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Trial sequential analysis

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https://www.readbyqxmd.com/read/28445237/effects-of-polymyxin-b-hemoperfusion-on-mortality-in-patients-with-severe-sepsis-and-septic-shock-a-systemic-review-meta-analysis-update-and-disease-severity-subgroup-meta-analysis
#1
Tzu Chang, Yu-Kang Tu, Chen-Tse Lee, Anne Chao, Chi-Hsiang Huang, Ming-Jiuh Wang, Yu-Chang Yeh
OBJECTIVE: Several studies have reported a survival benefit for polymyxin B hemoperfusion treatment in patients with severe sepsis and septic shock. However, recently, a propensity-matched analysis and a randomized controlled trial reported no survival benefit for polymyxin B hemoperfusion treatment. We performed an up-to-date meta-analysis to determine the effect of polymyxin B hemoperfusion treatment on mortality in patients with severe sepsis and septic shock. DATA SOURCES: PubMed, Embase, and Cochrane Library were searched from inception to May 2016...
April 25, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28443283/vascular-access-site-for-renal-replacement-therapy-in-acute-kidney-injury-a-post-hoc-analysis-of-the-atn-study
#2
Yue-Harn Ng, Kavitha Ganta, Herbert Davis, V Shane Pankratz, Mark Unruh
BACKGROUND: Acute kidney injury requiring renal replacement therapy (RRT) in the intensive care unit portends a poor prognosis. The decisions regarding dialysis catheter placement is based mainly on physician discretion with little evidence to support the choice of dialysis catheter location. METHODS: The Veterans Affairs/National Institutes of Health Acute Renal Failure Trial Network Study was a multicenter, prospective, randomized trial of intensive vs. less intensive RRT in critically ill patients with AKI...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/28438130/the-safety-and-efficacy-of-percutaneous-intraductal-radiofrequency-ablation-in-unresectable-malignant-biliary-obstruction-a-single-institution-experience
#3
Wei Cui, Wenzhe Fan, Mingjian Lu, Yingqiang Zhang, Wang Yao, Jiaping Li, Yu Wang
BACKGROUND: Patients with unresectable malignant biliary obstruction have limited life expectancy because of limited stent patency and tumor progression. The aim of our study was to retrospectively evaluate the safety and efficacy of combining intraductal RFA with biliary metal stent placement for patients with malignant biliary obstruction. METHODS: Patients who received percutaneous intraductal RFA and biliary stent placement for malignant biliary obstruction between 2013 and 2015 were identified...
April 24, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28429603/effect-of-high-flow-nasal-cannula-oxygen-therapy-versus-conventional-oxygen-therapy-and-noninvasive-ventilation-on-reintubation-rate-in-adult-patients-after-extubation-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#4
Hua-Wei Huang, Xiu-Mei Sun, Zhong-Hua Shi, Guang-Qiang Chen, Lu Chen, Jan O Friedrich, Jian-Xin Zhou
PURPOSE: We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to evaluate the effect of high-flow nasal cannula (HFNC) on reintubation in adult patients. PROCEDURES: Ovid Medline, Embase, and Cochrane Database of Systematic Reviews were searched up to November 1, 2016, for RCTs comparing HFNC versus conventional oxygen therapy (COT) or noninvasive ventilation (NIV) in adult patients after extubation. The primary outcome was reintubation rate, and the secondary outcomes included complications, tolerance and comfort, time to reintubation, length of stay, and mortality...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28425141/efficacy-of-helicobacter-pylori-eradication-therapies-in-korea-a-systematic-review-and-network-meta-analysis
#5
REVIEW
Yoon Suk Jung, Chan Hyuk Park, Jung Ho Park, Eunwoo Nam, Hang Lak Lee
BACKGROUND: The efficacy of Helicobacter pylori eradication regimens may depend on the country where the studies were performed because of the difference in antibiotic resistance. We aimed to analyze the efficacy of H. pylori eradication regimens in Korea where clarithromycin resistance rate is high. METHODS: We searched for all relevant randomized controlled trials published until November 2016 that investigated the efficacy of H. pylori eradication therapies in Korea...
