Systematic review and meta-analysis of randomised controlled trials of bitemporal versus high-dose right unilateral ECT for depression

2017 ◽  
Vol 10 (2) ◽  
pp. 358
Author(s):  
D.M. McLoughlin ◽  
E. Kolshus ◽  
A. Jelovac
Keyword(s):  
Systematic Review ◽  
Randomised Controlled Trials ◽  
Meta Analysis ◽  
Controlled Trials ◽  
High Dose ◽  
Randomised Controlled

scholarly journals Pharmacological interventions for the prevention of contrast-induced acute kidney injury in high-risk adult patients undergoing coronary angiography: a systematic review and meta-analysis of randomised controlled trials

Open Heart ◽  
2019 ◽  
Vol 6 (1) ◽  
pp. e000864 ◽  
Author(s):  
Alexander J Sharp ◽  
Nishith Patel ◽  
Barney C Reeves ◽  
Gianni D Angelini ◽  
Francesca Fiorentino
Keyword(s):  
Systematic Review ◽  
Acute Kidney Injury ◽  
High Risk ◽  
Coronary Angiography ◽  
Randomised Controlled Trials ◽  
Meta Analysis ◽  
Kidney Injury ◽  
Controlled Trials ◽  
High Dose ◽  
Randomised Controlled

ObjectiveQuantify the efficacy of strategies to prevent contrast-induced acute kidney injury (CI-AKI) in high-risk patients undergoing coronary angiography (CAG) with or without percutaneous coronary intervention (PCI).BackgroundCI-AKI remains a common problem. The renoprotective efficacy of existing pharmacological agents remains uncertain in high-risk populations.MethodsSystematic review and meta-analysis of randomised controlled trials (RCTs) to compare different strategies versus hydration in patients with chronic kidney disease (CKD) undergoing CAG±PCI. Primary outcome was incident CI-AKI. Fixed-effects meta-analyses estimated ORs, 95% CIs and heterogeneity.ResultsForty-eight RCTs were included. Seven pharmacological strategies were evaluated by multiple RCTs and 10 by one RCT each. These had varying risk of bias; >25% of trials were at high risk of performance bias. Five strategies significantly reduced the odds of CI-AKI: N-acetylcysteine (NAC) (27 trials, 5694 participants; OR=0.77, 95% CI 0.65 to 0.91, p=0.002, I2=36%), ascorbic acid (four trials, 759 participants; OR=0.59, 95% CI 0.39 to 0.89, p=0.01, I2=0%), statin (two trials, 3234 participants; OR=0.59, 95% CI 0.39 to 0.89, p=0.75, I2=0%), trimetazidine (two trials, 214 participants; OR=0.27, 95% CI 0.10 to 0.71, p=0.01, I2=0%) and nicorandil (two trials, 389 participants; OR=0.47, 95% CI 0.23 to 0.94, p=0.03, I2=52%). Theophylline had a similar, but non-significant, effect. A subgroup analysis found that the benefit of NAC was highest in patients requiring a high-contrast dose.ConclusionsSeveral drugs are renoprotective in patients with CKD undergoing CAG±PCI. The evidence is strongest for NAC. We recommend that NAC should be used when a high dose of contrast is anticipated.Trial registration numberPROSPERO registration CRD42014014704.Open Science Framework link: https://osf.io/vxg7d/?view_only=62bad0404b18405abd39ff2ead2575a8

scholarly journals Efficacy of antimicrobial lock solutions in preventing catheter-related blood stream infection in haemodialysis patients: a systematic review and meta-analysis of prospective randomised controlled trials

2016 ◽  
Vol 31 (3) ◽  
pp. 95-102
Author(s):  
Ahmad M. Yakasai ◽  
Hamza Muhammad ◽  
Garba Iliyasu ◽  
Aisha M. Nalado ◽  
Mahmood M. Dalhat ◽  
...  
Keyword(s):  
Systematic Review ◽  
Randomised Controlled Trials ◽  
Low Dose ◽  
Blood Stream Infection ◽  
Meta Analysis ◽  
Blood Stream ◽  
Controlled Trials ◽  
High Dose ◽  
Significant Difference ◽  
Randomised Controlled

Background: Catheter-related blood stream infection (CRBSI) contributes to morbidity and mortality among patients on haemodialysis (HD). We carried out a systematic review and meta-analysis to assess the efficacy of antimicrobial lock solutions (ALS) in preventing CRBSI.Method: Electronic search of randomised controlled trials (RCTs) comparing ALS with other agents was performed up to January 2013. DerSimonian and Laird meta-analysis was performed to obtain pooled relative risk (RR) from which efficacy of ALS and numbers needed to treat (NNT) were calculated. In a restricted analysis, pooled RRs where compared using a test of interaction to calculate ratio of relative risks (RRR). Meta-regression analysis was employed to explore sources of heterogeneity.Results: Sixteen RCTs involving 2016 individuals met the inclusion criteria. The efficacy of ALS in preventing CRBSI was 80% with NNT of 3 patients to prevent one CRBSI. The RR of CRBSI was significantly lower with ALS compared with heparin-only lock solution [RR {95% confidence interval (CI)} = 0.20 (0.13-0.31)]. With low dose (≤ 5 mg/ml) and high dose (40 mg/ ml) gentamicin-containing ALS, the RR (95% CI) of developing CRBSI was 0.03 (0.01-0.13) and 0.18 (0.03-0.98), respectively, with no significant difference [RRR (95% CI) = 0.2 (0.02-1.61), p = 0.126]. Heterogeneity was explained by a statistically significant association between rate of CRBSI and catheter days (p = 0.037). Conclusion: ALS are effective in preventing CRBSI. Low dose gentamicin should be preferred over high dose gentamicin as an ALS because it offers similar benefit in preventing CRBSI with lesser risk of toxicity from systemic leakage and subsequent development of drug resistance.

