A systematic literature review and meta-analysis of randomized clinical trials of parenteral glutamine supplementation

Despite the large number of available surgical interventions aimed at the treatment of rectovaginal fistulas, the results of their use remain extremely disappointing, associated with the high recurrence rate of the disease reaching 80 %, as well as the lack of a single tactic to minimize the risk of anal incontinence and the need for colostomy. Objective: to conduct a systematic literature review in order to summarize information related to the rectovaginal fistulas surgery. The systematic review includes the results of an analysis of 97 clinical trials selected from 756 publications found in databases. Inclusion criteria: a full-text article, the presence of at least 5 patients in the study, as well as data on the outcome of surgery. Clinical trials with different surgical treatments were identified and classified into the following categories: elimination of the rectovaginal septal defect with a displaced flap (rectal and vaginal); Martius surgery; gracilis muscle transposition; transperineal procedure; abdominal procedure including endoscopic and laparoscopic methods; use of biological or biocompatible materials. Treatment outcomes vary significantly from 0 % to > 80 %. None of the studies were randomized. Due to the low quality of the identified studies, comparison of results and meta-analysis conduction were not possible. Conclusion: as a result of the systematic review, data for the analysis and development of any strategic and tactical algorithms for the treatment of RVF were not obtained. The most important questions still remain open: what and when surgical method to choose, is it necessary to form a disconnecting stoma?

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USE OF FLUNARIZINE AS A PREVENTIVE FOR VESTIBULAR MIGRAINE CRISES IN COMPARISON WITH OTHER DRUGS: SYSTEMATIC LITERATURE REVIEW

10.1101/2021.11.13.21266224 ◽

2021 ◽

Author(s):

Lara Estupina Braghieri ◽

Paula Lopes ◽

Osmar Person ◽

Fernando Junior ◽

Priscila Bogar

Keyword(s):

Literature Review ◽

Systematic Literature Review ◽

Randomized Clinical Trials ◽

Meta Analysis ◽

Vestibular Migraine ◽

Moderate Degree ◽

Level Of Evidence ◽

Grade Method ◽

Episodic Vertigo ◽

Preventive Drug

INTRODUCTION: Vestibular migraine is the main cause of episodic vertigo and the second most common cause of dizziness in adults. Treatment for vestibular migraine encompasses the prevention of crises and the control of acute symptoms. Flunarizine works by preventing the contraction of labyrinthine vessels and altering blood flow, thus preventing symptoms. Due to the high prevalence of the disease, its negative impacts on individual health and increased expenditure on public health, preventive pharmacological and non-pharmacological treatment must be implemented early. PURPOSE: To evaluate the efficacy of Flunarizine as a preventive for migraine and vestibular crises compared to other preventive drugs. MATERIAL AND METHODS: Scientific articles were searched in the databases using the terms (vestibular migraine OR migrainous vertigo) AND (flunarizine) AND (prophylaxis). Subsequently, a systematic literature review and meta-analysis was performed, including 3 randomized clinical trials comparing flunarizine and other preventive drugs in terms of efficacy and safety for preventing migraine vertigo attacks. The studies were analyzed using a ROB table, analysis using the GRADE method and meta-analysis. RESULTS: Qualitatively, the analysis showed that flunariniza was positive for decreasing the frequency of vertigo in cases of vestibular migraine, with a moderate degree of evidence, a relative risk of 0.34 and a confidence interval of 0.15 to 0.76. CONCLUSIONS: There are few studies available in the scientific literature on the use of flunarizine in vestibular migraine, many of which are heterogeneous among themselves, mainly in the way of evaluating and monitoring patients, carried out mainly through subjective methods. The meta-analysis showed a positive result for flunarizine as a preventive drug for the studied population. Furthermore, in all the studies analyzed, no serious side effects resulting from the use of the medication were reported, which makes it safe for patients to use. Flunarizine is a good drug for the prevention of vestibular migraine, especially in reducing the number of attacks, with a good level of evidence.