April 19, 2017: Helicobacter
https://www.readbyqxmd.com/read/28417463/pharmacological-interventions-for-primary-sclerosing-cholangitis-an-attempted-network-meta-analysis
#6
REVIEW
Francesca Saffioti, Kurinchi Selvan Gurusamy, Neil Hawkins, Clare D Toon, Emmanuel Tsochatzis, Brian R Davidson, Douglas Thorburn
BACKGROUND: Primary sclerosing cholangitis is a chronic cholestatic liver disease that is associated with both hepatobiliary and colorectal malignancies, which can result in liver cirrhosis and its complications. The optimal pharmacological treatment for patients with primary sclerosing cholangitis remains controversial. OBJECTIVES: To assess the comparative benefits and harms of different pharmacological interventions in people with primary sclerosing cholangitis by performing a network meta-analysis, and to generate rankings of available pharmacological interventions according to their safety and efficacy...
March 28, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28416632/null-epac-mutants-reveal-a-sequential-order-of-versatile-camp-effects-during-drosophila-aversive-odor-learning
#7
Antje Richlitzki, Philipp Latour, Martin Schwärzel
Here, we define a role of the cAMP intermediate EPAC in Drosophila aversive odor learning by means of null epac mutants. Complementation analysis revealed that EPAC acts downstream from the rutabaga adenylyl cyclase and in parallel to protein kinase A. By means of targeted knockdown and genetic rescue we identified mushroom body Kenyon cells (KCs) as a necessary and sufficient site of EPAC action. We provide mechanistic insights by analyzing acquisition dynamics and using the "performance increment" as a means to access the trial-based sequential organization of odor learning...
May 2017: Learning & Memory
https://www.readbyqxmd.com/read/28412743/autologous-transplantation-of-cytokine-induced-killer-cells-as-an-adjuvant-therapy-for-hepatocellular-carcinoma-in-asia-an-update-meta-analysis-and-systematic-review
#8
Xiu-Rong Cai, Xing Li, Jin-Xiang Lin, Tian-Tian Wang, Min Dong, Zhan-Hong Chen, Chang-Chang Jia, Ying-Fen Hong, Qu Lin, Xiang-Yuan Wu
BACKGROUND: High recurrence rate after curative treatment is the major problem for hepatocellular carcinoma (HCC). Cytokine-induced killer cells (CIKs) therapy was extensively studied among HCC patients. However, the value of CIKs therapy was controversial. A meta-analysis was performed to investigate the efficacy of adjuvant CIKs after invasive treatments among HCC patients. METHODS: We searched online for literatures studying sequential CIKs therapy for HCC patients...
February 17, 2017: Oncotarget
https://www.readbyqxmd.com/read/28409169/the-effectiveness-of-a-peer-coaching-education-on-control-and-management-of-type-2-diabetes-in-women-a-protocol-for-a-randomized-controlled-trial
#9
Maryam Aalaa, Mahnaz Sanjari, Hamid Reza Aghaei Meybodi, Mohammad Reza Amini, Mostafa Qorbani, Hossien Adibi, Neda Mehrdad
BACKGROUND: Diabetes Education by Peer Coaching is a strategy which helps the patients with diabetes in the field of behavioral and emotional problems. However, the results of studies in this field in other countries could not be generalized in our context. So, the current study aimed to examine the effectiveness of Diabetes Education by Peer Coaching on Diabetes Management. METHODS: Outcome variables for patients and peer coaches are measured at baseline and in3,6 and 12 months...
April 2017: International Journal of Community Based Nursing and Midwifery
https://www.readbyqxmd.com/read/28408193/imipramine-versus-placebo-for-multiple-functional-somatic-syndromes-stress-3-a-double-blind-randomised-study
#10
Johanne L Agger, Andreas Schröder, Lise K Gormsen, Jens S Jensen, Troels S Jensen, Per K Fink
BACKGROUND: Functional somatic syndromes, including chronic fatigue syndrome or irritable bowel syndrome, often co-exist. Treatment guidelines supported by high quality evidence exist for most functional somatic syndromes, but are lacking for multiple comorbid functional somatic syndromes. We aimed to assess the effect of the tricyclic antidepressant, imipramine, in patients with multiple functional somatic syndromes defined by the criteria for multiorgan bodily distress syndrome, a unifying diagnosis that encompasses most functional somatic syndromes and somatoform disorders...
