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GRADE system AND meta-analysis

Shanshan Wu, Le Gao, Andrea Cipriani, Yi Huang, Zhirong Yang, Jun Yang, Shuqing Yu, Yuan Zhang, Sanbao Chai, Zilu Zhang, Feng Sun, Siyan Zhan
AIM: To evaluate the comparative effects of incretin-based therapies, including glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and dipeptidyl peptidase-4 inhibitors (DPP-4Is), on beta-cell function and insulin resistance in patients with type 2 diabetes mellitus (T2DM). MATERIALS AND METHODS: Medline, Embase, the Cochrane Library and were searched for randomized controlled trials (RCTs) with duration≥4 weeks. Network meta-analysis was performed, followed by subgroup analysis and meta-regression...
December 9, 2018: Diabetes, Obesity & Metabolism
Farasat Kazmi, Yu Yang Soon, Yiat Horng Leong, Wee Yao Koh, Balamurugan Vellayappan
PURPOSE: To determine the efficacy and toxicity of re-irradiation for patients with recurrent GBM. MATERIALS AND METHODS: We searched various biomedical databases from 1998 to 2018, for eligible studies where patients were treated with re-irradiation for recurrent GBM. Outcomes of interest were 6 and 12-month overall survival (OS-6, OS-12), 6 and 12-month progression free survival (PFS-6, PFS-12) and serious (Grade 3 +) adverse events (AE). We used the random effects model to pool outcomes across studies and compared pre-defined subgroups using interaction test...
December 6, 2018: Journal of Neuro-oncology
Junhong Wang, Qingbian Ma, Hua Zhang, Shaoyu Liu, Yaan Zheng
BACKGROUND: This systemic review aimed to explore the predictors of discharge and neurologic outcome of adult extracorporeal cardiopulmonary resuscitation (ECPR) to provide references for patient selection. METHODS: Electronically searching of the Pubmed, Embase, Cochrane Library, and manual retrieval were done for clinical trials about predictors for adult ECPR which were published between January 2000 and January 2018 and included predictors for discharge and neurologic outcome...
November 2018: Medicine (Baltimore)
José Ignacio Domínguez, Martin de Amesti, Alejandro Majerson
INTRODUCTION: The adequate preservation of the allograft prior to kidney transplant is key for a good outcome after transplantation. Currently, there are two main methods: hypothermic machine perfusion and static cold preservation. The main objective of this summary is to compare both preservation systems. METHODS: We searched in Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others...
November 30, 2018: Medwave
Jorinde Aw Polderman, Violet Farhang-Razi, Susan Van Dieren, Peter Kranke, J Hans DeVries, Markus W Hollmann, Benedikt Preckel, Jeroen Hermanides
BACKGROUND: In the perioperative period, dexamethasone is widely and effectively used for prophylaxis of postoperative nausea and vomiting (PONV), for pain management, and to facilitate early discharge after ambulatory surgery.Long-term treatment with steroids has many side effects, such as adrenal insufficiency, increased infection risk, hyperglycaemia, high blood pressure, osteoporosis, and development of diabetes mellitus. However, whether a single steroid load during surgery has negative effects during the postoperative period has not yet been studied...
November 23, 2018: Cochrane Database of Systematic Reviews
Aamer Imdad, Maribeth R Nicholson, Emily E Tanner-Smith, Joseph P Zackular, Oscar G Gomez-Duarte, Dawn B Beaulieu, Sari Acra
BACKGROUND: Inflammatory bowel disease (IBD) is a chronic, relapsing disease of the gastrointestinal tract that is thought to be associated with a complex interplay between microbes and the immune system, leading to an abnormal inflammatory response in genetically susceptible individuals. Dysbiosis, characterized by the alteration of the composition of the resident commensal bacteria in a host compared to healthy individuals, is thought to play a major role in the pathogenesis of ulcerative colitis (UC) and Crohn's disease (CD), two subtypes of IBD...
November 13, 2018: Cochrane Database of Systematic Reviews
Yvette Hm Claassen, Maxime Jm van der Valk, Anne J Breugom, Martine A Frouws, Esther Bastiaannet, Gerrit-Jan Liefers, Cornelis Jh van de Velde, Ellen Kapiteijn
BACKGROUND: For patients with asymptomatic, incurable, metastatic colorectal cancer, palliative, systemic treatment can be started immediately, or can be delayed until disease-related symptoms occur. How the potential survival benefit of starting palliative, systemic treatment immediately after diagnosis weighs up against the potential side effects is currently under debate, and was investigated in this review. OBJECTIVES: To assess the effects of immediate versus delayed chemotherapy, with or without targeted therapy, on overall survival, toxicity, quality of life, progression-free survival, and compliance with chemotherapy for individuals with asymptomatic, metastatic, incurable colorectal cancer...
