PP137 Toric Intraocular Lenses and Spectacle Independence: A Systematic Review

2019 ◽  
Vol 35 (S1) ◽  
pp. 64-64
Author(s):  
Derek O'Boyle ◽  
Caridad Perez Vives ◽  
Jan de Haan ◽  
Frank Ender ◽  
Rafael Busutil
Keyword(s):  
Cataract Surgery ◽  
Randomized Controlled Trials ◽  
Intraocular Lenses ◽  
Cochrane Library ◽  
Control Group ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Number Of Patients ◽  
Toric Iols ◽  
Cataract Patients

IntroductionAstigmatism is a common ocular condition that causes reduced visual acuity. The condition is highly prevalent in cataract patients, with preoperative astigmatism of at least 0.5 diopters being present in 78 percent of cataractous eyes. Residual uncorrected astigmatism after cataract surgery is associated with significant costs, primarily driven by the lifetime cost of spectacles (estimated at EUR 1,608 to EUR 3,608 in Europe). Toric intraocular lenses (IOLs) are a safe and effective way of correcting astigmatism, while also reducing the need for spectacles after cataract surgery. The objective of this review was to assess the published evidence relating to spectacle independence in patients implanted with toric IOLs, compared with those receiving non-toric IOLs with or without astigmatism reducing surgical interventions (SI).MethodsA systematic literature search was conducted of the EMBASE, MEDLINE, and Cochrane Library databases. Articles were selected if they included adult patients undergoing phacoemulsification who had age-related cataracts and preoperative regular corneal astigmatism of at least 0.5 diopters, and assessed spectacle independence as an outcome.ResultsSeven studies met the inclusion criteria: four randomized controlled trials and one non-randomized comparative study comparing toric IOLs with non-toric IOLs, and two randomized controlled trials comparing toric IOLs with non-toric IOLs plus SI. Spectacle independence was evaluated as the number of patients who reported not requiring spectacles for distance viewing at 3 or 6 months. Figures for spectacle independence ranged from 60 to 100 percent for toric IOLs, 31 to 50 percent for non-toric IOLs, and 36 to 65 percent for non-toric IOLs plus SI. In each study, toric IOLs demonstrated superior spectacle independence compared with the control group.ConclusionsThe benefits of toric IOL implantation for astigmatic cataract patients included a higher rate of spectacle independence, compared with non-toric IOLs with or without SI. For this group of patients, the lifetime economic burden of spectacle acquisition costs can be reduced with the implantation of toric IOLs during cataract surgery.

Efficacy and Safety of Non-Steroidal Anti-Androgens in Patients with Metastatic Prostate Cancer: Meta-Analysis of Randomized Controlled Trials

2020 ◽  
Vol 15 (1) ◽  
pp. 34-47 ◽  
Author(s):  
Muhammed Rashid ◽  
Madhan Ramesh ◽  
K. Shamshavali ◽  
Amit Dang ◽  
Himanshu Patel ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Adverse Events ◽  
Randomized Controlled Trials ◽  
Quality Assessment ◽  
Cochrane Library ◽  
Control Group ◽  
Controlled Trials ◽  
Efficacy And Safety ◽  
Randomized Controlled ◽  
Significant Difference

