Use of pre-operative calcium and vitamin D supplementation to prevent post-operative hypocalcaemia in patients undergoing thyroidectomy: a systematic review

2021 ◽  
pp. 1-6
Author(s):  
A S Khatiwada ◽  
A S Harris
Keyword(s):  
Systematic Review ◽  
Vitamin D ◽  
Clinical Trials ◽  
Total Thyroidectomy ◽  
Risk Reduction ◽  
Operative Treatment ◽  
Absolute Risk ◽  
Absolute Risk Reduction ◽  
Vitamin D Supplementation ◽  
Absolute Reduction

Abstract Objective This systematic review aimed to establish the evidence behind the use of pre-operative calcium, vitamin D or both calcium and vitamin D to prevent post-operative hypocalcaemia in patients undergoing thyroidectomy. Method This review included prospective clinical trials on adult human patients that were published in English and which studied the effects of pre-operative supplementation with calcium, vitamin D or both calcium and vitamin D on the rate of post-operative hypocalcaemia following total thyroidectomy. Results Seven out of the nine trials included reported statistically significantly reduced rates of post-operative laboratory hypocalcaemia (absolute risk reduction, 13–59 per cent) and symptomatic hypocalcaemia (absolute reduction, 11–40 per cent) following pre-operative supplementation. Conclusion Pre-operative treatment with calcium, vitamin D or both calcium and vitamin D reduces the risk of post-operative hypocalcaemia and should be considered in patients undergoing total thyroidectomy.

Folic Acid and Folinic Acid for Reducing Side Effects in Patients Receiving Methotrexate for Rheumatoid Arthritis

2014 ◽  
Vol 41 (6) ◽  
pp. 1049-1060 ◽  
Author(s):  
Beverley Shea ◽  
Michael V. Swinden ◽  
Elizabeth Tanjong Ghogomu ◽  
Zulma Ortiz ◽  
Wanruchada Katchamart ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Clinical Trials ◽  
Folic Acid ◽  
Side Effects ◽  
Folinic Acid ◽  
Risk Reduction ◽  
Absolute Risk ◽  
Absolute Risk Reduction ◽  
Risk Of Bias ◽  
Serum Transaminase

Objective.To perform a systematic review of the benefits and harms of folic acid and folinic acid in reducing the mucosal, gastrointestinal, hepatic, and hematologic side effects of methotrexate (MTX); and to assess whether folic or folinic acid supplementation has any effect on MTX benefit.Methods.We searched the Cochrane Library, MEDLINE, EMBASE, and US National Institutes of Health clinical trials registry from inception to March 2012. We selected all double-blind, randomized, placebo-controlled clinical trials in which adult patients with rheumatoid arthritis (RA) were treated with MTX (dose ≤ 25 mg/week) concurrently with folate supplementation. We included only trials using low-dose folic or folinic acid (a starting dose of ≤ 7 mg weekly) because the high dose is no longer recommended or used. Data were extracted from the trials, and the trials were independently assessed for risk of bias using a predetermined set of criteria.Results.Six trials with 624 patients were eligible for inclusion. Most studies had low or unclear risk of bias for key domains. The quality of the evidence was rated as “moderate” for each outcome as assessed by the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) working group, with the exception of hematologic side effects, which were rated as “low.” There was no significant heterogeneity between trials, including where folic acid and folinic acid studies were pooled. For patients supplemented with any form of exogenous folate (either folic or folinic acid) while receiving MTX therapy for RA, a 26% relative (9% absolute) risk reduction was seen for the incidence of gastrointestinal side effects such as nausea, vomiting, or abdominal pain (RR 0.74, 95% CI 0.59 to 0.92; p = 0.008). Folic and folinic acid also appear to be protective against abnormal serum transaminase elevation caused by MTX, with a 76.9% relative (16% absolute) risk reduction (RR 0.23, 95% CI 0.15 to 0.34; p < 0.00001), as well as reducing patient withdrawal from MTX for any reason [60.8% relative (15.2% absolute) risk reduction, RR 0.39, 95% CI 0.28 to 0.53; p < 0.00001].Conclusion.The results support a protective effect of supplementation with either folic or folinic acid for patients with RA during treatment with MTX. There was a clinically important significant reduction shown in the incidence of GI side effects and hepatic dysfunction (as measured by elevated serum transaminase levels), as well as a clinically important significant reduction in discontinuation of MTX treatment for any reason.

