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Trial sequential analysis

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https://www.readbyqxmd.com/read/27924386/cost-analysis-of-laparoendoscopic-rendezvous-versus-preoperative-ercp-and-laparoscopic-cholecystectomy-in-the-management-of-cholecystocholedocholithiasis
#1
Aldo Garbarini, Dario Reggio, Simone Arolfo, Marco Bruno, Roberto Passera, Giorgia Catalano, Claudio Barletti, Mauro Salizzoni, Mario Morino, Luca Petruzzelli, Alberto Arezzo
BACKGROUND: Evidence from controlled trials and meta-analyses suggests that laparoendoscopic rendezvous (LERV) is preferable to sequential treatment in the management of common bile duct stones. MATERIALS AND METHODS: With this retrospective analysis of a prospective database that included consecutive patients treated for cholecystocholedocholithiasis at our institution between January 2007 and July 2015, we compared LERV with sequential treatment. The primary endpoint was global cost, defined as the cost/patient/hospital stay, and the secondary end points were efficacy and morbidity...
December 6, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/27919645/empirical-mono-versus-combination-antibiotic-therapy-in-adult-intensive-care-patients-with-severe-sepsis-a-systematic-review-with-meta-analysis-and-trial-sequential-analysis
#2
REVIEW
Fredrik Sjövall, Anders Perner, Morten Hylander Møller
OBJECTIVES: To assess benefits and harms of empirical mono- vs. combination antibiotic therapy in adult patients with severe sepsis in the intensive care unit (ICU). METHODS: We performed a systematic review according to the Cochrane Collaboration methodology, including meta-analysis, risk of bias assessment and trial sequential analysis (TSA). We included randomised clinical trials (RCT) assessing empirical mono-antibiotic therapy versus a combination of two or more antibiotics in adult ICU patients with severe sepsis...
December 2, 2016: Journal of Infection
https://www.readbyqxmd.com/read/27919293/perioperative-statin-therapy-in-cardiac-surgery-a-meta-analysis-of-randomized-controlled-trials
#3
Alessandro Putzu, Bruno Capelli, Alessandro Belletti, Tiziano Cassina, Enrico Ferrari, Michele Gallo, Gabriele Casso, Giovanni Landoni
BACKGROUND: Several studies suggest beneficial effects of perioperative statin therapy on postoperative outcome after cardiac surgery. However, recent randomized controlled trials (RCTs) show potential detrimental effects. The objective of this systematic review is to examine the association between perioperative statin therapy and clinical outcomes in cardiac surgery patients. METHODS: Electronic databases were searched up to 1 November 2016 for RCTs of preoperative statin therapy versus placebo or no treatment in adult cardiac surgery...
December 5, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27912934/effect-of-sequential-treatment-with-tcm-syndrome-differentiation-on-acute-exacerbation-of-chronic-obstructive-pulmonary-disease-and-aecopd-risk-window
#4
Li Jiansheng, Wang Haifeng, Li Suyun, Zhang Hailong, Yu Xueqing, Zhang Xiaoyun, Li Fengsen, Zhou Xianmei, Sun Zikai, Mao Yimin, Ma Lijun, Zhang Yijie, Zhang Guojun, Tang Bingxiang
OBJECTIVE: To evaluate the efficacy and safety of the comprehensive interventions based on three Traditional Chinese medicine (TCM) patterns therapy in acute exacerbations of chronic obstructive pulmonary disease (AECOPD) and AECOPD risk window. METHODS: A prospective, multi-center, single-blinded, double-dummy and randomized controlled clinical trial is being conducted to test the therapeutic effects of a sequential two stage treatment. A total of 364 patients were enrolled into this study with 182 in each treatment group (TCM and conventional)...
December 2016: Complementary Therapies in Medicine
https://www.readbyqxmd.com/read/27908968/psa-stratified-performance-of-18f-and-68ga-labeled-tracers-in-psma-pet-imaging-of-patients-with-biochemical-recurrence-of-prostate-cancer
#5
Felix Dietlein, Carsten Kobe, Stephan Neubauer, Matthias Schmidt, Simone Stockter, Thomas Fischer, Klaus Schomäcker, Axel Heidenreich, Boris D Zlatopolskiy, Bernd Neumaier, Alexander Drzezga, Markus Dietlein
PURPOSE: Several studies outlined the sensitivity of (68)Ga-labeled PET tracers against the prostate-specific membrane antigen (PSMA) for localization of relapsed prostate cancer in patients with renewed increase in the prostate-specific antigen (PSA), commonly referred to as biochemical recurrence. Labeling of PSMA tracers with (18)F offers numerous advantages, including improved image resolution, longer half-life and increased production yields. The aim of this study was to assess the PSA-stratified performance of the (18)F-labeled PSMA tracer (18)F-DCFPyL and the (68)Ga-labeled reference (68)Ga-PSMA-HBED-CC...