November 21, 2018: Cochrane Database of Systematic Reviews
Jian Yu, Wen Wang, He Huang
OBJECTIVES: Multiple clinical trials have been conducted to investigate the therapeutic effects of blinatumomab on acute lymphoblastic leukemia (ALL) and non-Hodgkin's lymphoma (NHL). We did a meta-analysis including 8 clinical trials to verify the efficacy and safety of blinatumomab in patients with relapsed/refractory ALL and NHL. METHODS: We searched and investigated all relevant publications from PubMed, Web of Science, Embase, and The primary endpoint was complete remission (CR)...
December 2019: Hematology (Amsterdam, Netherlands)
M Heesen, K Rijs, N Hilber, W D Ngan Kee, R Rossaint, C van der Marel, M Klimek
BACKGROUND: Phenylephrine is the preferred vasopressor for the prevention and treatment of spinal anaesthesia-induced hypotension during caesarean section, because studies on low-risk elective patients found it to have a less detrimental effect on umbilical artery pH compared with ephedrine. However, limited data exist from high-risk parturients and parturients with uteroplacental insufficiency. METHODS: We systematically searched for randomised, controlled, double-blinded trials of these two vasopressors in high-risk caesarean sections...
October 19, 2018: International Journal of Obstetric Anesthesia
Shannon Leduc, Peter Kelly, Venkatesh Thiruganasambandamoorthy, George Wells, Christian Vaillancourt
BACKGROUND: Older adults are more likely to access the emergency department, which suffers from overcrowding and congestion, for conditions that could potentially be treated in other settings. Older adults living in long-term care centers have access to healthcare resources in their residence, and several programs have been created with the intent of treating medical conditions on-site. The aim of this study is to identify and systematically review programs and interventions at long-term care centers that aim to treat patients on-site, avoiding unscheduled transportation to the emergency department...
November 23, 2018: Systematic Reviews
Seon-Cheol Park, Mi Young Choi, Jina Choi, Eunjung Park, Ha Jin Tchoe, Jae Kyung Suh, Young Hoon Kim, Seung Hee Won, Young-Chul Chung, Kyung-Yeol Bae, Sang-Kyu Lee, Chan Mi Park, Seung-Hwan Lee
We aimed to compare the efficacy and safety of long-acting injectable (LAI) and oral second-generation antipsychotics (SGAs) in treating schizophrenia by performing a systematic review and meta-analysis. MEDLINE, EMBASE, PsycINFO, CINAHL, and the Cochrane Library, as well as five Korean databases, were systemically searched to identify studies published from 2000 to 16 April 2015, which compared the efficacy and safety of LAI and oral SGAs. Using data from randomized controlled trials (RCTs), meta-analyses were conducted...
November 30, 2018: Clinical Psychopharmacology and Neuroscience: the Official Scientific Journal of the Korean College of Neuropsychopharmacology
Davide La Regina, Francesco Mongelli, Stefano Cafarotti, Andrea Saporito, Marcello Ceppi, Matteo Di Giuseppe, Antonjacopo Ferrario di Tor Vajana
BACKGROUND: Surgical site infections complicate elective laparoscopic cholecystectomies in 2,4-3,2% of cases. During the operation the gallbladder is commonly extracted with a retrieval bag. We conducted a meta-analysis to clarify whether its use plays a role in preventing infections. METHODS: Inclusion criteria: elective cholecystectomy, details about the gallbladder extraction and data about local or systemic infection rate. EXCLUSION CRITERIA: cholecystitis, jaundice, concurrent antibiotic therapy, immunosuppression, cancer...
November 19, 2018: BMC Surgery
Hanyujie Kang, Huqin Yang, Zhaohui Tong
PURPOSE: To determine if recruitment manoeuvres (RMs) would decrease 28-day mortality of patients with acute respiratory distress syndrome (ARDS) compared with standard care. MATERIALS AND METHODS: Relevant randomized controlled trials (RCTs) published prior to April 26, 2018 were systematically searched. The primary outcome was mortality. The secondary outcomes were oxygenation, barotrauma or pneumothorax, the need for rescue therapies. Data were pooled using the random effects model...
November 3, 2018: Journal of Critical Care
Cong Cheng, Bin Chen, Hongwei Xu, Zhongwei Zhang, Weibin Xu
BACKGROUND: Scientific evidence is not clear regarding the routine use of acromioplasty in the treatment of rotator cuff repair. The aim of this study was to compare clinical outcomes between patients undergoing arthroscopic rotator cuff repair with and without concomitant acromioplasty. METHODS: Medline, Cochrane Library, and EMBASE databases were searched to identify eligible studies focused on arthroscopic rotator cuff repair with and without acromioplasty from January 2000 to February 2018...
