Medical expulsive therapy for ureteric stones: Analysing the evidence from systematic reviews and meta-analysis of powered double-blinded randomised controlled trials

A randomised, double-blinded, controlled trial was performed to compare traditional digital blocks with single subcutaneous palmar injection blocks at the base of the finger. A search for randomised controlled trials of digital blocks through MEDLINE, EMBASE, Cochrane Controlled Trials Register and CBM was conducted and a meta-analysis including the current trial was performed. The current trial showed no difference between traditional digital blocks and single subcutaneous palmar injection bocks at the base of the finger in respect of injection pain and time to anaesthesia. The meta-analysis suggests that traditional digital blocks and single subcutaneous palmar injection blocks are similar with regard to injection pain and are less painful than the transthecal digital block. The palmar techniques, including single subcutaneous palmar block and transthecal block, carry a risk of not anaesthetising the dorsum of the digit adequately, particularly the dorsum of the thumb and the proximal phalanx of the fingers.

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Pharmacotherapeutic Options for Managing Neuropathic Pain: A Systematic Review and Meta-Analysis

Pain Research and Management ◽

10.1155/2021/6656863 ◽

2021 ◽

Vol 2021 ◽

pp. 1-13

Author(s):

Giulia Di Stefano ◽

Andrea Di Lionardo ◽

Giuseppe Di Pietro ◽

Giorgio Cruccu ◽

Andrea Truini

Keyword(s):

Systematic Review ◽

Neuropathic Pain ◽

Systematic Reviews ◽

Randomised Controlled Trials ◽

Fatty Acid Amide Hydrolase ◽

Data Extraction ◽

Meta Analysis ◽

Acid Amide ◽

Controlled Trials ◽

Randomised Controlled

Despite an increasing number of available therapies, the treatment of neuropathic pain remains a major issue. Systematic reviews and meta-analyses indicate that only a minority of patients with neuropathic pain have an adequate response to pharmacological treatment and that most drugs have dose-limiting side effects. We conducted a systematic review and meta-analysis of randomised controlled trials published in the last five years. We searched for relevant papers within PubMed, EMBASE, the Cochrane Database of Systematic Reviews, and the Clinical Trials database (ClinicalTrials.gov). Two authors independently selected studies for inclusion, data extraction, and bias assessment. We identified 39 randomised controlled trials and included 16 in the meta-analysis. Trial outcomes were generally modest even for first-line drugs such as tricyclic antidepressants, serotonin-noradrenaline reuptake inhibitors, and gabapentinoids. Many drugs acting on new pain targets are currently under development. Clinical data are currently available for sodium channel isoform-specific antagonists, anti-nerve growth factor molecules, and fatty acid amide hydrolase inhibitors.

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Movement Disorders Associated With Antipsychotic Medication in People With Schizophrenia: An Overview of Cochrane Reviews and Meta-Analysis

The Canadian Journal of Psychiatry ◽

10.1177/0706743718777392 ◽

2018 ◽

Vol 63 (11) ◽

pp. 730-739 ◽

Cited By ~ 16

Author(s):

Davide Martino ◽

Vikram Karnik ◽

Sydney Osland ◽

Thomas R. E. Barnes ◽

Tamara M. Pringsheim

Keyword(s):

