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https://www.readbyqxmd.com/read/29330854/combined-spinal-epidural-vs-spinal-anaesthesia-for-caesarean-section-meta-analysis-and-trial-sequential-analysis
#1
REVIEW
M Klimek, R Rossaint, M van de Velde, M Heesen
Combined spinal-epidural and single-shot spinal anaesthesia are both used for caesarean section. It has been claimed in individual trials that combined spinal-epidural is associated with higher sensory spread and greater cardiovascular stability. We set out to gather all available evidence. We performed: a systematic literature search to identify randomised controlled trials comparing combined spinal-epidural with spinal anaesthesia for caesarean section: conventional meta-analysis; trial-sequential analysis; and assessment of trial quality using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system...
January 13, 2018: Anaesthesia
https://www.readbyqxmd.com/read/29326090/the-addition-of-chemotherapy-to-radiation-therapy-improves-survival-in-elderly-patients-with-stage-iii-non-small-cell-lung-cancer
#2
Eric D Miller, James L Fisher, Karl E Haglund, John C Grecula, Meng Xu-Welliver, Erin M Bertino, Kai He, Peter G Shields, David P Carbone, Terence M Williams, Gregory A Otterson, Jose G Bazan
INTRODUCTION: Elderly patients represent the majority of lung cancer diagnoses but are poorly represented in clinical trials. We evaluated the overall survival (OS) of elderly patients with stage III non-small cell lung cancer (NSCLC) treated with definitive radiation compared to those treated with definitive chemoradiation. METHODS: We conducted a comparative effectiveness study of radiation therapy vs. chemoradiation in elderly (≥70 years old) patients with stage III NSCLC not treated surgically diagnosed from 2003-2014 using the National Cancer Database...
December 18, 2017: Journal of Thoracic Oncology
https://www.readbyqxmd.com/read/29325728/myo-inositol-lowers-the-risk-of-developing-gestational-diabetic-mellitus-in-pregnancies-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials-with-trial-sequential-analysis
#3
REVIEW
Xianshan Guo, Shizhe Guo, Zhiyi Miao, Zhen Li, Hongya Zhang
AIMS: to explore the potential benefit of myo-inositol on pregnant women with high risk of developing gestational diabetes mellitus (GDM). METHODS: Pubmed, Embase, and Cochrane library were systematically searched for randomized controlled trials (RCTs) comparing myo-inositol with placebo for pregnant women with risk factors of GDM. Primary outcome were the incidence of GDM and birth weight. Secondary outcomes included fasting, 1h, and 2h oral glucose tolerance test (OGTT), and complications...
July 21, 2017: Journal of Diabetes and its Complications
https://www.readbyqxmd.com/read/29306484/meta-analysis-comparing-patent-foramen-ovale-closure-versus-medical-therapy-to-prevent-recurrent-cryptogenic-stroke
#4
Tomo Ando, Anthony A Holmes, Mohit Pahuja, Arshad Javed, Alenxandros Briasoulis, Tesfaye Telila, Hisato Takagi, Theodore Schreiber, Luis Afonso, Cindy L Grines, Sripal Bangalore
New evidence suggests that closure of a patent foramen ovale (PFO) plus medical therapy (MT; antiplatelet or anticoagulation) is superior to MT alone to prevent recurrent cryptogenic stroke. We performed a meta-analysis of randomized controlled trials that compared PFO closure plus MT with MT alone in patients with cryptogenic stroke. The efficacy end points were recurrent stroke, transient ischemia attack, and death. The safety end points were major bleeding and newly detected atrial fibrillation. Trials were pooled using random effects and fixed effects models...
December 11, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/29304799/study-protocol-evaluation-of-specialized-outpatient-palliative-care-sopc-in-the-german-state-of-hesse-elsah-study-work-package-ii-palliative-care-for-pediatric-patients
#5
Lisa-R Ulrich, Dania Gruber, Michaela Hach, Stefan Boesner, Joerg Haasenritter, Katrin Kuss, Hannah Seipp, Ferdinand M Gerlach, Antje Erler
BACKGROUND: In 2007, the European Association of Palliative Care (EAPC) provided a comprehensive set of recommendations and standards for the provision of adequate pediatric palliative care. A number of studies have shown deficits in pediatric palliative care compared to EAPC standards. In Germany, pediatric palliative care patients can be referred to specialized outpatient palliative care (SOPC) services, which are known to enhance quality of life, e.g. by avoiding hospitalization. However, current regulations for the provision of SOPC in Germany do not account for the different circumstances and needs of children and their families compared to adult palliative care patients...