Background: Prostate cancer (PCa) is the sixth primary cause of cancer death. However, conflicts are present about the efficacy and safety of Non-steroidal anti-androgens (NSAA) for its treatment. The aim of this study was to assess the efficacy and safety of NSAAs versus any comparator for the treatment of advanced or metastatic PCa (mPCa). Methodology: MEDLINE and the Cochrane Library were searched. References of included studies and clinicaltrials.gov were also searched for relevant studies. Only English language studies after 1990 were considered for review. Randomized controlled trials (RCTs) examining the efficacy and safety of NSAAs as compared with any other comparator including surgery or chemotherapy in mPCa patients were included. The outcomes include efficacy, safety and the tolerability of the treatment. The Cochrane Risk of Bias Assessment Tool was used for quality assessment. Two authors were independently involved in the selection, extraction and quality assessment of included studies and disagreements were resolved by discussion or by consulting a third reviewer. Results: Fifty-eight out of 1307 non-duplicate RCTs with 29154 patients were considered for the review. NSAA showed significantly better progression-free survival [PFS] (Hazard ratio [HR], 0.60; 95% confidence interval [CI], 0.46-0.78; P=0.0001), time to distant metastasis or death [TTD] (HR, 0.80; 95% CI 0.73-0.91; p<0.0001), objective response (Odds ratio [OR], 1.64; 95% CI 1.06-2.54; P=0.03) and clinical benefits (OR, 1.33; 95% CI 1.08-1.63; P=0.006) as compared to the control group. There was no significant difference observed between the groups in terms of overall survival (HR, 0.95; 95%CI, 0.87-1.03; P=0.18) and time to progression (HR, 0.93; 95% CI 0.77-1.11; P=0.43). Treatment-related adverse events were more with the NSAA group, but the discontinuation due to lack of efficacy reason was 43% significantly lesser than the control group in patients with mPCa. Rest of the outcomes were appeared to be non-significant. Conclusion: Treatment with NSAA was appeared to be better efficacious with respect to PFS, TTD, and response rate with considerable adverse events when compared to the control group in patients with metastatic PCa.

scholarly journals Impact of Ketamine on Pain Management in Cesarean Section: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 2;23 (4;2) ◽  
pp. 135-148
Author(s):  
Zifeng Xu
Keyword(s):  
Cesarean Section ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Control Group ◽  
Controlled Trials ◽  
Control Effect ◽  
Randomized Controlled ◽  
Time Required ◽  
The Cochrane Library

Background: The pain control effect of ketamine versus control in women during cesarean operation is not well determined. Objectives: The present meta-analysis aimed to evaluate the clinical efficacy of ketamine versus control in cesarean section anesthesia for reducing the postoperative pain and analgesia. Study Design: We used meta-analysis to address this concern. Setting: Meta-analysis-based study. Methods: The databases PubMed, Embase, and the Cochrane Library were systematically searched to identify the relevant randomized controlled trials (RCTs) of ketamine versus control in controlling pain after cesarean section from inception to August 2018. Based on the Cochrane Handbook, the combined analysis was performed using Revman 5.3 software. Results: A total of 20 RCTs with 1,737 patients who underwent cesarean section were included. Meta-analysis showed that the pain score in the ketamine group was less than that of the control group (mean difference [MD], –1.10; 95% confidence interval [CI], –1.61, –0.59; P < 0.0001). Application of ketamine during cesarean section also resulted in decreased consumption of morphine when compared with the control group (MD, –6.11 mg; 95% CI, –9.93, –2.29; P = 0.002). In addition, the first time required for analgesia was significantly longer in the ketamine group than that of the control group (MD, 72.48 minutes; 95% CI, 50.85, 94.11; P < 0.00001). Limitations: Limited patients were included with moderate strength. Conclusions: Ketamine supplementation during cesarean section reduces pain and morphine consumption and prolongs the postoperative analgesia. Key words: Ketamine, cesarean section, randomized controlled trials, meta-analysis

scholarly journals Ear Acupressure for Allergic Rhinitis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2021 ◽  
Vol 2021 ◽  
pp. 1-20
Author(s):  
Juan Zhong ◽  
Shuqin Liu ◽  
Dan Lai ◽  
Tao Lu ◽  
Yifeng Shen ◽  
...  
Keyword(s):  
Systematic Review ◽  
Allergic Rhinitis ◽  
Randomized Controlled Trials ◽  
Symptom Score ◽  
Latin American ◽  
Cochrane Library ◽  
Control Group ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Randomized Controlled

