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Wang J, Xia Q, Zhu F, Huang W, Meng Y, Wang Y, Liu Y, Liu X, Li H, Sun B. Effects of Acupuncture on Adverse Events in Colonoscopy: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Pain Ther 2022; 11:1095-1112. [PMID: 35922617 PMCID: PMC9633895 DOI: 10.1007/s40122-022-00415-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 07/07/2022] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Acupuncture has gradually penetrated into many disciplines in clinical medicine, such as surgery, anesthesia, and outpatient examinations. Although a number of clinical trials have investigated the effects of acupuncture on colonoscopy, the results were inconsistent. In this meta-analysis, we analyzed the effects of acupuncture on colonoscopy to provide evidence for subsequent research and clinical application of acupuncture in colonoscopy. METHODS This meta-analysis was performed using Review Manager version 5.4 and Stata version 16 software. The primary outcome was the incidence of adverse events, and the secondary outcomes included patients' anxiety score before colonoscopy, time to insert the colonoscope, total detection time, propofol consumption, patients' pain score, and patient satisfaction rate. RESULTS The results showed that the incidence of adverse events (odds ratio [OR] 0.27, 95% confidence interval [CI] 0.16-0.43, P = 0.00, I2 = 25%), patients' pain score (mean difference [MD] - 1.03, 95% CI - 1.45 to - 0.62, P = 0.00, I2 = 94%), and time to insert the colonoscope (MD = - 2.54, 95% CI - 4.96 to - 0.13, P = 0.04, I2 = 0%) were significantly lower in the treatment group than in the control group. Compared with the control group, the satisfaction rate of patients (OR 2.53, 95% CI 1.56-4.10, P = 0.00, I2 = 47%) in the treatment group was significantly improved. There was no significant between-group difference in patients' anxiety score, the total detection time, and propofol dosage. CONCLUSIONS During colonoscopy, acupuncture can significantly reduce the incidence of adverse events, relieve patients' pain, and improve patient satisfaction. REGISTRATION PROSPERO registration number CRD42022324428.
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Affiliation(s)
- Jing Wang
- Department of Neurobiology, School of Basic Medical Sciences, Harbin Medical University, 157 Health Road, Nangang District, Harbin, Heilongjiang, 150081, People's Republic of China
| | - Qing Xia
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Harbin Medical University, Harbin, Heilongjiang, People's Republic of China
| | - Fangyi Zhu
- Department of Neurobiology, School of Basic Medical Sciences, Harbin Medical University, 157 Health Road, Nangang District, Harbin, Heilongjiang, 150081, People's Republic of China
| | - Wei Huang
- Department of Neurobiology, School of Basic Medical Sciences, Harbin Medical University, 157 Health Road, Nangang District, Harbin, Heilongjiang, 150081, People's Republic of China
| | - Yanting Meng
- Department of Neurobiology, School of Basic Medical Sciences, Harbin Medical University, 157 Health Road, Nangang District, Harbin, Heilongjiang, 150081, People's Republic of China
| | - Yanping Wang
- Department of Neurobiology, School of Basic Medical Sciences, Harbin Medical University, 157 Health Road, Nangang District, Harbin, Heilongjiang, 150081, People's Republic of China
| | - Yumei Liu
- Department of Neurobiology, School of Basic Medical Sciences, Harbin Medical University, 157 Health Road, Nangang District, Harbin, Heilongjiang, 150081, People's Republic of China
| | - Xijun Liu
- Department of Neurobiology, School of Basic Medical Sciences, Harbin Medical University, 157 Health Road, Nangang District, Harbin, Heilongjiang, 150081, People's Republic of China
| | - Hulun Li
- Department of Neurobiology, School of Basic Medical Sciences, Harbin Medical University, 157 Health Road, Nangang District, Harbin, Heilongjiang, 150081, People's Republic of China. .,The Key Laboratory of Myocardial Ischemia, Harbin Medical University, Ministry of Education, Harbin, Heilongjiang, People's Republic of China.
| | - Bo Sun
- Department of Neurobiology, School of Basic Medical Sciences, Harbin Medical University, 157 Health Road, Nangang District, Harbin, Heilongjiang, 150081, People's Republic of China.