January 5, 2018: BMC Palliative Care
https://www.readbyqxmd.com/read/29289938/pharmacological-interventions-for-preventing-post-operative-atrial-fibrillation-in-patients-undergoing-cardiac-surgery-a-network-meta-analysis-protocol
#6
Xiaoqin Wang, Liang Yao, Long Ge, Lun Li, Fuxiang Liang, Qi Zhou, Yaolong Chen, Yongfeng Wang, Kehu Yang
INTRODUCTION: Postoperative atrial fibrillation (POAF) is the most common complication following cardiac surgery, and randomised clinical trials (RCTs) and systematic reviews have been conducted to compare and evaluate different pharmacological interventions for preventing POAF. This study aimed to explore the effect of different pharmacological interventions for prophylaxis against POAF after cardiac surgery using network meta-analysis (NMA). METHODS AND ANALYSIS: A systematic search will be performed in PubMed, EMBASE and the Cochrane Library to identify RCTs, systematic reviews, meta-analyses or NMA of different pharmacological interventions for POAF...
December 29, 2017: BMJ Open
https://www.readbyqxmd.com/read/29289579/sequential-application-of-non-pharmacological-interventions-reduces-the-severity-of-labour-pain-delays-use-of-pharmacological-analgesia-and-improves-some-obstetric-outcomes-a-randomised-trial
#7
Rubneide Barreto Silva Gallo, Licia Santos Santana, Alessandra Cristina Marcolin, Geraldo Duarte, Silvana Maria Quintana
QUESTION: Among women in labour, does sequential application of non-pharmacological interventions relieve labour pain, shorten labour, and delay pharmacological analgesia use? DESIGN: Randomised trial with concealed allocation, assessor blinding, and intention-to-treat analysis. PARTICIPANTS: Eighty women admitted in labour at the end of a low-risk pregnancy. INTERVENTION: Participants in the experimental group received three interventions for up to 40minutes each in particular stages of labour: exercise on a Swiss ball at 4 to 5cm of cervical dilation; lumbosacral massage at 5 to 6cm dilation; and a warm shower at >7cm dilation...
December 27, 2017: Journal of Physiotherapy
https://www.readbyqxmd.com/read/29288321/rassf1a-promoter-methylation-was-associated-with-the-development-progression-and-metastasis-of-cervical-carcinoma-a-meta-analysis-with-trial-sequential-analysis
#8
Fei Zheng, Huimin Yu
BACKGROUND: RASSF1A promoter methylation has been reported in cervical cancer. However, clinical effect of RASSF1A promoter methylation in cervical cancer remains unclear. This meta-analysis was conducted to assess the correlation between RASSF1A promoter methylation and cervical cancer and the association of RASSF1A promoter methylation with clinicopathological features. METHODS: Electronic databases were searched to identify eligible publications. The pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated...
December 29, 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/29280475/the-comparative-efficacy-and-safety-of-sugammadex-and-neostigmine-in-reversing-neuromuscular-blockade-in-adults-a-cochrane-systematic-review-with-meta-analysis-and-trial-sequential-analysis
#9
REVIEW
A-M Hristovska, P Duch, M Allingstrup, A Afshari
We compared the efficacy and safety of sugammadex and neostigmine in reversing neuromuscular blockade in adults. Our outcomes were: recovery time from second twitch to train-of-four ratio > 0.9; recovery time from post-tetanic count 1-5 to train-of-four ratio > 0.9; and risk of composite adverse and serious adverse events. We searched for randomised clinical trials irrespective of publication status and date, blinding status, outcomes reported or language. We included 41 studies with 4206 participants...
December 27, 2017: Anaesthesia
https://www.readbyqxmd.com/read/29276014/early-selective-serotonin-reuptake-inhibitors-for-recovery-after-stroke-a-meta-analysis-and-trial-sequential-analysis
#10
Si-Chun Gu, Chang-De Wang
BACKGROUND: Potential benefits and risks of early (≤30 days from stroke onset) selective serotonin reuptake inhibitors (SSRIs) treatment for neurologic functional recovery after stroke are not fully understood. METHODS: We searched PubMed, Embase, and the Cochrane Library to identify randomized controlled trials that assessed SSRI medications during the initial ictus after stroke versus placebo. Primary outcome was decrease in National Institutes of Health Stroke Scale (NIHSS) score...
December 21, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29273007/efficacy-and-safety-of-weekly-nab-paclitaxel-plus-gemcitabine-in-chinese-patients-with-metastatic-adenocarcinoma-of-the-pancreas-a-phase-ii-study
#11
Ruihua Xu, Xianjun Yu, Jihui Hao, Liwei Wang, Hongming Pan, Guohong Han, Jianming Xu, Yanqiao Zhang, Shujun Yang, Jia Chen, Jieer Ying, Guanghai Dai, Mingyu Li, Damir Begic, Brian Lu, Lin Shen
BACKGROUND: This phase II bridging study assessed the safety and efficacy of nab-paclitaxel/gemcitabine (Metastatic Pancreatic Adenocarcinoma Clinical Trial [MPACT] regimen) in Chinese patients with metastatic pancreatic cancer (MPC). METHODS: This 3-part sequential study evaluated nab-paclitaxel 125 mg/m2 plus gemcitabine 1000 mg/m2 on days 1, 8, and 15 every 4 weeks. Part 1 evaluated safety. Part 2 evaluated efficacy using Simon's optimal 2-stage design: if >2 responses were observed in Stage 1 (n = 28), 54 additional patients would be enrolled in Stage 2...