December 1, 2016: Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine
https://www.readbyqxmd.com/read/27908607/impact-of-remote-ischaemic-preconditioning-on-major-clinical-outcomes-in-patients-undergoing-cardiovascular-surgery-a-meta-analysis-with-trial-sequential-analysis-of-32-randomised-controlled-trials
#6
Shifei Wang, Hairui Li, Nvqin He, Yili Sun, Shengcun Guo, Wangjun Liao, Yulin Liao, Yanmei Chen, Jianping Bin
BACKGROUND: The impact of remote ischaemic preconditioning (RIPC) on major clinical outcomes in patients undergoing cardiovascular surgery remains controversial. We systematically reviewed the available evidence to evaluate the potential benefits of RIPC in such patients. METHODS: PubMed, Embase, and Cochrane Library databases were searched for relevant randomised controlled trials (RCTs) conducted between January 2006 and March 2016. The pooled population of patients who underwent cardiovascular surgery was divided into the RIPC and control groups...
November 17, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27907885/complete-revascularization-versus-culprit-only-revascularization-in-st-segment-elevation-myocardial-infarction-and-multivessel-disease-patients-undergoing-primary-percutaneous-coronary-intervention-a-meta-analysis-and-trial-sequential-analysis
#7
REVIEW
Chong-Hui Wang, Shu-Yang Zhang, Xiao-Feng Jin
The present study compared the outcomes of complete revascularization (CR) and culprit-only revascularization (COR) performed during primary percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI) and multivessel disease through a meta-analysis in order to determine which strategy is more appropriate. Published randomized controlled trials (RCTs) were retrieved from the PubMed, EMBASE, and CENTRAL databases. Eight RCTs with 2060 patients were selected (1080 patients underwent CR [immediate (ICR) or staged (SCR)] and 980 patients underwent COR)...
November 10, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27900987/effect-of-half-dose-and-standard-dose-conjugated-equine-estrogens-combined-with-natural-progesterone-or-dydrogesterone-on-components-of-metabolic-syndrome-in-healthy-postmenopausal-women-a-randomized-controlled-trial
#8
Wei Xue, Yan Deng, Yan-Fang Wang, Ai-Jun Sun
BACKGROUND: Menopausal hormone therapy (MHT) has been proven to have beneficial effects on several components of metabolic syndrome. However, the effects vary according to different regimens, dosages, and duration of MHT. The aim of the study was to evaluate the effect of standard-dose 0.625 mg conjugated equine estrogen (CEE) and half-dose 0.3 mg CEE daily with different progestogens in a continuous sequential regimen on postmenopausal metabolic parameters in generally healthy postmenopausal women...
2016: Chinese Medical Journal
https://www.readbyqxmd.com/read/27899470/i-trach-validating-a-tool-for-predicting-prolonged-mechanical-ventilation
#9
Paul A Clark, Ryan C Inocencio, Christopher J Lettieri
PURPOSE: We previously developed a bedside model (I-TRACH), which used commonly obtained data at the time of intubation to predict the duration of mechanical ventilation (MV). We now sought to validate this in a prospective trial. METHODS: A prospective, observational study of 225 consecutive adult medical intensive care unit patients requiring MV. Utilizing the original 6 variables used in the I-TRACH model (Intubation in the ICU, Tachycardia [heart rate > 110], Renal dysfunction [blood urea nitrogen > 25], Acidemia [pH < 7...
November 28, 2016: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/27898166/neither-10-nor-14-day-sequential-treatment-is-better-than-standard-triple-therapy-for-helicobacter-pylori-eradication
#10
Emanuel Warrington, Orlando López-Román, Rafael Tirado Montijo, Rafael Urbina, Marcia Cruz-Correa, Doris H Toro
OBJECTIVE: Helicobacter pylori is a bacterial pathogen associated with chronic gastritis, peptic ulcer disease, gastric adenocarcinoma, and gastric mucosa associated lymphoid tissue lymphoma. Current treatment guidelines support a 7- to 14-day, triple-drug protocol consisting of a proton-pump inhibitor (PPI), clarithromycin, and either amoxicillin or an imidazole. The initial eradication rates for this regimen were 80 to 90%. Nevertheless its effectiveness has declined as the antibiotic resistance to clarithromycin and metronidazole has emerged...