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Alyabsi M, Meza J, Islam KMM, Soliman A, Watanabe-Galloway S. Colorectal Cancer Screening Uptake: Differences Between Rural and Urban Privately-Insured Population. Front Public Health 2020; 8:532950. [PMID: 33330301 PMCID: PMC7710856 DOI: 10.3389/fpubh.2020.532950] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 10/26/2020] [Indexed: 12/18/2022] Open
Abstract
Earlier studies investigated rural-urban colorectal cancer (CRC) screening disparities among older adults or used surveys. The objective was to compare screening uptake between rural and urban individuals 50–64 years of age using private health insurance. Data were analyzed from 58,774 Blue Cross Blue Shield of Nebraska beneficiaries. Logistic regression was used to assess the association between rural-urban and CRC screening use. Results indicate that rural individuals were 56% more likely to use the Fecal Occult Blood Test (FOBT) compared with urban residents, but rural females were 68% less likely to use FOBT. Individuals with few Primary Care Physician (PCP) visits and rural-women are the least to receive screening. To enhance CRC screening, a policy should be devised for the training and placement of female PCP in rural areas. In particular, multilevel interventions, including education, more resources, and policies to increase uptake of colorectal cancer screening, are needed. Further research is warranted to investigate barriers to CRC screening in rural areas.
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Affiliation(s)
- Mesnad Alyabsi
- Population Health Research Section, King Abdullah International Medical Research Center (KAIMRC), Riyadh, Saudi Arabia.,King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Jane Meza
- Department of Biostatistics, Nebraska Medical Center, College of Public Health, University of Nebraska Medical Center, Omaha, NE, United States
| | - K M Monirul Islam
- Department of Epidemiology, Nebraska Medical Center, College of Public Health, University of Nebraska Medical Center, Omaha, NE, United States
| | - Amr Soliman
- Community Health and Social Medicine, City University of New York School of Medicine, New York, NY, United States
| | - Shinobu Watanabe-Galloway
- Department of Epidemiology, Nebraska Medical Center, College of Public Health, University of Nebraska Medical Center, Omaha, NE, United States
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LC-MS-based lipid profile in colorectal cancer patients: TAGs are the main disturbed lipid markers of colorectal cancer progression. Anal Bioanal Chem 2019; 411:5079-5088. [DOI: 10.1007/s00216-019-01872-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 04/10/2019] [Accepted: 04/16/2019] [Indexed: 12/12/2022]
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Alyabsi M, Charlton M, Meza J, Islam KMM, Soliman A, Watanabe-Galloway S. The impact of travel time on colorectal cancer stage at diagnosis in a privately insured population. BMC Health Serv Res 2019; 19:172. [PMID: 30885199 PMCID: PMC6423832 DOI: 10.1186/s12913-019-4004-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Accepted: 03/12/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Rural residents are less likely to receive screening for colorectal cancer (CRC) than urban residents. However, the mechanisms underlying this disparity, especially among people aged 50-64 years old with private health insurance, are not well understood. We examined the impact of travel time on stage at CRC diagnosis. METHODS This retrospective cohort study used data from the Blue Cross and Blue Shield of Nebraska. Members of this private insurance company aged 50-64 years, diagnosed with CRC during the period 2012-2016, and continuously enrolled in the insurance plan for at least 6 months prior to CRC diagnosis, were selected for this study. Using Google Maps, we estimated patients' travel time from their home ZIP code to the ZIP code of their colonoscopy provider. Using logistic regression, we analyzed the association between stage at CRC diagnosis, travel time, use of preventive services (i.e., check-ups or counseling to prevent or detect illness at an early stage) and patient characteristics. RESULTS A total of 307 subjects met the inclusion criteria. People who had not used preventive services 6 months prior to CRC diagnosis had 2.80 (95% CI, 1.00-7.90) times the odds of metastatic CRC compared to those who had used these services. No statistically significant association was found between travel time and metastatic CRC diagnosis (P = 0.99; 95% CI, 0.98-1.01). CONCLUSIONS The fact that 13% of the study population presented with metastatic CRC suggests some noncompliance with preventive services such as screening guidelines. To increase screening uptake and reduce metastatic cases, employers should offer incentives for their employees to make use of preventive services such as CRC screening.