December 22, 2017: BMC Cancer
https://www.readbyqxmd.com/read/29249276/adjunctive-rifampicin-for-staphylococcus-aureus-bacteraemia-arrest-a-multicentre-randomised-double-blind-placebo-controlled-trial
#12
Guy E Thwaites, Matthew Scarborough, Alexander Szubert, Emmanuel Nsutebu, Robert Tilley, Julia Greig, Sarah A Wyllie, Peter Wilson, Cressida Auckland, Janet Cairns, Denise Ward, Pankaj Lal, Achyut Guleri, Neil Jenkins, Julian Sutton, Martin Wiselka, Gonzalez-Ruiz Armando, Clive Graham, Paul R Chadwick, Gavin Barlow, N Claire Gordon, Bernadette Young, Sarah Meisner, Paul McWhinney, David A Price, David Harvey, Deepa Nayar, Dakshika Jeyaratnam, Tim Planche, Jane Minton, Fleur Hudson, Susan Hopkins, John Williams, M Estee Török, Martin J Llewelyn, Jonathan D Edgeworth, A Sarah Walker
BACKGROUND: Staphylococcus aureus bacteraemia is a common cause of severe community-acquired and hospital-acquired infection worldwide. We tested the hypothesis that adjunctive rifampicin would reduce bacteriologically confirmed treatment failure or disease recurrence, or death, by enhancing early S aureus killing, sterilising infected foci and blood faster, and reducing risks of dissemination and metastatic infection. METHODS: In this multicentre, randomised, double-blind, placebo-controlled trial, adults (≥18 years) with S aureus bacteraemia who had received ≤96 h of active antibiotic therapy were recruited from 29 UK hospitals...
December 14, 2017: Lancet
https://www.readbyqxmd.com/read/29246209/airway-administration-of-corticosteroids-for-prevention-of-bronchopulmonary-dysplasia-in-premature-infants-a-meta-analysis-with-trial-sequential-analysis
#13
Zhi-Qun Zhang, Ying Zhong, Xian-Mei Huang, Li-Zhong Du
BACKGROUND: Uncertainly prevails with regard to the use of inhalation or instillation steroids to prevent bronchopulmonary dysplasia in preterm infants. The meta-analysis with sequential analysis was designed to evaluate the efficacy and safety of airway administration (inhalation or instillation) of corticosteroids for preventing bronchopulmonary dysplasia (BPD) in premature infants. METHODS: We searched MEDLINE, EMBASE, CINAHL, and Cochrane CENTRAL from their inceptions to February 2017...
December 15, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/29245998/effects-of-levosimendan-on-mortality-in-patients-with-septic-shock-systematic-review-with-meta-analysis-and-trial-sequential-analysis
#14
Benji Wang, Rujie Chen, Xianyang Guo, Wenwu Zhang, Jianjian Hu, Yuqiang Gong, Bihuan Cheng
Object: Several studies have investigated a survival benefit for levosimendan treatment in patients with septic shock. However, data are conflicting. We conducted a meta-analysis to evaluate the effect of levosimendan treatment on mortality in patients with septic shock. Materials and Methods: We searched PubMed, EMBASE and Cochrane Library Databases up to March 27, 2017, without language restrictions. We searched for terms related to septic shock, levosimendan, randomized clinical trial...
November 21, 2017: Oncotarget
https://www.readbyqxmd.com/read/29243749/association-between-berries-intake-and-cardiovascular-diseases-risk-factors-a-systematic-review-with-meta-analysis-and-trial-sequential-analysis-of-randomized-controlled-trials
#15
REVIEW
Ângelo Luís, Fernanda Domingues, Luísa Pereira
The main goal of this work was to clarify the effects of the consumption of berries on cardiovascular disease (CVD) risk factors by performing a systematic review according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) statement, followed by a meta-analysis and a trial sequential analysis (TSA) of randomized controlled trials (RCTs). The electronic search was conducted in PubMed, Scopus, SciELO, Web of Science and Cochrane Library between April and June 2016. To be included, RCTs had to report 1 or more of the following outcomes: total cholesterol (TC), HDL-cholesterol (HDL), LDL-cholesterol (LDL), triglycerides (TG), blood pressure (BP), C-reactive protein (CRP), tumour necrosis factor-α (TNF-α), interleukin-6 (IL-6), vascular cell adhesion molecule-1 (VCAM), intercellular adhesion molecule-1 (ICAM), glucose, insulin, apolipoprotein A-I (Apo A-I) or apolipoprotein B (Apo B)...