Systematic Reviews ◽

Movement Disorders ◽

Randomised Controlled Trials ◽

Meta Analysis ◽

Controlled Trials ◽

Antipsychotic Medications ◽

Cochrane Reviews ◽

Prevalence Estimates ◽

Randomised Controlled ◽

New Onset

Movement disorders associated with antipsychotic medications are relatively common, stigmatising, and potentially disabling. Their prevalence in people with psychosis who are prescribed second-generation antipsychotics (SGAs) is uncertain, as is their level of recognition by clinicinas. We conducted meta-analyses of randomised controlled trials included in the Cochrane Database of Systematic Reviews on schizophrenia and schizophrenia-like psychoses to estimate the prevalence of new-onset dystonia, akathisia, parkinsonism, and tremor with SGAs (amisulpride, asenapine, aripiprazole, clozapine, olanzapine, paliperidone, quetiapine, risperidone, L-sulpiride, and ziprasidone) approved in Canada and the UK, comparing them with haloperidol and chlorpromazine. We used a random effects model because of the heterogeneity between-studies in drug dosage and method of ascertainment of movement disorders. Our systematic search yielded 37 Cochrane systematic reviews (28 for SGAs), which generated 316 informative randomised controlled trials (243 for SGAs). With respect to SGAs, prevalence estimates ranged from 1.4% (quetiapine) to 15.3% (L-sulpiride) for dystonia, 3.3% (paliperidone) to 16.4% (L-sulpiride) for akathisia, 2.4% (asenapine) to 29.3% (L-sulpiride) for parkinsonism, and 0.2% (clozapine) to 28.2% (L-sulpiride) for tremor. Prevalence estimates were not influenced by treatment duration, the use of a flexible or fixed dosing scheme, or whether studies used validated instruments for the screening/rating of movement disorders. Overall, we found high overlap on the prevalence of new-onset movement disorders across different SGAs precribed for established psychoses. Variations in prevalence figures across antipsychotic medications were observed for the different movement disorders. Differences in pharmacological properties, such as for the dopamine D2 R association rate and serotonin 5-HT2A antagonism, could contribute to this variation.

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Effects of physical exercise during pregnancy on mothers’ and neonates’ health: a protocol for an umbrella review of systematic reviews and meta-analysis of randomised controlled trials

BMJ Open ◽

10.1136/bmjopen-2019-030162 ◽

2019 ◽

Vol 9 (9) ◽

pp. e030162

Author(s):

Gema Sanabria-Martínez ◽

Raquel Poyatos-León ◽

Blanca Notario-Pacheco ◽

Celia Álvarez-Bueno ◽

Iván Cavero-Redondo ◽

...

Keyword(s):

Pregnant Women ◽

Systematic Reviews ◽

Fixed Effects ◽

Randomised Controlled Trials ◽

Meta Analysis ◽

Cochrane Collaboration ◽

Evaluation Framework ◽

Controlled Trials ◽

Randomised Controlled ◽

Meta Analyses

IntroductionA growing interest has emerged on the effects of exercise during gestation. Several systematic reviews and meta-analyses have shown that prenatal exercise could reduce the mothers’ risk for some disorders. Despite this, evidence regarding the risk of caesarean section, birth weight or Apgar score at delivery is still controversial. Furthermore, practitioners are reluctant to recommend exercise to pregnant women suffering from some disorders, such as hypertension, pre-eclampsia or pregnant women with obesity. Moreover, the scarcity of studies addressing the risks and benefits of exercise at higher intensity prevent practitioners from recommending it at higher dosages. Umbrella reviews represent an appropriate design to elucidate the reasons behind the contradictory findings of previous systematic reviews.MethodsThis protocol was developed according to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols and the Cochrane Collaboration Handbook. Medline, EMBASE, Web of Science, Cochrane database of systematic reviews, Epistemonikos, Prospero register and SPORTDiscuss databases will be searched to identify systematic reviews, meta-analyses and randomised controlled trials that examine the effect of exercise on pregnancy outcomes from inception to August 2019. Searches will be conducted from September to November 2019.Statistical analysisMethodological quality will be evaluated using the AMSTAR 2 tool. The certainty of evidence and strength of recommendations for meta-analyses will be assessed by the Grading of Recommendations Assessment, Development and Evaluation framework. The summary effect sizes will be calculated through the use of random-effects and fixed-effects models. Heterogeneity among studies will be assessed using the I2statistic, and evidence of excess significance bias and evidence of small study effects will also be evaluated.Ethics and disseminationEthical approval will not be needed for this review protocol. The results will be disseminated to academic audiences by peer-reviewed publications. Furthermore, results will be disseminated to clinical audiences through professionals’ associations and social networks, and may influence guidelines developers in order to improve outcomes in mothers and offspring.PROSPERO registration numberCRD42019123410.

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