Safety and efficacy of Cerebrolysin in early post-stroke recovery: a meta-analysis of nine randomized clinical trials

Objective This meta-analysis was performed to evaluate the safety and efficacy of the oblique-axis plane in ultrasound-guided internal jugular vein puncture. Methods We searched Embase, PubMed, the Cochrane Library, Web of Science, and China National Knowledge Infrastructure for relevant randomized clinical trials comparing the oblique axis with the short axis in ultrasound-guided internal jugular vein puncture. Results Five randomized clinical trials were included in this meta-analysis. The pooled meta-analysis showed that the incidence of arterial puncture in the oblique-axis group was significantly lower than that in the short-axis group. No significant difference was found in the first-pass success rate between the oblique-axis group and short-axis group. Additionally, there were no significant differences in the puncture success rate or number of attempts required between the two groups. Conclusion Ultrasound-guided internal jugular vein puncture using the oblique-axis plane reduced the risk of arterial puncture, but no difference was found in the first-pass success rate, puncture success rate, or number of attempts required.

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Acupuncture Treatments for Post-stroke Depression: A Systematic Review and Network Meta-analysis

10.21203/rs.3.rs-951353/v1 ◽

2021 ◽

Author(s):

Lam Wai Ching ◽

Hui Juan Li ◽

Jianwen Guo ◽

Liang Yao ◽

Janita Chau ◽

...

Keyword(s):

Clinical Trials ◽

Randomized Clinical Trials ◽

Rating Scale ◽

Meta Analysis ◽

Cochrane Library ◽

Depression Symptoms ◽

Post Stroke ◽

Significant Difference ◽

Post Stroke Depression ◽

The Impact

Abstract Background: Depression is one of the most common complications after stroke, with a prevalence of 30-33%. Patients with post-stroke depression (PSD) usually experience anxiety, hopelessness, and insomnia, which have a negative impact on their daily activities and post-stroke rehabilitation. In this review, we aimed to explore the impact of acupuncture in alleviating symptoms of PSD and to evaluate the difference in effectiveness between acupuncture combined with pharmacotherapies and various non-pharmacotherapies in order to provide guides and advice for clinical personnel. Methods: Six databases (Cochrane Library, PubMed, EMBASE, China National Knowledge Infrastructure, Wanfang Database, Chongqing VIP Database) and two clinical trials registration platforms were searched from inception to May 2021. Randomized clinical trials (RCTs) comparing needle-based acupuncture with pharmacotherapy, and other non-pharmacotherapy or invalid group were included. Two independent reviewers identified eligible studies. Two reviewers independently abstracted and recorded data into a pre-made form. A Bayesian network meta-analysis (NMA) was conducted to assess and compare different techniques using RStudio 3.6.0. The primary outcome was the change in scores of scales measuring depressive symptoms. The secondary outcomes were changes in serotonin levels and in quality of life. Results: Fifty-nine RCTs were included. The results of this NMA showed that compared with western medicine (WM), acupuncture alone or with repetitive transcranial magnetic stimulation (RTMS), Traditional Chinese medicine (TCM) alone or with WM, were superior for alleviating depression symptoms. Compared to Usual Care, acupuncture alone or plus other therapies could significantly decrease scores of the Hamilton Depression Rating scale. However, there was no significant difference found among acupuncture, WM, TCM with AC plus any of other treatment.Conclusions: The results of this study indicate that acupuncture alone or combined with other therapies appear to be effective in improving depression symptoms of stroke survivors. Moreover, in comparison with WM, acupuncture alone or plus RTMS, TCM, TCM with WM, or WM, were more effective in improving depression symptoms. Also, acupuncture with RTMS seems to be the most effective with the highest probability.

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Clinical Effectiveness of Traditional Herbal Medicine in the Treatment of Central Post-Stroke Pain and Thalamic Syndrome: a Systemic Review and Meta-analysis of Randomized Clinical Trials Based on Traditional Chinese Medicine Journals

The Journal of Internal Korean Medicine ◽

10.22246/jikm.2019.40.3.295 ◽

2019 ◽

Vol 40 (3) ◽

pp. 295-311

Author(s):

Yu-jin Jung ◽

Eun-jin Kang ◽

Sang-hoon Hong

Keyword(s):

Clinical Trials ◽

Chinese Medicine ◽

Herbal Medicine ◽

Traditional Chinese Medicine ◽

Randomized Clinical Trials ◽

Meta Analysis ◽

Clinical Effectiveness ◽

Systemic Review ◽

Traditional Herbal Medicine ◽

Post Stroke

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Erenumab safety and efficacy in migraine: A systematic review and meta-analysis of randomized clinical trials

Psychoneuroendocrinology ◽

10.1016/j.psyneuen.2019.07.114 ◽

2019 ◽

Vol 107 ◽

pp. 40

Author(s):

Changyu Zhu ◽

Rongsheng Tong ◽

Jianmei Guan ◽

Hua Xiao ◽

Weinan Luo

Keyword(s):

Systematic Review ◽

Clinical Trials ◽

Randomized Clinical Trials ◽

Meta Analysis ◽

Safety And Efficacy

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Early oral protein-containing diets following elective lower gastrointestinal tract surgery in adults: a meta-analysis of randomized clinical trials

Perioperative Medicine ◽

10.1186/s13741-021-00179-3 ◽

2021 ◽

Vol 10 (1) ◽

Author(s):

Hong Pu ◽

Philippa T. Heighes ◽

Fiona Simpson ◽

Yaoli Wang ◽

Zeping Liang ◽

...

