scholarly journals GRADE Guidance 24. Optimizing the integration of randomized and non-randomized studies of interventions in evidence syntheses and health guidelines

2021 ◽  
Author(s):  
Carlos A. Cuello-Garcia ◽  
Nancy Santesso ◽  
Rebecca L. Morgan ◽  
Jos Verbeek ◽  
Kris Thayer ◽  
...  
Keyword(s):  
Randomized Studies

Drug-eluting stents for treatment of focal infrapopliteal lesions

VASA ◽  
2012 ◽  
Vol 41 (2) ◽  
pp. 90-95 ◽  
Author(s):  
Rastan ◽  
Noory ◽  
Zeller
Keyword(s):  
Limb Salvage ◽  
Bare Metal Stents ◽  
Target Lesion ◽  
Drug Eluting Stents ◽  
Metal Stents ◽  
Target Lesion Revascularisation ◽  
Randomized Studies ◽  
Drug Eluting ◽  
The Mean

We have investigated the role of drug-eluting stents on patency rates after treatment of focal infrapopliteal lesions in patients with intermittent claudication and critical limb ischemia. Reports indicate that drug-eluting stents reduce the risk of restenosis after percutaneous infrapopliteal artery revascularization. A Pub Med, EMBASE, Cochrane database review search of non-randomized studies investigating patency rates, target lesion revascularisation rates, limb salvage rates and mortality rates in an up to 3-year follow-up period after drug-eluting stent placement was conducted. In addition, preliminary results of randomized studies comparing drug-eluting stents with bare-metal stents and plain balloon angioplasty in treatment of focal infrapopliteal lesions were included in this review. A total of 1039 patients from 10 non-randomized and randomized studies were included. Most commonly used drug-eluting stents were sirolimus-eluting. The mean follow-up period was 12.6 (range 8 - 24). The mean 1-year primary patency rate was 86 ± 5 %. The mean target lesion revascularization rate and limb salvage rate was 9.9 ± 5 % and 96.6 %±4 %, respectively. Results from non-randomized and preliminary results from prospective, randomized trials show a significant advantage for drug-eluting stents in comparison to plain balloon angioplasty and bare-metal stents concerning target lesion patency and in parts target lesion revascularisation. No trial reveals an advantage for drug-eluting stents with regard to limb salvage and mortality.

Primary dysmenorrhea: strategy and tactics of treatment

GYNECOLOGY ◽  
2018 ◽  
Vol 20 (1) ◽  
pp. 31-34
Author(s):  
Yu E Dobrokhotova ◽  
E I Borovkova ◽  
S A Zalesskaia
Keyword(s):  
Clinical Case ◽  
Primary Dysmenorrhea ◽  
Therapeutic Result ◽  
Randomized Studies ◽  
Effect Of Therapy ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

The article summarizes the results of numerous randomized studies and structured the approach to the tactics of managing patients with primary dysmenorrhea. The starting therapy is the administration of non-steroidal anti-inflammatory drugs and/or estrogen-progestational drugs. In the absence of the effect of therapy for 3 months, it is advisable to switch to a drug of another group or a combination of drugs. Failure to achieve the desired therapeutic result within 6 months is the basis for clarifying the diagnosis. The article is illustrated by the clinical case of a patient with primary dysmenorrhea.

scholarly journals Exploring the Relationship between Biologics and Postoperative Surgical Morbidity in Ulcerative Colitis: A Review

2021 ◽  
Vol 10 (4) ◽  
pp. 710
Author(s):  
Abel Botelho Quaresma ◽  
Fernanda da Silva Barbosa Baraúna ◽  
Fábio Vieira Teixeira ◽  
Rogério Saad-Hossne ◽  
Paulo Gustavo Kotze
Keyword(s):  
Ulcerative Colitis ◽  
Postoperative Complications ◽  
Meta Analysis ◽  
Qualitative Evaluation ◽  
Complication Rates ◽  
Surgical Morbidity ◽  
Randomized Studies ◽  
Pubmed Database ◽  
Increased Risk ◽  
The Impact

Background: With the paradigm shift related to the overspread use of biological agents in the treatment of inflammatory bowel diseases (IBD), several questions emerged from the surgical perspective. Whether the use of biologicals would be associated with higher rates of postoperative complications in ulcerative colitis (UC) patients still remains controversial. Aims: We aimed to analyze the literature, searching for studies that correlated postoperative complications and preoperative exposure to biologics in UC patients, and synthesize these data qualitatively in order to check the possible impact of biologics on postoperative surgical morbidity in this population. Methods: Included studies were identified by electronic search in the PUBMED database according to the PRISMA (Preferred Items of Reports for Systematic Reviews and Meta-Analysis) guidelines. The quality and bias assessments were performed by MINORS (methodological index for non-randomized studies) criteria for non-randomized studies. Results: 608 studies were initially identified, 22 of which were selected for qualitative evaluation. From those, 19 studies (17 retrospective and two prospective) included preoperative anti-TNF. Seven described an increased risk of postoperative complications, and 12 showed no significant increase postoperative morbidity. Only three studies included surgical UC patients with previous use of vedolizumab, two retrospective and one prospective, all with no significant correlation between the drug and an increase in postoperative complication rates. Conclusions: Despite conflicting results, most studies have not shown increased complication rates after abdominal surgical procedures in patients with UC with preoperative exposure to biologics. Further prospective studies are needed to better establish the impact of preoperative biologics and surgical complications in UC.

Treating Knee Osteoarthritis With Platelet-Rich Plasma and Hyaluronic Acid Combination Therapy: A Systematic Review

2021 ◽  
pp. 036354652199801
Author(s):  
Michael R. Baria ◽  
W. Kelton Vasileff ◽  
James Borchers ◽  
Alex DiBartola ◽  
David C. Flanigan ◽  
...  
Keyword(s):  
Systematic Review ◽  
Hyaluronic Acid ◽  
Combination Therapy ◽  
Knee Osteoarthritis ◽  
Platelet Rich Plasma ◽  
Case Series ◽  
Final Analysis ◽  
Preparation Technique ◽  
Randomized Studies ◽  
Patient Reported

Background: Platelet-rich plasma (PRP) and hyaluronic acid (HA) are injectable treatments for knee osteoarthritis. The focus of previous studies has compared their efficacy against each other as monotherapy. However, a new trend of combining these 2 injections has emerged in an attempt to have a synergistic effect. Purpose: To systematically review the clinical literature examining the combined use of PRP + HA. Design: Systematic review. Methods: A systematic review was performed according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines using PubMed and Embase. The following search terms were used: knee osteoarthritis AND platelet rich plasma AND hyaluronic acid. The review was performed by 2 independent reviewers who applied the inclusion/exclusion criteria and independently extracted data, including methodologic scoring, PRP preparation technique, HA composition, and patient-reported outcomes (PROs). Results: A total of 431 articles were screened, 12 reviewed in full, and 8 included in the final analysis: 2 case series, 3 comparative, and 3 randomized studies. Average follow-up was 9 months. The modified Coleman Methodology Score was 38.13 ± 13.1 (mean ± SD). Combination therapy resulted in improved PROs in all studies. Of the comparative and randomized studies, 2 demonstrated that combination therapy was superior to HA alone. However, when PRP alone was used as the control arm (4 studies), combination therapy was not superior to PRP alone. Conclusion: Combination therapy with PRP + HA improves PROs and is superior to HA alone but is not superior to PRP alone.

Sign in / Sign up

Export Citation Format

Share Document