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Affiliation(s)
- Mesnad Alyabsi
- Department of Population Health Research, King Abdullah International Medical Research Center (KAIMRC), King Saud bin Abdulaziz University for Health Sciences, P.O. Box 3660, Riyadh, 11481, 1515 Saudi Arabia
| | - Mary Charlton
- Department of Epidemiology, University of Iowa College of Public Health, 145 N. Riverside Drive, Iowa City, Iowa, 52242 USA
| | - Jane Meza
- Department of Biostatistics, University of Nebraska Medical Center, College of Public Health, 984375 Nebraska Medical Center, Omaha, NE 68198–4395 USA
| | - K. M. Monirul Islam
- Department of Epidemiology, University of Nebraska Medical Center, College of Public Health, 984395 Nebraska Medical Center, Omaha, NE 68198–4395 USA
| | - Amr Soliman
- City University of New York School of Medicine, Community Health and Social Medicine, 160 Convent Avenue, New York, NY 10031 USA
| | - Shinobu Watanabe-Galloway
- Department of Epidemiology, University of Nebraska Medical Center, College of Public Health, 984395 Nebraska Medical Center, Omaha, NE 68198–4395 USA
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Systematic evaluation of supervised classifiers for fecal microbiota-based prediction of colorectal cancer. Oncotarget 2018; 8:9546-9556. [PMID: 28061434 PMCID: PMC5354752 DOI: 10.18632/oncotarget.14488] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Accepted: 12/15/2016] [Indexed: 12/13/2022] Open
Abstract
Predicting colorectal cancer (CRC) based on fecal microbiota presents a promising method for non-invasive screening of CRC, but the optimization of classification models remains an unaddressed question. The purpose of this study was to systematically evaluate the effectiveness of different supervised machine-learning models in predicting CRC in two independent eastern and western populations. The structures of intestinal microflora in feces in Chinese population (N = 141) were determined by 454 FLX pyrosequencing, and different supervised classifiers were employed to predict CRC based on fecal microbiota operational taxonomic unit (OTUs). As a result, Bayes Net and Random Forest displayed higher accuracies than other algorithms in both populations, although Bayes Net was found with a lower false negative rate than that of Random Forest. Gut microbiota-based prediction was more accurate than the standard fecal occult blood test (FOBT), and the combination of both approaches further improved the prediction accuracy. Moreover, when unclassified OTUs were used as input, the BayesDMNB text algorithm achieved higher accuracy in the Chinese population (AUC=0.994). Taken together, our results suggest that Bayes Net classification model combined with unclassified OTUs may present an accurate method for predicting CRC based on the compositions of gut microbiota.
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Zhang J, Cheng Z, Ma Y, He C, Lu Y, Zhao Y, Chang X, Zhang Y, Bai Y, Cheng N. Effectiveness of Screening Modalities in Colorectal Cancer: A Network Meta-Analysis. Clin Colorectal Cancer 2017; 16:252-263. [PMID: 28687458 DOI: 10.1016/j.clcc.2017.03.018] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Accepted: 03/16/2017] [Indexed: 12/15/2022]
Abstract
The aim of the study was to evaluate on the effectiveness of screening modalities in the prevention of colorectal cancer (CRC) occurrence and deaths. General meta-analysis was performed to produce pooled estimates of the effect of CRC incidence and mortality using a search of PubMed, Web of Science, and the Cochrane Library for eligible studies from January 1992 to March 2016. A network meta-analysis was performed to synthetically compare the effectiveness of 5 frequently used screening modalities. A total of 44 studies with a focus on mortality from CRC using different screening methods were included. General meta-analysis showed that fecal immunohistochemical testing (FIT), flexible sigmoidoscopy (FS), colonoscopy, combination of fecal occult blood testing and FS screening respectively reduced CRC mortality by 59% (relative risk [RR], 0.41; 95% confidence interval [CI], 0.29-0.59), 33% (RR, 0.67; 95% CI, 0.58-0.78), 61% (RR, 0.39; 95% CI, 0.31-0.50), 38% (RR, 0.62; 95% CI, 0.42-0.91) compared with no screening, whereas guaiac fecal occult blood testing (gFOBT) reduced CRC-related mortality by 14% (RR, 0.86; 95% CI, 