April 10, 2017: Lancet Psychiatry
https://www.readbyqxmd.com/read/28407220/patient-controlled-analgesia-with-remifentanil-versus-alternative-parenteral-methods-for-pain-management-in-labour
#11
REVIEW
Stephanie Weibel, Yvonne Jelting, Arash Afshari, Nathan Leon Pace, Leopold Hj Eberhart, Johanna Jokinen, Thorsten Artmann, Peter Kranke
BACKGROUND: Multiple analgesic strategies for pain relief during labour are available. Recently remifentanil, a short-acting opioid, has recently been used as an alternative analgesic due to its unique pharmacological properties. OBJECTIVES: To systematically assess the effectiveness of remifentanil intravenous patient-controlled analgesia (PCA) for labour pain, along with any potential harms to the mother and the newborn. SEARCH METHODS: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (9 December 2015), ClinicalTrials...
April 13, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28396128/perioperative-analgesic-profile-of-dexmedetomidine-infusions-in-morbidly-obese-undergoing-bariatric-surgery-a-meta-analysis-and-trial-sequential-analysis
#12
Preet Mohinder Singh, Rajesh Panwar, Anuradha Borle, Jan P Mulier, Ashish Sinha, Basavana Goudra
BACKGROUND: Opioid-sparing analgesia for bariatric surgery in morbidly obese can potentially prevent catastrophic airway complications. Our meta-analysis attempts to consolidate the evidence on dexmedetomidine evaluating its analgesic and safety profile. METHODS: Trails comparing perioperative dexmedetomidine infusion to conventional analgesic regimens for bariatric surgery were searched. Comparisons were made for 24-hour and postanesthesia care unit (PACU) morphine consumed, PACU pain scores, postoperative nausea and vomiting pain scores, and heartrate...
March 10, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28393258/intermittent-noninvasive-ventilation-after-extubation-in-patients-with-chronic-respiratory-disorders-a-multicenter-randomized-controlled-trial-vhyper
#13
Frédéric Vargas, Marc Clavel, Pascale Sanchez-Verlan, Sylvain Garnier, Alexandre Boyer, Hoang-Nam Bui, Benjamin Clouzeau, Charline Sazio, Aissa Kerchache, Olivier Guisset, Antoine Benard, Julien Asselineau, Bernard Gauche, Didier Gruson, Stein Silva, Philippe Vignon, Gilles Hilbert
PURPOSE: Early noninvasive ventilation (NIV) after extubation decreases the risk of respiratory failure and lowers 90-day mortality in patients with hypercapnia. Patients with chronic respiratory disease are at risk of extubation failure. Therefore, it could be useful to determine the role of NIV with a discontinuous approach, not limited to patients with hypercapnia. We assessed the efficacy of early NIV in decreasing respiratory failure after extubation in patients with chronic respiratory disorders...
April 9, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28392771/find-the-hidden-object-understanding-play-in-psychological-assessments
#14
Alessandra Fasulo, Janhavi Shukla, Stephanie Bennett
Standardized psychological assessments are extensively used by practitioners to determine rate and level of development in different domains of ability in both typical and atypical children. The younger the children, the more likely the trials will resemble play activities. However, mode of administration, timing and use of objects involved are constrained. The purpose of this study is to explore what kind of play is play in psychological assessments, what are the expectations about children's performance and what are the abilities supporting the test activities...
2017: Frontiers in Psychology
https://www.readbyqxmd.com/read/28388943/time-dependent-roc-curve-analysis-in-medical-research-current-methods-and-applications
#15
Adina Najwa Kamarudin, Trevor Cox, Ruwanthi Kolamunnage-Dona
BACKGROUND: ROC (receiver operating characteristic) curve analysis is well established for assessing how well a marker is capable of discriminating between individuals who experience disease onset and individuals who do not. The classical (standard) approach of ROC curve analysis considers event (disease) status and marker value for an individual as fixed over time, however in practice, both the disease status and marker value change over time. Individuals who are disease-free earlier may develop the disease later due to longer study follow-up, and also their marker value may change from baseline during follow-up...