December 15, 2017: Food & Function
https://www.readbyqxmd.com/read/29237497/hyaluronic-acid-is-associated-with-organ-dysfunction-in-acute-respiratory-distress-syndrome
#16
Anthony J Esposito, Pavan K Bhatraju, Renee D Stapleton, Mark M Wurfel, Carmen Mikacenic
BACKGROUND: Hyaluronic acid (HA), an extracellular matrix component, is degraded in response to local tissue injury or stress. In various animal models of lung injury, HA has been shown to play a mechanistic role in modulating inflammation and injury. While HA is present in the lungs of patients with acute respiratory distress syndrome (ARDS), its relationship to patient outcomes is unknown. METHODS: We studied 86 patients with ARDS previously enrolled in the Phase II Randomized Trial of Fish Oil in Patients with Acute Lung Injury (NCT00351533) at five North American medical centers...
December 14, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29237293/cdh1-promoter-methylation-in-patients-with-cervical-carcinoma-a-systematic-meta-analysis-with-trial-sequential-analysis
#17
Guanyuan Liu
AIM: This study was performed to evaluate the correlation between CDH1 promoter methylation and cervical cancer. METHODS: Trial sequential analysis was conducted to evaluate the required information size. RESULTS: A total of 15 studies with 950 cervical cancers and 829 controls were identified. CDH1 promoter methylation was higher in cervical cancer than in cervical intraepithelial neoplasia lesions and normal cervical tissues. Subgroup analysis of ethnicity showed that CDH1 promoter methylation correlated with cervical cancer in Caucasians, but not in Asians...
December 14, 2017: Future Oncology
https://www.readbyqxmd.com/read/29230665/relevant-factors-for-the-optimal-duration-of-extended-endocrine-therapy-in-early-breast-cancer
#18
Erik J Blok, Judith R Kroep, Elma Meershoek-Klein Kranenbarg, Marjolijn Duijm-de Carpentier, Hein Putter, Gerrit-Jan Liefers, Johan W R Nortier, Emiel J Th Rutgers, Caroline M Seynaeve, Cornelis J H van de Velde
PURPOSE: For postmenopausal patients with hormone receptor-positive early breast cancer, the optimal subgroup and duration of extended endocrine therapy is not clear yet. The aim of this study using the IDEAL patient cohort was to identify a subgroup for which longer (5 years) extended therapy is beneficial over shorter (2.5 years) extended endocrine therapy. METHODS: In the IDEAL trial, 1824 patients who completed 5 years of adjuvant endocrine therapy (either 5 years of tamoxifen (12%), 5 years of an AI (29%), or a sequential strategy of both (59%)) were randomized between either 2...
December 12, 2017: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/29226570/campath-calcineurin-inhibitor-reduction-and-chronic-allograft-nephropathy-the-3c-study-results-of-a-randomized-controlled-clinical-trial
#19
Richard Haynes, Lisa Blackwell, Natalie Staplin, William G Herrington, Jonathan Emberson, Parminder K Judge, Benjamin C Storey, Martin J Landray, Paul N Harden, Colin Baigent, Peter Friend
Calcineurin inhibitors (CNI e.g. tacrolimus) reduce short-term kidney transplant failure, but chronic nephrotoxicity may contribute to late transplant loss. Elective conversion to inhibitors of the mammalian target of rapamycin pathway (mTOR e.g. sirolimus) might avoid long-term CNI renal damage and improve outcomes. The 3C Study was a pragmatic randomized controlled trial comprising sequential randomizations between alemtuzumab and basiliximab induction therapy (at the time of surgery) and between tacrolimus and sirolimus maintenance therapy at 6-months post-transplant...
December 11, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/29224040/treatment-of-auditory-hallucinations-with-bilateral-theta-burst-stimulation-ctbs-protocol-of-a-randomized-double-blind-placebo-controlled-multicenter-trial
#20
Christian Plewnia, Bettina Brendel, Tobias Schwippel, Peter Martus, Joachim Cordes, Alkomiet Hasan, Andreas J Fallgatter
Auditory verbal hallucinations (AH) are core symptoms of schizophrenia. They are often severely distressing and refractory to therapy. Their perception is associated with increased activity in temporoparietal areas of the brain. Repetitive transcranial magnetic stimulation (rTMS) can reduce focal brain hyperactivity and has been shown to ameliorate AH. However, controlled multicenter clinical trials are still missing, effect sizes are moderate, and the treatment with rTMS is time consuming. Continuous theta burst stimulation (cTBS) is a quicker and potentially more effective technique to reduce cortical hyperactivity...
December 9, 2017: European Archives of Psychiatry and Clinical Neuroscience
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