Triptorelin (TRI), a gonadotropin-releasing hormone agonist allowing ovulation synchronization in pigs, is indispensable for fixed-time artificial insemination (FTAI) protocols. However, the effect of FTAI using TRI (FTAI-TRI) on the reproductive performance is controversial. We performed a meta-analysis to determine whether FTAI-TRI affects reproductive performance of pigs, including pregnancy rate (PR), number of pigs born alive per litter (NBA), farrowing rate (FR) and total number of pigs born per litter (TNB). A total of 37 trials from 15 studies were extracted and analysed in Stata. A weighted mean difference (WMD) with 95% confidence interval (CI) was calculated for NBA and TNB, and risk ratio (RR) with 95% CI was calculated for PR and FR. Pregnancy rate, TNB and NBA data were applied to a fixed-effect protocol, and FR data were applied to a random-effect protocol. We found that for weaned sows, the FTAI-TRI group had comparable reproductive performance to the artificial insemination (AI) following oestrus detection (EDAI) group. Fixed-time AI has many advantages, including the elimination of the need to heat-check twice daily, so that FTAI-TRI is a good substitute for EDAI. Subgroup analysis indicated that the optimal timing of triptorelin treatment was 96 h after weaning, which gave significant positive effects on PR (RR = 1.08, P = 0.000) and non-significant positive effects on TNB (WMD = 0.12, P = 0.452). Triptorelin at a dose of 100 μg showed better effects than 200 μg, with significant positive effects on PR (RR = 1.09, P = 0.005) and FR (RR = 1.06, P = 0.036). So a single dose of 100 μg was recommended. The optimal protocol was insemination at 24 h and again at 48 h after triptorelin administration if they remained in standing oestrus, and this provided a significantly higher NBA (WMD = 0.59, P = 0.013) that increased by 0.59. For gilts, the FTAI-TRI group showed decreased (not significant) PR (RR = 0.96, P = 0.127) and significantly decreased FR (RR = 0.93, P = 0.013), TNB (WMD = −0.85, P = 0.006) and NBA (WMD = −0.98, P = 0.000), which were inferior to those in the EDAI group. In conclusion, the effects of FTAI-TRI on the reproductive performance of pigs were parity-, treatment timing-, insemination timing-, and dosage-dependent. Fixed-time AI using triptorelin could effectively replace the EDAI protocol for sows, but not for gilts.
Background The association between frailty and older patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI) is unclear. Therefore, we conducted a systematic review and meta‐analysis to investigate the prevalence of frailty in older patients with AMI following PCI, and determine the relationship between frailty and adverse outcomes in these patients. Hypothesis Older patients with AMI have a higher prevalence of frailty after PCI, and the frailty in these patients increases the risk of adverse outcomes. Methods A comprehensive search of the PubMed, Cochrane, Ovid (Medline), Ovid (Embase), and Web of Science databases was performed for articles published until October 2021. A meta‐analysis was performed using stata12.0 software. A random‐effects model was used when I 2 was greater than 50%; otherwise, a fixed‐effects model was used. Results There were a total of 274,976 older patients in the included studies. Nine studies investigated the prevalence of frailty in older patients with AMI after PCI, with an overall prevalence of 39% (95% confidence interval [CI]: 18%–60%, p < .001). Six studies included adverse outcomes of frailty in older patients with AMI after PCI, including all‐cause mortality (hazard ratio [HR] = 2.29, 95% CI: 1.65–3.16, p = .285), rehospitalization (HR = 2.53, 95% CI: 1.38–4.63), and in‐hospital major bleeding (HR = 1.93, 95% CI: 1.29–2.90, p = .825). Conclusion The frailty prevalence is increased in older patients with AMI after PCI, especially in ST‐segment elevation myocardial infarction (STEMI). AMI with frailty after PCI is more likely to be associated with worse clinical outcomes, such as death, bleeding, and rehospitalization.
Objective To investigate the prevalence of frailty in patients with acute myocardial infarction after percutaneous coronary intervention and the relationship between frailty and adverse outcomes in patients with acute myocardial infarction after percutaneous coronary intervention. Methods We searched relevant studies published from database establishment to October 2021 and performed a meta-analysis using stata12.0 software. A random-effects model was used for I2 greater than > 50%; otherwise, a fixed-effects model was used. Results There were 274,976 elderly patients. The degree of frailty was assessed using different frailty assessment tools, the most common of which was the Frailty Index Scale. Nine studies investigated the prevalence of frailty in patients with acute myocardial infarction after PCI, with an overall prevalence of 39% (95% CI: 18%-60%, P < 0.001). Six studies included adverse outcomes in frail patients with acute myocardial infarction after PCI, including all-cause mortality (HR = 2.29, 95%CI:1.65–3.16, P = 0.285), re-hospitalization (HR = 2.53, 95% CI: 1.38–4.63), and in-hospital major bleeding (HR = 1.93, 95% CI: 1.29–2.90,P = 0.825). Conclusion In patients with acute myocardial infarction after PCI, the frailty prevalence is increased, especially in STEMI. Frailty patients after PCI, acute myocardial infarction is more likely to be associated with worse clinical outcomes, such as death, bleeding, and re-hospitalization.
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