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Factors influencing efficacy endpoints in clinical trials for new oral medicinal treatments for overactive bladder: a systematic literature review and meta-analysis

International Urology and Nephrology ◽

10.1007/s11255-018-1869-y ◽

2018 ◽

Vol 50 (6) ◽

pp. 1021-1030

Author(s):

Shingo Iino ◽

Masayuki Kaneko ◽

Mamoru Narukawa

Keyword(s):

Clinical Trials ◽

Overactive Bladder ◽

Literature Review ◽

Systematic Literature Review ◽

Meta Analysis ◽

Factors Influencing

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Therapeutic Plasma Exchange in Myasthenia Gravis: A Systematic Literature Review and Meta-Analysis of Comparative Evidence

Frontiers in Neurology ◽

10.3389/fneur.2021.662856 ◽

2021 ◽

Vol 12 ◽

Author(s):

Tina S. Ipe ◽

Adeola R. Davis ◽

Jay S. Raval

Keyword(s):

Literature Review ◽

Myasthenia Gravis ◽

Plasma Exchange ◽

Systematic Literature Review ◽

Randomized Clinical Trials ◽

Meta Analysis ◽

Treatment Options ◽

Therapeutic Plasma Exchange ◽

Cochrane Library ◽

Pubmed Database

Background: Patients with Myasthenia Gravis (MG) can be treated acutely with therapeutic plasma exchange (TPE) or intravenous immune globulin (IVIG). To date, there is no definitive understanding of which of the two treatments is more effective and safer. The purpose of this study was to systematically review the literature on the comparative efficacy and safety of TPE to other available treatments for MG.Methods: A systematic literature search for studies published between 1997 and 2017 was performed per Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines using two database sources, MEDLINE (through the PubMed database) and Cochrane Library.Results: The search strategy resulted in 535 articles whose abstracts were reviewed. Among these, 165 full texts articles were reviewed for eligibility and 101 articles were excluded. Of the 165 articles, 64 articles were included for a systematic literature and 11 articles for a meta-analysis.Conclusions: This systematic literature review and meta-analysis of treatment options showed that there was a higher response rate with TPE than IVIG in acute MG patients and patients undergoing thymectomy. There was no difference in mortality between the two treatment options. Our findings highlight the need for additional randomized clinical trials in these patients with MG.

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P-190: A systematic literature review and indirect treatment comparison among randomized clinical trials to estimate the relative efficacy of treatments for relapsed/refractory multiple myeloma

Clinical Lymphoma Myeloma & Leukemia ◽

10.1016/s2152-2650(21)02317-x ◽

2021 ◽

Vol 21 ◽

pp. S141-S142

Author(s):

Rachel Bhak ◽

Holly Cranmer ◽

Jonathan Dabora ◽

Iryna Bocharova ◽

Dasha Cherepanov ◽

...

Keyword(s):

Multiple Myeloma ◽

Clinical Trials ◽

Literature Review ◽

Systematic Literature Review ◽

Randomized Clinical Trials ◽

Relative Efficacy ◽

Indirect Treatment Comparison ◽

Refractory Multiple Myeloma ◽

Treatment Comparison ◽

Indirect Treatment

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Stannous Fluoride Effects on Enamel: A Systematic Review

Biomimetics ◽

10.3390/biomimetics5030041 ◽

2020 ◽

Vol 5 (3) ◽

pp. 41 ◽

Cited By ~ 4

Author(s):

Luca Fiorillo ◽

Gabriele Cervino ◽

Alan Scott Herford ◽

Luigi Laino ◽

Marco Cicciù

Keyword(s):

Systematic Review ◽

Clinical Trials ◽

Literature Review ◽

Biofilm Formation ◽

Randomized Clinical Trials ◽

Meta Analysis ◽

Gingival Inflammation ◽

Exclusion Criteria ◽

Manual Analysis ◽

Stannous Fluoride

In recent years there has been a lot of talk about toothpastes with a particular chemical compound: stannous fluoride (SnF2). Its presence is currently still highly controversial, as the latter could have negative health effects. The different companies that produce toothpastes express its dosage in ppm. The purpose of this systematic literature review is to analyze all randomized clinical trials in the literature over the last 10 years and to draw clear results on the function of stannous fluoride, for this purpose the authors performed a Mann–Whitney U Test. Materials: The first analysis of the literature produced a number greater than 800 results, subsequently applying the inclusion and exclusion criteria, and following a manual analysis of the results, 26 manuscripts have been obtained. Results: From the results analyzed in this review, it could be shown that stannous fluoride does not present important contraindications, if not those commonly reported for fluorine. A meta-analysis on enamel loss has been conducted, it shows that SnF2 products provide better results with a p < 0.05 value. Conclusion: This compound could have significant effects in favor of erosion and recalcification of the enamel, on the biofilm formation, gingival inflammation, and in addition, it could be an important aid in the removal of tooth stains and halitosis.

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