scholarly journals Immune response to nucleotide-supplemented infant formulae: systematic review and meta-analysis

2007 ◽  
Vol 98 (S1) ◽  
pp. S64-S67 ◽  
Author(s):  
Pedro Gutiérrez-Castrellón ◽  
Ignacio Mora-Magaña ◽  
Luisa Díaz-García ◽  
Carlos Jiménez-Gutiérrez ◽  
Jaime Ramirez-Mayans ◽  
...  
Keyword(s):  
Systematic Review ◽  
Breast Milk ◽  
Infant Health ◽  
Respiratory Infections ◽  
Meta Analysis ◽  
Oral Polio Vaccine ◽  
Infant Formulae ◽  
Mean Differences ◽  
Dose Response Effect ◽  
Randomised Controlled

Human milk is recommended as the only alimentary source for the first six months of life. Additionally there is a medical and social need for safe and effective alternative forms of nutrition for infants who cannot be fed with breast milk. Recently the safety and efficacy of some ingredients in infant formulae, such as nucleotides have been discussed. This systematic review analyzed the available evidence to establish the efficacy, safety and dose-response effect of ribonucleotide-supplemented infant formulae (RSIFs). Randomised controlled clinical trials (RCTs) comparing RSIFs to formulae without nucleotides or breast milk were considered in this review. Outcome measures were: antibody titres to common paediatric vaccinations, total lymphocytes, lymphocyte subclasses and NK-cells, episodes of diarrhoea and acute respiratory infection. Publication quality was determined using Jadad and CONSORT guidelines. Results were combined using a random effects model and reported through standardised mean differences (WMD) or risk ratio (RR). Systematic review and meta-analysis showed that RSIFs were associated with a better antibody response to immunisation with Haemopillus influenzae vaccine [SMD 1·74 (99 %CI 1·43–2·05), P = 0·001], diphtheria toxoid [SMD 0·94 (0·75–1·12), P = 0·001], oral polio vaccine [SMD 0·73 (0·51–0·95), P = 0·001], and fewer episodes of diarrhoea [RR 0·67 (0·58–0·76), P = 0·02]. We did not find a major risk of upper respiratory infections [RR 1·11 (0·90–1·36), P = 0·50]. Available evidence suggests a positive benefit of RSFIs on infant health without any risk. These benefits begin with nucleotide addition of 1·9 mg/418·4 kJ and are maintained or increased with 10·78 mg/418·4 kJ.

scholarly journals Protective Treatments against Endothelial Glycocalyx Degradation in Surgery: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 11 (15) ◽  
pp. 6994
Author(s):  
Hasnain Q. R. B. Khan ◽  
Gwendolen C. Reilly
Keyword(s):  
Systematic Review ◽  
Randomised Controlled Trials ◽  
Meta Analysis ◽  
Mean Difference ◽  
The Body ◽  
Endothelial Glycocalyx ◽  
Controlled Trials ◽  
Post Operation ◽  
Mean Differences ◽  
Randomised Controlled

The aim was to explore the body of literature focusing on protective treatments against endothelial glycocalyx degradation in surgery. A comprehensive systematic review of relevant articles was conducted across databases. Inclusion criteria: (1) treatments for the protection of the endothelial glycocalyx in surgery; (2) syndecan-1 used as a biomarker for endothelial glycocalyx degradation. Outcomes analysed: (1) mean difference of syndecan-1 (2) correlation between glycocalyx degradation and inflammation; (3) correlation between glycocalyx degradation and extravasation. A meta-analysis was used to present mean differences and 95% confidence intervals. Seven articles with eight randomised controlled trials were included. The greatest change from baseline values in syndecan-1 concentrations was generally from the first timepoint measured post-operatively. Interventions looked to either dampen the inflammatory response or fluid therapy. Methylprednisolone had the highest mean difference in plasma syndecan-1 concentrations. Ulinastatin showed correlations between alleviation of degradation and preserving vascular permeability. In this systematic review of 385 patients, those treated were more likely than those treated with placebo to exhibit less shedding of the endothelial glycocalyx. Methylprednisolone has been shown to specifically target the transient increase of glycocalyx degradation immediately post-operation and has displayed anti-inflammatory effects. We have proposed suggestions for improved uniformity and enhanced confidence for future randomised controlled trials.

scholarly journals Efficacy and Safety of Intranasal Ketamine for Acute Pain Management in the Emergency Setting: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 10 (17) ◽  
pp. 3978
Author(s):  
Yee Sin Seak ◽  
Junainah Nor ◽  
Tuan Hairulnizam Tuan Kamauzaman ◽  
Ariff Arithra ◽  
Md Asiful Islam
Keyword(s):  
Systematic Review ◽  
Pain Management ◽  
Acute Pain ◽  
Meta Analysis ◽  
Emergency Setting ◽  
Efficacy And Safety ◽  
Acute Pain Management ◽  
Significant Difference ◽  
Mean Differences ◽  
Randomised Controlled