0.82-0.90). Subgroup analysis showed that summary estimates of reduction in distal CRC mortality and proximal CRC mortality were 26% (95% CI, 62%-89%) and 10% (95% CI, 83%-98%). A network meta-analysis revealed rank probability analysis in which the colonoscopy had a 94.6% probability of being the most effective examination to reduce CRC mortality. In addition, the network meta-analysis estimated odds ratio, which was a 79% reduction (95% CI, 0.09-0.60) in CRC mortality when screening with FIT was compared with annual or biennial gFOBT and colonoscopy was approximately 80% more effective than gFOBT for reducing CRC mortality (RR, 0.25; 95% CI, 0.13-0.54). Analysis of the effects of different screening methods showed that there was a significant reduction in the incidence of colon cancer, excluding gFOBT. This meta-analysis confirmed that gFOBT, FIT, FS, and colonoscopy were all effective in preventing CRC deaths and a major reduction in distal but not proximal CRC mortality was found. In addition, they were more effective in preventing CRC incidence in addition to gFOBT. The network meta-analysis suggests that colonoscopy is the most effective screening for preventing CRC deaths.
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Affiliation(s)
- Jianping Zhang
- Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu, PR China
| | - Zhiyuan Cheng
- Center of Evidence-Based Medicine of Lanzhou University, Basic Medical College, Lanzhou University, Lanzhou, Gansu, PR China; Medical School, Yale University, New Haven, CT
| | - Yubao Ma
- Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu, PR China
| | - Caili He
- Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu, PR China
| | - Yongbin Lu
- Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu, PR China
| | - Yaxue Zhao
- Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu, PR China
| | - Xiaoyu Chang
- Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu, PR China
| | - Yawei Zhang
- Medical School, Yale University, New Haven, CT
| | - Yana Bai
- Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu, PR China
| | - Ning Cheng
- Basic Medical College, Lanzhou University, Lanzhou, Gansu, PR China.
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Picarelli A, Di Tola M, Borghini R, Isonne C, Saponara A, Marino M, Casale R, Tiberti A, Pica R, Donato G, Frieri G, Corazziari E. Colonic Involvement in Celiac Disease and Possible Implications of the Sigmoid Mucosa Organ Culture in its Diagnosis. J Clin Immunol 2013; 33:1250-6. [DOI: 10.1007/s10875-013-9920-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2013] [Accepted: 06/24/2013] [Indexed: 12/12/2022]
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Nelson DA, Landau WM. Intrathecal steroid therapy for postherpetic neuralgia: a review. Expert Rev Neurother 2010; 2:631-7. [PMID: 19810978 DOI: 10.1586/14737175.2.5.631] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Two recent publications advocated intrathecal injection of methylprednisolone acetate for postherpetic neuralgia. Conceptually, these therapeutic trials were based on the failed assumption that chronic inflammation persists in dorsal root ganglia even after the lesions of acute zoster have healed. Constructionally, these publications can be criticized on numerous grounds: cranial zoster was excluded, follow up periods were too short, dangers or reactivating the varicella virus were ignored, no methylprednisolone acetate-only group was included, pharmacological dangers of intrathecal lidocaine were overlooked. In addition to these basic conceptual deficiencies, multiple dangers of intrathecal methylprednisolone (therapeutically and by accidental injection) are manifest in a literature dating back over two decades in which several hundred serious complications are described. In summary, all rational evidence indicates that this treatment should not be prescribed.
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Affiliation(s)
- Dewey A Nelson
- Department of Neurology, Thomas Jefferson University Medical College, Philadelpia, Pennsylvania, USA
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Borràs JM, Espinàs JA. [Colorectal cancer screening: between doubts and evidence]. GACETA SANITARIA 2002; 16:285-7. [PMID: 12106546 DOI: 10.1016/s0213-9111(02)71925-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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