scholarly journals Outcome Reporting Bias in COVID-19 mRNA Vaccine Clinical Trials

Medicina ◽  
2021 ◽  
Vol 57 (3) ◽  
pp. 199
Author(s):  
Ronald B. Brown
Keyword(s):  
Clinical Trials ◽  
Relative Risk ◽  
Risk Reduction ◽  
Relative Risk Reduction ◽  
Absolute Risk ◽  
Absolute Risk Reduction ◽  
Reporting Bias ◽  
Outcome Reporting Bias ◽  
Outcome Reporting ◽  
Risk Reduction Measures

Relative risk reduction and absolute risk reduction measures in the evaluation of clinical trial data are poorly understood by health professionals and the public. The absence of reported absolute risk reduction in COVID-19 vaccine clinical trials can lead to outcome reporting bias that affects the interpretation of vaccine efficacy. The present article uses clinical epidemiologic tools to critically appraise reports of efficacy in Pfzier/BioNTech and Moderna COVID-19 mRNA vaccine clinical trials. Based on data reported by the manufacturer for Pfzier/BioNTech vaccine BNT162b2, this critical appraisal shows: relative risk reduction, 95.1%; 95% CI, 90.0% to 97.6%; p = 0.016; absolute risk reduction, 0.7%; 95% CI, 0.59% to 0.83%; p < 0.000. For the Moderna vaccine mRNA-1273, the appraisal shows: relative risk reduction, 94.1%; 95% CI, 89.1% to 96.8%; p = 0.004; absolute risk reduction, 1.1%; 95% CI, 0.97% to 1.32%; p < 0.000. Unreported absolute risk reduction measures of 0.7% and 1.1% for the Pfzier/BioNTech and Moderna vaccines, respectively, are very much lower than the reported relative risk reduction measures. Reporting absolute risk reduction measures is essential to prevent outcome reporting bias in evaluation of COVID-19 vaccine efficacy.

scholarly journals Vitamin D Supplementation and Breast Cancer Prevention: A Systematic Review and Meta-Analysis of Randomized Clinical Trials

PLoS ONE ◽  
2013 ◽  
Vol 8 (7) ◽  
pp. e69269 ◽  
Author(s):  
Francesca Sperati ◽  
Patrizia Vici ◽  
Marcello Maugeri-Saccà ◽  
Saverio Stranges ◽  
Nancy Santesso ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Systematic Review ◽  
Vitamin D ◽  
Clinical Trials ◽  
Cancer Prevention ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Vitamin D Supplementation ◽  
Breast Cancer Prevention

scholarly journals Vitamin D supplementation and incident preeclampsia: A systematic review and meta-analysis of randomized clinical trials

2020 ◽  
Vol 39 (6) ◽  
pp. 1742-1752 ◽  
Author(s):  
Silvia Fogacci ◽  
Federica Fogacci ◽  
Maciej Banach ◽  
Erin D. Michos ◽  
Adrian V. Hernandez ◽  
...  
Keyword(s):  
Systematic Review ◽  
Vitamin D ◽  
Clinical Trials ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Vitamin D Supplementation

The effect of vitamin D supplementation on the androgenic profile in men: A systematic review and meta‐analysis of clinical trials

Andrologia ◽  
2019 ◽  
Vol 51 (9) ◽  
Author(s):  
Elham Hosseini Marnani ◽  
Mehdi Mollahosseini ◽  
Alireza Gheflati ◽  
Akram Ghadiri‐Anari ◽  
Azadeh Nadjarzadeh
Keyword(s):  
Systematic Review ◽  
Vitamin D ◽  
Clinical Trials ◽  
Meta Analysis ◽  
Vitamin D Supplementation
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