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Guidelines, Randomized Controlled Trials, Meta analysis

Tim Michael Feenstra, Chris Dickhoff, Jaap Deunk
PURPOSE: Tube thoracostomy is frequently used in thoracic trauma patients. However, there is no consensus on whether low pressure suction or water seal is the optimal method of tube management. Against this background, we performed a systematic review of studies comparing suction and water seal management of chest tubes placed for traumatic chest injuries in adults. Evaluated outcomes are duration of chest tube treatment, length of stay in hospital, incidence of persistent air leak, clotted hemothorax, and the need for (re-)interventions...
March 15, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Myung Han Hyun, Young-Sun Lee, Ji Hoon Kim, Chan Uk Lee, Young Kul Jung, Yeon Seok Seo, Hyung Joon Yim, Jong Eun Yeon, Kwan Soo Byun
According to the American Association for the Study of Liver Disease treatment guidelines for hepatocellular carcinoma (HCC), the role of surgery has been expanded beyond the Barcelona Clinic Liver Cancer (BCLC) algorithm. We compared primary hepatectomy (PH) with transarterial chemoembolization (TACE) in patients with intermediate to advanced (BCLC stage-B/C) stage HCC to determine the current evidence. Through database search, we included 18 high-quality studies (1 randomized controlled trial [RCT], 5 propensity-score matching non-randomized comparative trials [NRCT], and 12 NRCTs) that compared survival outcomes of 5,986 patients after PH and TACE...
March 15, 2018: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
Jihye Seo, Cheol Hyun Kim, Hongmin Chu, Yeonju Moon, Sangkwan Lee
BACKGROUND: Migraine is a common disease of primary headache, which it causes many kinds of secondary diseases or symptoms. The treatment drugs have sometimes shown side effects such as overuse headache, stroke, and cardiovascular disease. Therefore, the demand for complementary and alternative interventions for migraine has increased. Herbal medicines are a representative intervention to treat migraine traditionally. Among these herbal medicines, Banhabaekchulchunma-tang (BBT) and Chongsanggeontong-tang (CGT) have been most commonly used for migraine treatment in traditional clinical practice...
March 2018: Medicine (Baltimore)
Seon Choe, Mudan Cai, Ui Min Jerng, Jun-Hwan Lee
Cognitive impairment is age-related and manageable only with early diagnosis and prevention. Moxibustion is widely accepted in East Asia as useful for preventing cognitive impairment. This systematic review of animal studies was conducted to verify the efficacy of moxibustion in preventing cognitive impairment and to elucidate the underlying mechanism. Randomized controlled animal trials that established the efficacy of moxibustion in preventing cognitive impairment were included in the analysis. Results of behavioral tests and the signaling pathways elucidated were extracted and a meta-analysis was conducted with the behavioral test results...
February 2018: Experimental Neurobiology
Patrick J Lindsay, Danielle Buell, Damon C Scales
BACKGROUND: Mild therapeutic hypothermia (TH), or targeted temperature management, improves survival and neurological outcomes in patients after out-of-hospital cardiac arrest (OHCA). International guidelines strongly support initiating TH for all eligible individuals presenting with OHCA; however, the timing of cooling initiation remains uncertain. This systematic review and meta-analysis was conducted with all available randomised controlled trials (RCTs) included to explore the efficacy and safety of initiating pre-hospital TH in patients with OHCA...
March 13, 2018: Critical Care: the Official Journal of the Critical Care Forum
Haitao Chen, Biao Chen, Kai Tie, Zhengdao Fu, Liaobin Chen
BACKGROUND: Both single-bundle (SB) and double-bundle (DB) techniques were widely used in anterior cruciate ligament (ACL) reconstruction recently. Nevertheless, up to now, no consensus has been reached on whether the DB technique was superior to the SB technique. Moreover, follow-up of the included studies in the published meta-analyses is mostly short term. Our study aims to compare the mid- to long-term outcome of SB and DB ACL reconstruction concerning knee stability, clinical function, graft failure rate, and osteoarthritis (OA) changes...
March 10, 2018: Journal of Orthopaedic Surgery and Research
Bo Zhou, Canyang Zhan, Yuan Ding, Sheng Yan, Shusen Zheng
Background: Treatment for pancreatic neuroendocrine tumors (PNETs) in patients with unresectable metastatic liver disease has long been a controversial issue. This systematic review aims to summarize the existing evidence concerning the value of primary tumor resection in this group of patients. Methods: A systematic review of the literature and a meta-analysis were performed. The PubMed and Cochrane databases were searched to identify articles that compared palliative primary tumor resection and nonsurgical regimens in patients with PNETs and unresectable liver metastases...
