scholarly journals Meta-analysis of Randomized Controlled Trials of Vancomycin for the Treatment of Patients With Gram-Positive Infections: Focus on the Study Design

2012 ◽  
Vol 87 (4) ◽  
pp. 349-363 ◽  
Author(s):  
Konstantinos Z. Vardakas ◽  
Michael N. Mavros ◽  
Nikolaos Roussos ◽  
Matthew E. Falagas
2020 ◽  
Vol 150 (5) ◽  
pp. 1151-1159 ◽  
Author(s):  
Oliver M Shannon ◽  
Inês Mendes ◽  
Christina Köchl ◽  
Mohsen Mazidi ◽  
Ammar W Ashor ◽  
...  

ABSTRACT Background The endothelium plays a key role in the maintenance of vascular health and represents a potential physiological target for dietary and other lifestyle interventions designed to reduce the risk of cardiovascular diseases (CVD) including stroke or coronary heart disease. Objective To conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) investigating the effects of the Mediterranean dietary pattern (MedDiet) on endothelial function. Methods Medline, Embase, and Scopus databases were searched from inception until January 2019 for studies that met the following criteria: 1) RCTs including adult participants, 2) interventions promoting the MedDiet, 3) inclusion of a control group, and 4) measurements of endothelial function. A random-effects meta-analysis was conducted. Metaregression and subgroup analyses were performed to identify whether effects were modified by health status (i.e., healthy participants versus participants with existing comorbidities), type of intervention (i.e., MedDiet alone or with a cointervention), study duration, study design (i.e., parallel or crossover), BMI, and age of participants. Results Fourteen articles reporting data for 1930 participants were included in the meta-analysis. Study duration ranged from 4 wk to 2.3 y. We observed a beneficial effect of the MedDiet on endothelial function [standardized mean difference (SMD): 0.35; 95% CI: 0.17, 0.53; P <0.001; I2 = 73.68%]. MedDiet interventions improved flow-mediated dilation (FMD)—the reference method for noninvasive, clinical measurement of endothelial function—by 1.66% (absolute change; 95% CI: 1.15, 2.17; P <0.001; I2 = 0%). Effects of the MedDiet on endothelial function were not modified by health status, type of intervention, study duration, study design, BMI, or age of participants (P >0.05). Conclusions MedDiet interventions improve endothelial function in adults, suggesting that the protective effects of the MedDiet are evident at early stages of the atherosclerotic process with important implications for the early prevention of CVD. This study has the PROSPERO registration number: CRD42018106188.


Author(s):  
Sumanta Saha ◽  
Sujata Saha

<p><strong>OBJECTIVE:</strong> A tubo-ovarian abscess needs hospitalization and early treatment with parenteral antibiotics only or along with imaging-guided drainage. This meta-analysis juxtaposes between these interventions - the length of stay in hospital in days, surgery requirement for those not responding to the initial treatment, and readmission.</p><p><strong>STUDY DESIGN:</strong> The eligible papers searched in various databases (PubMed, Central, Embase, and Scopus) irrespective of their language or date of publication. The Joanna Briggs Institute's Critical Appraisal tool and Cochrane collaboration tool were used to appraise observational and randomized controlled trials, respectively. When a comparable outcome was reported from at least three studies of similar study design, they were included in the meta-analysis (fixed-effect model). Otherwise, outcomes were reported narratively.</p><p><strong>RESULTS:</strong> From 164 studies, five eligible papers (four non-randomized studies and one randomized controlled trials) were reviewed. These studies sourced data from 609 tubo-ovarian abscess patients. Overall, all studies had at least one unclear risk of bias components. The length of stay in the hospital among the tubo-ovarian abscess patients favored the initial parenteral antibiotic only treatment (WMD= -3.26; 95% CI= -4.93 to -1.58; p&lt;0.001; I2=80.9%; p-value of Cochranes Q=0.005); however, on sensitivity analysis (meta-analysis with random-effect model) this difference disappeared. Less than three studies of a particular study design reported each of the remaining outcomes.</p><p><strong>CONCLUSION:</strong> The current evidence on how these outcomes vary between the juxtaposed interventions received by the tubo-ovarian abscess patients remains inconclusive due to the inadequate number of good quality randomized controlled trials</p>


2020 ◽  
Vol 146 (12) ◽  
pp. 1117-1145
Author(s):  
Kathryn R. Fox ◽  
Xieyining Huang ◽  
Eleonora M. Guzmán ◽  
Kensie M. Funsch ◽  
Christine B. Cha ◽  
...  

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