Due to overcrowding, personnel shortages, or problematic intravenous (IV) cannulation, acute pain management is often sub-optimal in emergency departments (EDs). The objective of this systematic review and meta-analysis was to evaluate the efficacy and safety of intranasal (IN) ketamine for adult acute pain in the emergency setting. We searched and identified studies up to 21 May 2021 via PubMed, Scopus, Web of Science, Cochrane Database, and Google Scholar. The random-effects model with 95% confidence intervals (CIs) was used to estimate mean differences (MDs) and odds ratios (ORs). The I2 statistic and Cochran’s Q test were used to determine heterogeneity. The protocol was registered in PROSPERO (CRD42020213391). Seven randomised controlled trials were included with a total of 1760 patients. There was no significant difference in pain scores comparing IN ketamine with IV analgesics or placebo at 5 (MD 0.94, p = 0.26), 15 (MD 0.15, p = 0.74), 25 (MD 0.24, p = 0.62), 30 (MD −0.05, p = 0.87), and 60 (MD −0.42, p = 0.53) minutes. There was also no significant difference in the need for rescue analgesics between IN ketamine and IV analgesics (OR 1.66, 95% CI: 0.57−4.86, p = 0.35, I2 = 70%). Only mild adverse effects were observed in patients who received IN ketamine. Our results suggest that IN ketamine is non-inferior to IV analgesics and may have a role in acute pain management among adults in the ED.

Effects of neurofeedback versus methylphenidate for the treatment of ADHD: systematic review and meta-analysis of head-to-head trials

2019 ◽  
Vol 22 (3) ◽  
pp. 111-117 ◽  
Author(s):  
Lixia Yan ◽  
Siyuan Wang ◽  
Yang Yuan ◽  
Junhua Zhang
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Sensitivity Analyses ◽  
Comparative Efficacy ◽  
Chinese Studies ◽  
Registration Number ◽  
Mean Differences ◽  
Randomised Controlled ◽  
Core Symptoms

BackgroundThe comparative efficacy and tolerability of methylphenidate (MPH) and neurofeedback (NF) in individuals with attention-deficit/hyperactivity disorder (ADHD) remains uncertain. This study aimed to fill this gap by means of a systematic review/meta-analysis.MethodsPubMed, OVID, ERIC, Web of Science, ClinialTrials.gov and a set of Chinese databases were searched until 22 August 2018. Standardised mean differences (SMD) were pooled using comprehensive meta-analysis software.Results18 randomised controlled trials (RCTs) were included (778 individuals with ADHD in the NF arm and 757 in the MPH group, respectively; 13 studies in Chinese, five in English). At the study first endpoint, MPH was significantly more efficacious than NF on ADHD core symptoms (ADHD symptoms combined: SMD=−0.578, 95% CI (−1.063 to –0.092)) and on two neuropsychological parameters (inattention:−0.959 (-1.711 to –0.208); inhibition:−0.469 (-0.872 to –0.066)). Dropouts were significantly lower in NF versus MPH (OR=0.412, 0.186 to 0.913). Results were robust to sensitivity analyses, with two important exceptions: removing Chinese studies and non-funded studies, no differences emerged between MPH and NF, although the number of studies was small. At the study follow-up, MPH was superior to NF in some outcomes, but results were inconsistent across raters.ConclusionsDue to the risk of bias of included studies, the results of the sensitivity analysis excluding Chinese and non-funded studies, and the mixed findings on at the follow-up endpoint, further high quality studies are needed to assess the comparative efficacy and acceptability of NF and MPH in individuals with ADHD.Trial registration numberCRD42018090256.

scholarly journals Effectiveness and safety of acupuncture and moxibustion for defecation dysfunction after sphincter-preserving surgery for rectal cancer: protocol for systematic review and meta-analysis

BMJ Open ◽  
2020 ◽  
Vol 10 (5) ◽  
pp. e034152
Author(s):  
Guixing Xu ◽  
Qiwei Xiao ◽  
Hanzhou Lei ◽  
Yanan Fu ◽  
Jing Kong ◽  
...  
Keyword(s):  
Systematic Review ◽  
Rectal Cancer ◽  
Fixed Effects ◽  
Controlled Trial ◽  
Meta Analysis ◽  
Fixed Effects Model ◽  
Data Synthesis ◽  
Acupuncture And Moxibustion ◽  
Mean Differences ◽  
Randomised Controlled

IntroductionDefecation dysfunction (DD) is one of the most common complications following sphincter-preserving surgery for rectal cancer. And there is no effective treatment of DD after sphincter-preserving surgery for rectal cancer. Although some studies suggested that acupuncture and moxibustion (AM) is effective and safe for DD after sphincter-preserving surgery for rectal cancer, lacking strong evidence, for instance, the relevant systematic review, meta-analysis and randomised controlled trial (RCT) of a large, multicentre sample, makes the effects and safety remain uncertain. The present protocol is described for a systematic review and meta-analysis to investigate the effectiveness and safety of AM for DD after sphincter-preserving surgery for rectal cancer.Methods and analysisWe will search nine online databases from inception to 1 October 2019; the language of included trials will not be restricted. This study will include RCTs that performed AM as the main method of the experimental group for patients with DD after sphincter-preserving surgery for rectal cancer. Two of the researchers will independently select the studies, conduct risk of bias assessment and extract the data. We will use the fixed-effects model or random-effects model of RevMan V.5.2 software to analyse data synthesis. The risk ratios with 95% CIs and weighted mean differences or standardised mean differences with 95% CIs will be used to present the data synthesis outcome of dichotomous data respectively and the continuous data. Evidence quality of outcome will be assessed by using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system.Ethics and disseminationEthical approval is not required in this secondary research evidence, and we will publish the results of this study in a journal or concerned conferences.Trial registration numberCRD42019140097.

