studies are needed to validate the applicability. [ABSTRACT FROM AUTHOR]

Distributed data networks representing large diverse populations are an expanding focus of drug safety research. However, interpreting results is difficult when treatment effect estimates vary across datasets (i.e., heterogeneity). In a previous study, risk estimates were generated for selected drugs and potential adverse outcomes. Analyses were replicated across eight distributed data sources using an identical analytic structure. To evaluate heterogeneity of risk estimates across data sources, the estimates were combined with summary-level data characterizing the population of each data source. Meta-analysis, meta-regression, and plots of the influence on overall results versus contribution to heterogeneity were examined and used to illustrate an approach to heterogeneity assessment. Heterogeneity, as measured by the I-squared statistic, was high with variability across outcomes. Plots of the relationship between influence on overall results and contribution to heterogeneity suggest that certain datasets and characteristics were influential but there was variability dependent on the drug and outcome being assessed. Exploratory meta-regression identified many possible influential factors, but may be subject to ecological bias and false positive conclusions. Distributed data network drug safety analyses can produce heterogeneous risk estimates that may not be easily explained. Approaches illustrated here can be useful for research that is subject to similar problems with heterogeneity. Copyright © 2014 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Background: Type 2 diabetes mellitus (T2DM) is a heterogeneous disease characterized by persistent hyperglycemia. Huang-Lian Jie-Du decoction (HLJDD) is a traditional Chinese medicine formula which is widely used in treating T2DM in China. A thorough understanding of current body of evidence is needed. Objective: this study aims to summarize the clinical evidence of HLJDD for T2DM to provide an up-to-date and accurate understanding of this issue for research and clinical practice. Methods: Six databases were searched from inception to June 27, 2020 without language and publication status restrictions and randomized controlled trials about HLJDD on T2DM were included. Two evaluators searched and screened citations independently. Risk of bias was assessed by 2019 version 2 of the Cochrane risk-of-bias tool for randomized trials (RoB2). Risk ratio (RR) with 95% confidence interval (CI) was used as an effect measure for dichotomous outcomes and mean difference (MD) with 95% CI was used for continuous outcomes. Subgroup analyses and sensitivity analyses were carried out. Results: Nine studies including 811 participants were included in this study. The overall risk of bias was high risk. Compared with metformin alone, combination treatment of HLJDD and metformin may result in a reduction in HbA1c, FBG, 2hPG, HOMA-IR and an improved lipid metabolism. Evidence comparing HLJDD and metformin or no intervention or placebo was insufficient. The quality of evidence was low. Conclusions: Current evidence about HLJDD on T2DM is still uncertain and more high-quality studies are needed to firmly establish the clinical efficacy and safety of HLJJD. [ABSTRACT FROM AUTHOR]

Spicy food is popular with people around the world and reports on the association between spicy food intake and esophageal cancer (EC) risk have been controversial. Therefore, we conducted a meta-analysis of 25 studies to provide the latest evidence for this uncertainty. We hypothesized that high spicy food intake is associated with an increased risk of EC. A database was searched to identify case-control or cohort studies of spicy food intake associated with EC through March 2022. Combined odds ratios (ORs) and their 95% CIs were used to estimate the effect of spicy food intake on EC. Subgroup analyses and sensitivity analyses were also performed. All data were analyzed using STATA 15.1 software. Twenty-five studies from 22 articles met the inclusion criteria for the meta-analysis (7810 patients with EC and 515,397 controls). Despite significant heterogeneity (P <.001), the comparison of highest versus lowest spicy food intake in each study showed a significant OR of 1.70 (95% CI, 1.30-2.22). In subgroup analyses, this positive association was found among the Chinese population, different sample sizes of EC, different sources of the control group, and different quality of articles. However, for India, as well as for other countries, esophageal squamous cell carcinoma and esophageal adenocarcinoma showed no statistically significant association. This meta-analysis suggests that high levels of spicy food intake may be associated with an increased risk of EC, although 1 prospective study found an inverse association. Additional studies are necessary to confirm the relationship between spicy food and EC risk. High spicy food intake is associated with a higher risk of esophageal cancer (EC). A statistically significant positive association was found between spicy food intake and the risk of EC. Dose-response analysis showed that every 1 time/week increase in spicy food intake was associated with a significant 9% increase in EC risk. [Display omitted] [ABSTRACT FROM AUTHOR]