Do sleep interventions change sleep duration in children aged 0-5 years? A systematic review and meta-analysis of randomised controlled trials

2021 ◽  
pp. 101498
Author(s):  
LouiseJ. Fangupo ◽  
Jillian J. Haszard ◽  
Andrew N. Reynolds ◽  
Albany W. Lucas ◽  
Deborah R. McIntosh ◽  
...  
Keyword(s):  
Systematic Review ◽  
Sleep Duration ◽  
Randomised Controlled Trials ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Randomised Controlled

scholarly journals Comparative efficacy and safety of interventions for treating head lice: a protocol for systematic review and network meta-analysis

2021 ◽  
Vol 5 (1) ◽  
pp. e001129
Author(s):  
Bill Stevenson ◽  
Wubshet Tesfaye ◽  
Julia Christenson ◽  
Cynthia Mathew ◽  
Solomon Abrha ◽  
...  
Keyword(s):  
Systematic Review ◽  
Randomised Controlled Trials ◽  
Meta Analysis ◽  
Grey Literature ◽  
Risk Of Bias ◽  
Controlled Trials ◽  
Head Lice ◽  
Efficacy And Safety ◽  
Randomised Controlled ◽  
Meta Analyses

BackgroundHead lice infestation is a major public health problem around the globe. Its treatment is challenging due to product failures resulting from rapidly emerging resistance to existing treatments, incorrect treatment applications and misdiagnosis. Various head lice treatments with different mechanism of action have been developed and explored over the years, with limited report on systematic assessments of their efficacy and safety. This work aims to present a robust evidence summarising the interventions used in head lice.MethodThis is a systematic review and network meta-analysis which will be reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement for network meta-analyses. Selected databases, including PubMed, Embase, MEDLINE, Web of Science, CINAHL and Cochrane Central Register of Controlled Trials will be systematically searched for randomised controlled trials exploring head lice treatments. Searches will be limited to trials published in English from database inception till 2021. Grey literature will be identified through Open Grey, AHRQ, Grey Literature Report, Grey Matters, ClinicalTrials.gov, WHO International Clinical Trials Registry and International Standard Randomised Controlled Trials Number registry. Additional studies will be sought from reference lists of included studies. Study screening, selection, data extraction and assessment of methodological quality will be undertaken by two independent reviewers, with disagreements resolved via a third reviewer. The primary outcome measure is the relative risk of cure at 7 and 14 days postinitial treatment. Secondary outcome measures may include adverse drug events, ovicidal activity, treatment compliance and acceptability, and reinfestation. Information from direct and indirect evidence will be used to generate the effect sizes (relative risk) to compare the efficacy and safety of individual head lice treatments against a common comparator (placebo and/or permethrin). Risk of bias assessment will be undertaken by two independent reviewers using the Cochrane Risk of Bias tool and the certainty of evidence assessed using the Grading of Recommendations, Assessment, Development and Evaluations guideline for network meta-analysis. All quantitative analyses will be conducted using STATA V.16.DiscussionThe evidence generated from this systematic review and meta-analysis is intended for use in evidence-driven treatment of head lice infestations and will be instrumental in informing health professionals, public health practitioners and policy-makers.PROSPERO registration numberCRD42017073375.

scholarly journals Corticosteroid Injection Alone or Combined with Surgical Excision of Keloids versus Other Therapies Including Ionising Radiotherapy: A Systematic Review and Meta-Analysis of Randomised Controlled Trials

2021 ◽  
Vol 2 (2) ◽  
pp. 41-54
Author(s):  
Ru Wang ◽  
Patricia L. Danielsen ◽  
Magnus S. Ågren ◽  
Janine Duke ◽  
Fiona Wood ◽  
...  
Keyword(s):  
Systematic Review ◽  
Randomised Controlled Trials ◽  
Corticosteroid Injection ◽  
Meta Analysis ◽  
Interferon Α ◽  
Surgical Removal ◽  
Controlled Trials ◽  
Intralesional Corticosteroid ◽  
Intralesional Injections ◽  
Randomised Controlled

Keloid scars are difficult to manage and remain a therapeutic challenge. Corticosteroid therapy alone or ionising radiation (radiotherapy) alone or combined with surgery are first-line treatments, but the scientific justification for these treatments is unclear. The aim of this systematic review and meta-analysis of randomised controlled trials (RCTs) is to assess the effects of intralesional corticosteroid injection in treating keloids or preventing their recurrence after surgical removal. Searches for RCTs were conducted through the MEDLINE, EMBASE, EBSCO and Cochrane databases from January 1974 to September 2017. Two authors independently reviewed study eligibility, extracted data, analysed the results, and assessed methodological quality. Sixteen RCTs that included more than 814 patients were scrutinised. The quality of evidence for most outcomes was moderate to high. In 10 RCTs, corticosteroid intralesional injections were compared with 5-fluorouracil, etanercept, cryosurgery, botulinum toxin, topical corticosteroid under a silicone dressing, and radiotherapy. Corticosteroid intralesional injections were more effective than radiotherapy (RR 3.3, 95% CI: 1.4–8.1) but equipotent with the other interventions. In conjunction with keloid excision, corticosteroid treatment was compared with radiotherapy, interferon α-2b and verapamil. In two RCTs, there were fewer keloid recurrences (RR 0.43, 95% CI: 0.21–0.89) demonstrated with adjuvant radiotherapy than with corticosteroid injections. More high-quality, large-scale RCTs are required to establish the effectiveness of corticosteroids and other therapies in keloid management.

Sign in / Sign up

Export Citation Format

Share Document