scholarly journals Caveat emptor: Folate in unipolar depressive illness, a systematic review and meta-analysis

2018 ◽  
Vol 32 (4) ◽  
pp. 377-384 ◽  
Author(s):  
Emmert Roberts ◽  
Ben Carter ◽  
Allan H Young
Keyword(s):  
Systematic Review ◽  
Depressive Disorders ◽  
Evidence Synthesis ◽  
Meta Analysis ◽  
Unipolar Depression ◽  
Evidence Base ◽  
Depressive Illness ◽  
International Guideline ◽  
Mean Differences ◽  
Randomised Controlled

Background: International guideline recommendations for the use of folate and its derivatives in the treatment of unipolar depressive disorders are confused and contradictory, perhaps reflecting wide variations in the underpinning evidence base. Introduction: We discuss differing methods of evidence synthesis in the formulation of international guideline recommendations. As an example we evaluated the efficacy of folate and its derivatives in unipolar depression via systematic review and meta-analysis. Methods: We searched Medline, EMBASE, PsychInfo and CENTRAL from database inception until 1 May 2017 for randomised controlled trials. We included trials that evaluated folate or its derivatives as monotherapy or to augment antidepressant therapy compared with placebo in patients with unipolar depressive illness. Standardised mean differences were used and studies were introduced as subgroups to explain the heterogeneity. Quality was assessed using the Grading of Recommendations Assessment, Development and Evaluation. Results: No trials report on folate or methylfolate versus placebo as a monotherapeutic option. Only when the evidence was restricted to folate at a dose of <5 mg/day or methylfolate at a dose of 15 mg once daily as an adjunct to selective serotonin reuptake inhibitor therapy was there a significant benefit compared with placebo. All evidence was graded as low or very low quality for each outcome. Discussion: Whilst previous guidelines on the treatment of unipolar depression have either avoided this topic entirely, or made recommendations on the basis of cherry-picked evidence, this review is the first to attempt to provide clinically useful recommendations based on comprehensive, current randomised placebo-controlled data. We invite discussion of the review and its recommendations, which are based on the limited evidence regarding folate formulation delivered and appropriate dosage.

Abstract TP437: Statin Treatment and Accrual of Covert Cerebral Ischemia on Neuroimaging: A Systematic Review and Meta-Analysis of Randomized Trials

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Aristeidis H Katsanos ◽  
Vasileios-Arsenios Lioutas ◽  
Andreas Charidimou ◽  
Luciana Catanese ◽  
Kelvin K Ng ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Statin Treatment ◽  
Cerebral Injury ◽  
White Matter Hyperintensity ◽  
Randomized Controlled ◽  
Mean Differences ◽  
Dose Response Effect ◽  
Risk Ratios ◽  
Middle Cerebral Artery Stenosis

Introduction: Stroke prevention is an established benefit of statin therapy, but the effects of statin treatment on the accrual of MRI markers of ischemic cerebral injury remain unknown. Methods: We performed a systematic review of MEDLINE and SCOPUS databases from inception to July 29 th , 2019 to identify all studies that randomized patients to statin treatment and assessed the effect of statin treatment on incident infarcts (asymptomatic and symptomatic), covert infarcts (asymptomatic evident only in neuroimaging) and white matter hyperintensity (WMH) accrual on magnetic resonance imaging. We included only studies reporting WMH change following normal distribution. We used random effects model to calculate the pooled estimates of the crude risk ratios (RRs) and standardized mean differences (SMDs). Results: We included data from 3 randomized controlled trials with a total of 1399 participants evaluating the effect of rosuvastatin (10mg/d) in 637 hypertensive patients older than 60 years of age over 5 years, pravastatin (40mg/d) in 554 elderly people more than 70 years of age over 3 years and simvastatin (20mg/d) in 208 patients with asymptomatic middle cerebral artery stenosis over 2 years. Patients randomized to statin treatment had decreased accrual of new infarcts (RR=0.59; 95%CI: 0.36, 0.95), new covert infarcts (RR=0.64, 95%CI: 0.46-0.89). Only one study reported WMH decreased volume change in patients randomized to statin treatment compared to patients randomized to non-statin treatment (SMD= -1.16; -1.33, -1.00). Conclusion: Our findings suggest that statin treatment can reduce the accrual of covert MRI markers of ischemic cerebral injury. Dose-response effect and population disparities need to be investigated in future studies.

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