Background. The treatment effects and safety of ear acupressure (EAP) for patients with allergic rhinitis (AR) have yet to be clarified. Objective. To evaluate the effects and safety of EAP in AR patients. Design. Systematic review of published studies. Methods. A total of 24 English and Chinese databases (PubMed, EMBASE (Excerpta Medical Database), Cochrane Central Register of Controlled Trials, CINAHL, Informit, ScienceDirect, LILACS (Latin American and Caribbean Health Sciences), ProQuest, AMED, Blackwell Synergy, PsycINFO, Panteleimon, AcuBriefs, KoreaMed, IndMed, Ingenta, mRCT, ISI Web of Knowledge, ERIC, VIP Information (http://www.cqvip.com), China National Knowledge Infrastructure (http://www.cnki.net), Cochrane Library, Chinese Cochrane Centre Controlled Trials Register Platform, and Wanfang Chinese Digital Periodical and Conference Database) were searched from their respective inceptions to August 2020 to collect randomized controlled trials of ear acupressure for allergic rhinitis. We performed literature inclusion, data extraction, and trial quality evaluations. Methodological quality was assessed according to the Cochrane Handbook. Revman5.3 was used for all analyses. Results. A total of 203 trials were identified and eleven studies involved 1094 participants aged 3–70 years. EAP was better than control group interventions in terms of effectiveness (risk ratio (RR): 0.51; 95% confidence interval (CI): 0.36–0.70; P < 0.0001 ). EAP was superior to sham EAP in terms of improvement of the total nasal symptom score (RR: −0.50; 95% CI: −0.96–0.05; P = 0.03), sneezing score (RR: −0.36; 95% CI: −0.59–0.12; P = 0.003), global QoL score (RR: 0.42; 95% CI: 0.04–0.08; P = 0.03), and eye symptom score (RR: −0.36; 95% CI: −0.67–0.05; P = 0.02). Conclusions. Despite the positive results, it is premature to confirm the efficacy of EAP for treating AR. More high-quality studies are needed to confirm safety and efficacy.

scholarly journals The Efficacy and Tolerability of Ubrogepant for Acute Migraine: A Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Yun Diao ◽  
Hang Yang ◽  
Yang Chun Zhou ◽  
Biao Du
Keyword(s):  
Systematic Review ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Acute Attack ◽  
Cochrane Library ◽  
Control Group ◽  
Controlled Trials ◽  
Acute Migraine ◽  
High Quality ◽  
Randomized Controlled

Abstract Objective: The aim of this review was to evaluate the efficacy and tolerability of ubrogepant in patients with acute migraine. Methods: We systematically searched PubMed, Embase, MEDLINE, Cochrane Library, and clinicaltrials.gov from inception to JULY, 2019. Randomized controlled trials of the efficacy and/or tolerability of ubrogepant for migraine were included. Meta-analysis was conducted by RevMan 5.3 software. Results: A total of 4 RCTs involving 4 163 patients were included. The meta-analysis showed that:compared to the control group, the percentage of participants with PF, the percentage of participants with PR, the percentage of participants with SPF, the percentage of participants with SPR,the absence of phonophobia in sound，the absence of phonophobia in light and the absence of nausea (RR=1.31,95%CI:1.18~1.45，P<0.00001, RR=1.63,95%CI:1.46~1.82，P<0.00001, RR=1.22,95%CI:1.15~1.29，P<0.00001, RR=1.32,95%CI:1.22~1.42，P<0.00001, RR=1.16,95%CI:1.05~1.27，P=0.002), all the differences were statistically significant. Conclusions: For adult patients with acute migraine, ubrogepant could effectively abort the acute attack. High-quality, adequately powered RCTs are needed to fully evaluate the efficacy and tolerability of ubrogepant for acute migraine.

scholarly journals The clinical efficacy of continuous renal replacement in the treatment of acute pancreatitis: a meta-analysis of randomized controlled trials