2018: PloS One
Yangqin Xun, Hongwei Tian, Lidong Hu, Peijing Yan, Kehu Yang, Tiankang Guo
This meta-analysis aims to clarify the clinical impacts of allogeneic blood transfusion (ABT) on hepatectomy outcome in hepatocellular carcinoma (HCC) patients. A systematic literature search was performed for relevant articles in international and Chinese databases up to May 2018. Random- or fixed-effect meta-analysis was used to pool the effect estimates. Publication bias was assessed by Egger's and Peters's test. Heterogeneity was assessed using the I statistic. The strength of evidence was rated by the Grading of Recommendations Assessment, Development, and Evaluation system...
October 2018: Medicine (Baltimore)
Xian Li, Li Zhang, Shuming Gu, Jianfeng Sun, Zongshi Qin, Jiaji Yue, Yu Zhong, Ning Ding, Rui Gao
BACKGROUND: Plantar fasciitis is one of the most common causes of adult heel pain. The aim of this study is to comprehensively compare the effectiveness of various therapies for plantar fasciitis using network meta-analysis. METHODS: Studies were comprehensively searched on Embase, MEDLINE via PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), and the Physiotherapy Evidence Database (PEDro) up to December 4, 2017. Randomized controlled trials that used extracorporeal shock wave therapy, ultrasound, ultrasound-guided pulsed radiofrequency treatment (UG-PRF), intracorporeal pneumatic shock therapy (IPST), low-level laser therapy (LLLT), and noninvasive interactive neurostimulation (NIN) for the treatment of plantar fasciitis were included...
October 2018: Medicine (Baltimore)
Jia Jiang, Da-Xu Ma, Bo Li, An-Shi Wu, Fu-Shan Xue
Background: Awake intubation with videolaryngoscopy (VL) is a novel method that is drawing more and more attention as an alternative to awake intubation with fiberoptic bronchoscope (FOB). This meta-analysis is designed to determine the performance of VL compared to the FOB for awake intubation. Methods: The Cochrane Central Register of Controlled Trials, PubMed, Embase, and Web of science were searched from database inception until October 30, 2017. Randomized controlled trials comparing VL and FOB for awake intubation were selected...
2018: Therapeutics and Clinical Risk Management
Allison Low, Ambar Faridi, Kavita V Bhavsar, Glenn C Cockerham, Michele Freeman, Rochelle Fu, Robin Paynter, Karli Kondo, Devan Kansagara
Intravitreal antivascular endothelial growth factor (VEGF) agents are widely used to treat ocular conditions but the benefits and harms of these treatments are uncertain. We conducted a systematic review to compare the effects of aflibercept, bevacizumab and ranibizumab on best-corrected visual acuity (BCVA) changes, quality of life and ocular or systemic adverse events in patients with neovascular age-related macular degeneration (NVAMD), diabetic macular oedema (DME) and central or branch retinal vein occlusion (RVO)...
November 8, 2018: British Journal of Ophthalmology
Nicola Luigi Bragazzi, Dennis McGonagle, Samaa Watad, Mohammad Adawi, Naim Mahroum, Giovanni Damiani, Rosalynn Conic, Charlie Bridgewood, Hussein Mahagna, Luca Giacomelli, Roberto Eggenhöffner, Mahmud Mahamid, Paolo Daniele Maria Pigatto, Howard Amital, Abdulla Watad
The immunological perturbations associated with systemic lupus erythematosus (SLE) puts many patients at higher risk of infections including pneumococcal pneumonia. However, the uptake and utility of anti-pneumococcal vaccines in SLE patient is both controversial and not completely agreed on. Indeed, several epidemiological studies of anti-pneumococcal vaccine safety and efficacy in SLE have reported short term immunogenicity with elevated anti-pneumococcal antibody titres but inconsistent long term findings with some studies finding poor responses, mainly for long-term immune protection...
November 5, 2018: Autoimmunity Reviews
Julie Wm Egholm, Bolette Pedersen, Ann Merete Møller, Johanna Adami, Carsten B Juhl, Hanne Tønnesen
BACKGROUND: Risky consumption of alcohol is a global problem. More than 3.3 million deaths annually are associated with risky use of alcohol, and global alcohol consumption continues to increase. People who have high alcohol consumption often require planned and emergency surgical procedures.Risky drinking is associated with increased postoperative complications such as infections, cardiopulmonary complications, and bleeding episodes. Alcohol causes disorders of the liver, pancreas, and nervous system...
November 8, 2018: Cochrane Database of Systematic Reviews
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