April 7, 2017: BMC Medical Research Methodology
https://www.readbyqxmd.com/read/28384980/anti-bacterial-efficacy-of-terminalia-chebula-terminalia-bellirica-embilica-officinalis-and-triphala-on-salivary-streptococcus-mutans-count-a-linear-randomized-cross-over-trial
#16
Smariti Saxena, Nagesh Lakshminarayan, Shanmukha Gudli, Manish Kumar
INTRODUCTION: From the oral health perspective, it is well established that microorganisms have an important role in caries aetiology. From the dawn of civilization, herbal plants have served an array of roles. Triphala a tradtional herbal Ayurvedic formula consists of three native fruits of india including Terminalia Chebula (T. chebula), Terminalia Bellirica (T. bellirica) and Embilica Officinalis (E. officinalis). As per Ayurvedic Formulary of India (AFI) Triphala is prepared by combining a 1:1:1 mixture of ground dry fruits called myrobalans...
February 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28381269/digoxin-versus-placebo-no-intervention-or-other-medical-interventions-for-atrial-fibrillation-and-atrial-flutter-a-protocol-for-a-systematic-review-with-meta-analysis-and-trial-sequential-analysis
#17
Naqash J Sethi, Sanam Safi, Joshua Feinberg, Emil E Nielsen, Christian Gluud, Janus C Jakobsen
BACKGROUND: Atrial fibrillation is the most common arrhythmia of the heart with a prevalence of approximately 2% in the western world. Atrial flutter, another arrhythmia, occurs less often with an incidence of approximately 200,000 new patients per year in the USA. Patients with atrial fibrillation and atrial flutter have an increased risk of death and morbidities. In the management of atrial fibrillation and atrial flutter, it is often necessary to use medical interventions to lower the heart rate...
April 5, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28381086/automated-quantitative-enzyme-biosensing-in-24-well-microplates
#18
Somjai Teanphonkrang, Albert Schulte
We report a novel system for glucose estimation in model and real samples, utilizing enzyme-modified pencil leads (PL) as effective electrochemical biosensors for robotic substrate quantification in 24-well microplates. Electrochemically formed carboxyl groups on the surface of the graphite were cross-linked to amino groups in the enzyme so as to attach glucose oxidase to the PL surface. Automated amperometric sensing of glucose solutions in microtiter-plate wells used computer-controlled stepper motors to move the biosensor/counter/reference electrode assemblies sequentially between the samples...
April 24, 2017: Analytical Chemistry
https://www.readbyqxmd.com/read/28380638/when-is-a-meta-analysis-conclusive-a-guide-to-trial-sequential-analysis-with-an-example-of-remote-ischemic-preconditioning-for-renoprotection-in-patients-undergoing-cardiac-surgery
#19
Pavel S Roshanov, Brittany B Dennis, Nicholas Pasic, Amit X Garg, Michael Walsh
Regardless of whether a randomized trial finds a statistically significant effect for an intervention or not, readers often wonder if the trial was large enough to be conclusive. To answer this question, we can estimate the required sample size for a trial by considering how commonly the outcome occurs, the smallest effect of clinical importance and the acceptable risk of falsely detecting or rejecting that effect. But when is a meta-analysis conclusive? We explain and illustrate the interpretation of Trial Sequential Analysis (TSA), a method increasingly used to answer this question...
April 1, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28373007/avelumab-for-metastatic-or-locally-advanced-previously-treated-solid-tumours-javelin-solid-tumor-a-phase-1a-multicohort-dose-escalation-trial
#20
Christopher R Heery, Geraldine O'Sullivan-Coyne, Ravi A Madan, Lisa Cordes, Arun Rajan, Myrna Rauckhorst, Elizabeth Lamping, Israel Oyelakin, Jennifer L Marté, Lauren M Lepone, Renee N Donahue, Italia Grenga, Jean-Marie Cuillerot, Berend Neuteboom, Anja von Heydebreck, Kevin Chin, Jeffrey Schlom, James L Gulley
BACKGROUND: Avelumab (MSB0010718C) is a human IgG1 monoclonal antibody that binds to PD-L1, inhibiting its binding to PD-1, which inactivates T cells. We aimed to establish the safety and pharmacokinetics of avelumab in patients with solid tumours while assessing biological correlatives for future development. METHODS: This open-label, single-centre, phase 1a, dose-escalation trial (part of the JAVELIN Solid Tumor trial) assessed four doses of avelumab (1 mg/kg, 3 mg/kg, 10 mg/kg, and 20 mg/kg), with dose-level cohort expansions to provide additional safety, pharmacokinetics, and target occupancy data...
March 31, 2017: Lancet Oncology
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