2018: OncoTargets and Therapy
Ian Jun Yan Wee, Thomas Stonier, Michael Harrison, Andrew M T L Choong
BACKGROUND: The carotid artery is a novel access route for transcatheter aortic valve implantation (TAVI), especially useful in patients unsuitable for traditional access routes including transfemoral (TF), subclavian, transapical (TAp), and aortic (TAo). This systematic review summarizes the evidence on TAVI via the carotid artery for its efficacy and safety. METHODS: A systematic review was conducted as per the Preferred Reporting Instructions for Systematic Reviews and Meta-analysis (PRISMA) guidelines on three online databases: Medline (via Pubmed), SCOPUS, and Cochrane Database...
February 27, 2018: Journal of Cardiology
Cameron M McDougall, Vin Shen Ban, Jeffrey Beecher, Lee Pride, Babu G Welch
OBJECTIVE The role of venous sinus stenting (VSS) for idiopathic intracranial hypertension (IIH) is not well understood. The aim of this systematic review is to attempt to identify subsets of patients with IIH who will benefit from VSS based on the pressure gradients of their venous sinus stenosis. METHODS MEDLINE/PubMed was searched for studies reporting venous pressure gradients across the stenotic segment of the venous sinus, pre- and post-stent pressure gradients, and clinical outcomes after VSS. Findings are reported according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines...
March 2, 2018: Journal of Neurosurgery
David Bargiela, Misha M Verkerk, Ian Wee, Kiera Welman, Eugene Ng, Andrew M T L Choong
BACKGROUND: Neurofibroblastoma (NF) or Von Recklinghausen disease, is an autosomal dominant disorder affecting one in 3000 individuals. Cardinal features of NF include multiple café-au-lait macules, benign neurofibromas, and iris hamartomas. Albeit less common, vascular lesions of medium and large-sized arteries and veins are a well-recognized complication, which can lead to fatal consequences such as rupture. METHOD: A systematic review was conducted as per the Preferred Reporting Instructions for Systematic Reviews and Meta-analysis (PRISMA) guidelines utilizing PubMed, EMBASE, and Cochrane databases...
March 2018: European Journal of Radiology
Oscar J Manrique, Kian Adabi, Jorys Martinez-Jorge, Pedro Ciudad, Fabio Nicoli, Kidakorn Kiranantawat
INTRODUCTION: There is an increased need for evidence-based practices in male-to-female (MtF) transgender vaginoplasty. Although there are a multitude of surgical techniques, there is a paucity of data comparing these procedures. A systematic review of retrospective studies on the outcomes of MtF vaginoplasty was conducted to minimize surgical complications and improve patient outcomes for transgender patients. METHODS: Applying the Preferred Reporting Items for Systematic Review and Meta-Analysis, a comprehensive search of several databases from 1985 to November 7, 2017, was conducted...
February 28, 2018: Annals of Plastic Surgery
Aixin Song, Xinchao Liu, Xiaojie Huang, Kathrine Meyers, Djin-Ye Oh, Jianhua Hou, Wei Xia, Bin Su, Ni Wang, Xiaofan Lu, Huan Xia, Xiaodong Yang, Hui Chen, Hao Wu
Background: The World Health Organization (WHO) Consolidated antiretroviral therapy (ART) guidelines set the CD4+ T-cell counts threshold to 500 cells/mm3 in 2013, and 2015 guidelines recommend treating all HIV-infected adults regardless of their CD4+ T-cell counts. To inform the decision-making around ART guidelines for people living with HIV, we systematically reviewed the literature to estimate differences in clinical benefits between individuals starting treatment with baseline CD4+ T-cell counts ≥500 cells/mm3 (early initiation) as compared to <500 cells/mm3 (deferred initiation)...
2018: Frontiers in Immunology
L Iacoviello, M Bonaccio, G Cairella, M V Catani, S Costanzo, L D'Elia, R Giacco, D Rendina, P Sabino, I Savini, P Strazzullo
BACKGROUND AND AIMS: To systematically review the latest evidence on established and emerging nutrition-related risk factors for incidence of and mortality from total, ischemic and haemorrhagic strokes. The present review was conducted in the framework of the work carried out through 2015 and 2016 for the preparation of the Italian Guidelines for the Prevention and Treatment of Stroke, 8th Edition, by ISO-SPREAD (Italian Stroke Organization and the Stroke Prevention and Educational Awareness Diffusion)...