December 2016: Puerto Rico Health Sciences Journal
https://www.readbyqxmd.com/read/27893839/no-association-between-tnf-%C3%AE-308g-a-polymorphism-and-idiopathic-recurrent-miscarriage-a-systematic-review-with-meta-analysis-and-trial-sequential-analysis
#11
Jiashu Dong, Jinwan Li, Gechen Zhou, Zheng Peng, Jingjing Li, Shengzhang Lin, Haihua Liu, Chunlin Wu, Yujie Huang, Xiaolan Lv, Shengming Dai
BACKGROUND: Conflicting results were reported on the association between the TNF-α -308G/A polymorphism and idiopathic recurrent miscarriage (IRM). Though three meta-analyses have been conducted on this topic, the conclusions were contradictory, and the results may be unreliable as certain crucial conditions were neglected. METHOD: A complete search was conducted in PubMed, Cochrane Library, and Embase, other sources like Google Scholar, ClinicalTrial.gov and reference lists of relevant articles were also retrieved...
2016: PloS One
https://www.readbyqxmd.com/read/27888759/prevention-of-statins-against-aki-and-mortality-following-cardiac-surgery-do-we-know-enough-a-trial-sequential-analysis
#12
Hong Weng, Sheng Li, Xian-Tao Zeng
No abstract text is available yet for this article.
November 12, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27888226/single-cell-sequencing-maps-gene-expression-to-mutational-phylogenies-in-pdgf-and-egf-driven-gliomas
#13
Sören Müller, Siyuan John Liu, Elizabeth Di Lullo, Martina Malatesta, Alex A Pollen, Tomasz J Nowakowski, Gary Kohanbash, Manish Aghi, Arnold R Kriegstein, Daniel A Lim, Aaron Diaz
Glioblastoma multiforme (GBM) is the most common and aggressive type of primary brain tumor. Epidermal growth factor (EGF) and platelet-derived growth factor (PDGF) receptors are frequently amplified and/or possess gain-of-function mutations in GBM However, clinical trials of tyrosine-kinase inhibitors have shown disappointing efficacy, in part due to intra-tumor heterogeneity. To assess the effect of clonal heterogeneity on gene expression, we derived an approach to map single-cell expression profiles to sequentially acquired mutations identified from exome sequencing...
November 25, 2016: Molecular Systems Biology
https://www.readbyqxmd.com/read/27884722/the-impact-of-age-on-quality-of-life-in-breast-cancer-patients-receiving-adjuvant-chemotherapy-a-comparative-analysis-from-the-prospective-multicenter-randomized-adebar-trial
#14
Elena Leinert, Susanne Singer, Wolfgang Janni, Nadia Harbeck, Tobias Weissenbacher, Brigitte Rack, Doris Augustin, Arthur Wischnik, Marion Kiechle, Johannes Ettl, Visnja Fink, Lukas Schwentner, Martin Eichler
BACKGROUND: Elderly breast cancer patients are affected by poorer quality of life (QoL) compared to younger patients. Because QoL has a relevant impact on guideline-adherent treatment, elderly breast cancer patients are often undertreated, especially with regard to adjuvant chemotherapy, and overall survival is decreased. Thus, understanding the impact of chemotherapy on QoL in elderly patients is crucial. This study compared QoL in patients aged < 65 years and 65 to 70 years receiving adjuvant chemotherapy as a secondary outcome in the prospective randomized multicenter ADEBAR trial...
October 19, 2016: Clinical Breast Cancer
https://www.readbyqxmd.com/read/27878754/efficiency-and-safety-effects-of-applying-eras-protocols-to-bariatric-surgery-a-systematic-review-with-meta-analysis-and-trial-sequential-analysis-of-evidence
#15
REVIEW
Preet Mohinder Singh, Rajesh Panwar, Anuradha Borle, Basavana Goudra, Anjan Trikha, Bart A van Wagensveld, Ashish Sinha
Application of the enhanced recovery after surgery (ERAS) to the bariatric surgical procedures is at its early stages with little consolidated evidence. This meta-analysis evaluates present literature and indicates pathways for development of evidence-based standardized ERAS protocols for bariatric surgery. Comparative trials between ERAS and conventional bariatric surgery published till June 2016 were searched in the medical database. Comparisons were made for length of stay (LOS), readmission, complications (major/minor), and reoperation rates...