Keyword(s):

Clinical Trials ◽

Gastrointestinal Tract ◽

Postoperative Complications ◽

Postoperative Nausea ◽

Randomized Clinical Trials ◽

Meta Analysis ◽

Postoperative Nausea And Vomiting ◽

Surgical Site Infections ◽

Lower Gastrointestinal Tract ◽

Safety And Efficacy

Abstract Background Although current guidelines make consensus recommendations for the early resumption of oral intake after surgery, a recent comprehensive meta-analysis failed to identify any patient-centered benefits. We hypothesized this finding was attributable to pooling studies providing effective protein-containing diets with ineffective non-protein liquid diets. Therefore, the aim of this paper was to investigate the safety and efficacy of early oral protein-containing diets versus later (traditional) feeding after elective lower gastrointestinal tract surgery in adults. Methods PubMed, Embase, and the China National Knowledge Infrastructure databases were searched from inception until 1 August 2019. Reference lists of retrieved studies were hand searched to identify randomized clinical trials reporting mortality. No language restrictions were applied. Study selection, risk of bias appraisal and data abstraction were undertaken independently by two authors. Disagreements were settled by obtaining an opinion of a third author. Majority decisions prevailed. After assessment of underlying assumptions, a fixed-effects method was used for analysis. The primary outcome was mortality. Secondary outcomes included surgical site infections, postoperative nausea and vomiting, serious postoperative complications and other key measures of safety and efficacy. Results Eight randomized clinical trials recruiting 657 patients were included. Compared with later (traditional) feeding, commencing an early oral protein-containing diet resulted in a statistically significant reduction in mortality (odds ratio [OR] 0.31, P = 0.02, I2 = 0%). An early oral protein-containing diet also significantly reduced surgical site infections (OR 0.39, P = 0.002, I2 = 32%), postoperative nausea and vomiting (OR 0.62, P = 0.04, I2 = 37%), serious postoperative complications (OR 0.60, P = 0.01, I2 = 25%), and significantly improved other major outcomes. No harms attributable to an early oral protein-containing diet were identified. Conclusions The results of this systematic review can be used to upgrade current guideline statements to a grade A recommendation supporting an oral protein-containing diet commenced before the end of postoperative day 1 after elective lower gastrointestinal surgery in adults.

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Early Oral Protein-Containing Diets Following Elective Lower Gastrointestinal Tract Surgery in Adults: A Meta-Analysis of Randomized Clinical Trials.

10.21203/rs.3.rs-29449/v1 ◽

2020 ◽

Author(s):

Hong PU ◽

Philippa T. Heighes ◽

Fiona Simpson ◽

Yaoli WANG ◽

Zeping LIANG ◽

...

Keyword(s):

Clinical Trials ◽

Gastrointestinal Tract ◽

Postoperative Complications ◽

Postoperative Nausea ◽

Randomized Clinical Trials ◽

Meta Analysis ◽

Postoperative Nausea And Vomiting ◽

Surgical Site Infections ◽

Lower Gastrointestinal Tract ◽

Safety And Efficacy

Abstract Background: Although current guidelines make consensus recommendations for the early resumption of oral intake after surgery, a recent comprehensive meta-analysis failed to identify any patient-centred benefits. We hypothesized this finding was attributable to pooling studies providing effective protein-containing diets with ineffective non-protein liquid diets. Therefore, the aim of this paper was to investigate the safety and efficacy of early oral protein-containing diets versus later (traditional) feeding after elective lower gastrointestinal tract surgery in adults. Methods: PubMed, Embase and the China National Knowledge Infrastructure databases were searched from inception until 1 August 2019. Reference lists of retrieved studies were hand searched to identify randomized clinical trials reporting mortality. No language restrictions were applied. Study selection, risk of bias appraisal and data abstraction were undertaken independently by two authors. Disagreements were settled by obtaining an opinion of a third author. Majority decisions prevailed. After assessment of underlying assumptions, a fixed-effects method was used for analysis. The primary outcome was mortality. Secondary outcomes included surgical site infections, postoperative nausea and vomiting, serious postoperative complications and other key measures of safety and efficacy . Results: Eight randomized clinical trials recruiting 657 patients were included. Compared with later (traditional) feeding, commencing an early oral protein-containing diet resulted in a statistically significant reduction in mortality (Odds Ratio [OR] 0.31, P =0.02, I 2 =0%). An early oral protein-containing diet also significantly reduced surgical site infections (OR 0.39, P =0.002, I 2 =32%), postoperative nausea and vomiting (OR 0.62, P =0.04, I 2 =37%), serious postoperative complications (OR 0.60, P =0.01, I 2 =25%) and significantly improved other major outcomes. No harms attributable to an early oral protein-containing diet were identified. Conclusions: The results of this systematic review can be used to upgrade current guideline statements to a Grade A recommendation supporting an oral protein-containing diet commenced before the end of postoperative day 1 after elective lower gastrointestinal surgery in adults.

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