January 17, 2018: Nutrition, Metabolism, and Cardiovascular Diseases: NMCD
Marion Savina, Sophie Gourgou, Antoine Italiano, Derek Dinart, Virginie Rondeau, Nicolas Penel, Simone Mathoulin-Pelissier, Carine Bellera
BACKGROUND: In cancer randomized controlled trials (RCT), alternative endpoints are increasingly being used in place of overall survival (OS) to reduce sample size, duration and cost of trials. It is necessary to ensure that these endpoints are valid surrogates for OS. Our aim was to identify meta-analyses that evaluated surrogate endpoints for OS and assess the strength of evidence for each meta-analysis (MA). MATERIALS AND METHODS: We performed a systematic review to identify MA of cancer RCTs assessing surrogate endpoints for OS...
March 2018: Critical Reviews in Oncology/hematology
Zhengrui Fan, Jianxiong Ma, Mingjie Kuang, Lukai Zhang, Biao Han, Baocheng Yang, Ying Wang, Xinlong Ma
BACKGROUND: Total knee arthroplasty (TKA) is gradually emerging as the treatment of choice for end-stage osteoarthritis. In the past, Perioperative dexamethasone treatment is still a controversial subject in total knee arthroplasty. Therefore, we write this systematic review and meta-analysis to evaluate the efficacy of dexamethasone on pain and recovery after Total knee Arthroplasty. MATERIALS AND METHODS: Embase, Pubmed, and Cochrane Library were comprehensively searched...
February 23, 2018: International Journal of Surgery
Andrea Cipriani, Toshi A Furukawa, Georgia Salanti, Anna Chaimani, Lauren Z Atkinson, Yusuke Ogawa, Stefan Leucht, Henricus G Ruhe, Erick H Turner, Julian P T Higgins, Matthias Egger, Nozomi Takeshima, Yu Hayasaka, Hissei Imai, Kiyomi Shinohara, Aran Tajika, John P A Ioannidis, John R Geddes
BACKGROUND: Major depressive disorder is one of the most common, burdensome, and costly psychiatric disorders worldwide in adults. Pharmacological and non-pharmacological treatments are available; however, because of inadequate resources, antidepressants are used more frequently than psychological interventions. Prescription of these agents should be informed by the best available evidence. Therefore, we aimed to update and expand our previous work to compare and rank antidepressants for the acute treatment of adults with unipolar major depressive disorder...
February 20, 2018: Lancet
Conor McLister, Michael Donnelly, Christopher R Cardwell, Ciaran Moore, Ciaran O'Neill, Paul Brocklehurst, Gerald McKenna
OBJECTIVES: A systematic review of randomised and non-randomised controlled trials was conducted to evaluate studies of the effectiveness of different tooth replacement strategies in adult patients with shortened dental arches. The objectives of the review were to determine the survival rates of different prosthodontic interventions, the risk of tooth loss with and without prosthodontic interventions, and the impact of different tooth replacement strategies on oral-health related quality of life (OHRQoL)...
February 21, 2018: Journal of Dentistry
Seihee Kim, Jinseub Hwang, Min Jee Kim, Jae-Young Lim, Woo Hyung Lee, Ji Eun Choi
OBJECTIVES: Rotator cuff tear is the leading cause of the decline in quality of life for older adults, but comparative evidence on treatment effectiveness is lacking. This study systematically reviewed the effects of various rotator cuff tear treatments through a Bayesian meta-analysis of the related randomized clinical trials (RCTs). METHODS: We searched nine electronic databases for RCTs evaluating rotator cuff tear treatments from their inception through June 2017...
February 22, 2018: International Journal of Technology Assessment in Health Care
Eoghan T Hurley, Daren Lim Fat, Cathal J Moran, Hannan Mullett
BACKGROUND: Basic science studies suggest that platelet-rich therapies have a positive effect on tendon repair. However, the clinical evidence is conflicted on whether this translates to increased tendon healing and improved functional outcomes. PURPOSE: To perform a systematic review of randomized controlled trials (RCTs) in the literature to ascertain whether platelet-rich plasma (PRP) or platelet-rich fibrin (PRF) improved patient outcomes in arthroscopic rotator cuff repair...
February 1, 2018: American Journal of Sports Medicine
Fengwen Yang, Jiahan Zou, Long Ge, Jinhui Tian, Myeong Soo Lee, Ji Hee Jun, Junhua Zhang
BACKGROUND: Chinese herbal injections (CHIs) are commonly used for the treatment of heart failure in China. Due to the variety of CHIs used in clinic, selecting a suitable CHI for patients with heart failure is vital. This study aims to assess and compare the effect of different CHIs for heart failure using network meta-analysis (NMA). METHODS: Six electronic databases, including PubMed, the Cochrane Central Register of Controlled Trials, Embase, China National Knowledge Infrastructure, Wanfang, and Chinese Biomedical Literature Database will be search from inception to January 2018...
February 2018: Medicine (Baltimore)
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