November 23, 2016: Obesity Surgery
https://www.readbyqxmd.com/read/27877216/investigating-a-correlation-between-chemoradiotherapy-schedule-parameters-and-overall-survival-in-a-real-life-ld-sclc-patient-cohort
#16
Farkhad Manapov, Chukwuka Eze, Maximilian Niyazi, Olarn Roengvoraphoj, Minglun Li, Nina-Sophie Hegemann, Guido Hildebrandt, Rainer Fietkau, Claus Belka
Background: Chemoradiotherapy (CRT) is a treatment standard in limited disease (LD) small cell lung cancer (SCLC). Currently, the timing of thoracic radiation therapy (TRT) remains the subject of randomised trials and meta-analyses. To investigate a correlation between CRT schedule parameters and overall survival (OS) in a real-life patient cohort, a temporal analysis was performed. Methods: 182 LD SCLC patients successfully treated with definitive CRT were retrospectively reviewed. TRT was applied concurrently or sequentially...
2016: Journal of Cancer
https://www.readbyqxmd.com/read/27872526/progesterone-receptors-pathological-complete-response-and-early-outcome-for-locally-advanced-breast-cancer-a-single-centre-study-pplb-01
#17
Sanjit Agrawal, Lalit Banswal, Animesh Saha, Indu Arun, Soumitra Shankar Datta, Sanjoy Chatterjee, Rosina Ahmed
Neoadjuvant chemotherapy (NACT) for locally advanced breast cancer (LABC), apart from increasing breast conservation rates, also provides an opportunity to assess tumour response to chemotherapy, with Pathological Complete Response (pCR) described as an independent prognostic factor and a surrogate marker for better outcome and survival. Our primary aim was to identify clinical and pathological factors associated with pCR following NACT in patients with LABC treated at our institution. Our secondary aim was to analyze the impact of pCR and associated factors on disease free survival (DFS) and overall survival (OS)...
December 2016: Indian Journal of Surgical Oncology
https://www.readbyqxmd.com/read/27871803/abdominal-drainage-versus-no-abdominal-drainage-for-laparoscopic-cholecystectomy-a-systematic-review-with-meta-analysis-and-trial-sequential-analysis
#18
REVIEW
Lv Yong, Bai Guang
The aim is to assess the benefits and harms of routine abdominal drainage in laparoscopic cholecystectomy. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library, MEDLINE, EMBASE, and Science Citation Index Expanded until August 2016. We included all randomised clinical trials comparing drainage versus no drainage after laparoscopic cholecystectomy irrespective of language and publication status. We used standard methodological procedures in accordance with the PRISMA guidelines...
November 15, 2016: International Journal of Surgery
https://www.readbyqxmd.com/read/27865900/detection-of-potentially-unnecessary-and-wasteful-clinical-trial-research-cumulative-meta-epidemiological-and-trial-sequential-analysis
#19
Philipp Storz-Pfennig
OBJECTIVE: The objective was to estimate the presence and extent to which potentially unnecessary and therefore maybe wasteful clinical trials regarding relevant interventions and outcomes in major clinical areas had been conducted. STUDY DESIGN AND METHODS: From current Cochrane collaboration systematic reviews in major medical fields (e.g. CVD, cancer, psychiatry) 13 different comparisons were sampled. A cumulative meta-analysis was conducted for each and trial sequential analysis applied to determine when in the course of evidence accrual evidence was found sufficient to reach a reliable conclusion...
November 16, 2016: Journal of Clinical Epidemiology
https://www.readbyqxmd.com/read/27864219/neoadjuvant-chemotherapy-nact-increases-immune-infiltration-and-programmed-death-ligand-1-pd-l1-expression-in-epithelial-ovarian-cancer-eoc
#20
S J L Mesnage, A Auguste, C Genestie, A Dunant, E Pain, F Drusch, S Gouy, P Morice, E Bentivegna, C Lhomme, P Pautier, J Michels, A Le Formal, B Cheaib, J Adam, A F Leary
BACKGROUND: Lymphocytic infiltration at diagnosis is prognostic in EOC, however the impact of NACT on tumour infiltrating lymphocytes (TILs) or PD-L1 expression remains poorly described. PATIENTS AND METHODS: Patients with EOC and sequential samples (pre-NACT, post-NACT or relapse) were retrospectively identified. TILs were evaluated on whole sections; stromal TILs (sTILs) scored as percentage of stromal area with high sTILs defined as ≥50%; intra-epithelial TILs (ieTILs) scored semi-quantitatively (0-3) with high ieTILs ≥2...
November 17, 2016: Annals of Oncology: Official Journal of the European Society for Medical Oncology
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