2021 ◽  
Author(s):  
sijia Ma ◽  
mingming Zhao ◽  
zhiyu Pan ◽  
jiao Fan ◽  
xuexue Zhang ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Randomized Controlled Trials ◽  
Clinical Efficacy ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Control Group ◽  
Controlled Trials ◽  
Review Author ◽  
Inclusion Criteria ◽  
Randomized Controlled

Abstract：Objective: The purpose of this study was to investigate the effect of continuous renal replacement therapy(CRRT) on patients with acute pancreatitis(AP). Methods: A comprehensive search of seven databases without language restrictions includes PubMed, Cochrane Library, Scopus, Embase, Web of Science, China National Knowledge Infrastructure(CNKI) and Wan fang database. Randomized controlled trials (RCTs) for the treatment of acute pancreatitis with CRRT were searched. All the included literatures were published before December 2020. Two review authors independently selected the study and extracted the data according to the inclusion criteria. A third review author will and discuss with the first two review authors and resolve the differences. Weighted mean difference(WMD), risk ratio (RR), and 95% confidence interval (CI) were used for estimating the clinical efficacy of AP in CRRT and control treatment. Results: Fifty-three RCTs met the inclusion criteria and were used in the meta-analysis, with a total of 3,382 effective samples. A comprehensive review of the system shows that the mortality rate of the CRRT group was significantly lower than that of the control group, and the difference was statistically significant(RR=0.44,95%CI0.34 to 0.57,P< 0.000001), the patients using CRRT had lower APACHE Ⅱ scores level(WMD=-3.78, 95%CI-4.66 to -2.90,P<0.00001),higher CRP, PCT,TNF-αand IL-6 clearance effect. According to liver function, the patients using CRRT had lower ALT and AST levels. In the same way, according to renal function, the patients using CRRT had lower SCr (WMD=-94.28, 95%CI-125.47 to -63.10, P<0.00001). The patients using CRRT also had higher ALB levels(WMD=2.32, 95%CI-1.05 to 3.59 ,P=0.0003). Moreover, Results shown no statistical difference in Serum potassium level (WMD=-0.00, 95%CI-0.31 to 0.31,P=1.00)between the two groups. Conclusions: Our findings suggest that treatment with CRRT for acute pancreatitis may be more beneficial than conventional treatment. However, high-quality studies with a larger sample size are still needed to confirm our results.

scholarly journals Effects of Neuromuscular Electrical Stimulation on Hemiplegic Upper Limb of Stroke Survivors: A Meta-Analysis of Randomized Controlled Trials

2019 ◽  
Author(s):  
Wenyue Zhang ◽  
Shuye Pei ◽  
Juan Huang ◽  
Yao Tang ◽  
Huaidong Hu
Keyword(s):  
Electrical Stimulation ◽  
Randomized Controlled Trials ◽  
Upper Extremity ◽  
Upper Limb ◽  
Meta Analysis ◽  
Neuromuscular Electrical Stimulation ◽  
Cochrane Library ◽  
Control Group ◽  
Controlled Trials ◽  
Randomized Controlled

Abstract Background: Whether NMES helps the recovery of upper limb function in patients with hemiparesis has not been confirmed. We conducted this meta-analysis to examine the effectiveness of neuromuscular electrical stimulation (NMES) for upper limb hemiparesis after stroke.Methods: Data sources such as Pubmed, Embase and Cochrane library databases were searched for all relevant studies that were carried out before December 1, 2018.We selected the randomized controlled trials (RCTs) which included chronic and acute stroke patients with upper extremity dysfunction. Then the intervention group which applied NMES was compared with a control group without NMES. Results: A total of 16 RCTs involving 691 patients were discerned from 248 searched articles. According to the forest plot ,NMES had a significant benefit on FMA-ue scale(SMD=0.44,95%CI 0.13 to 0.74,P=0.006).Also, NMES was positive for ARAT(SMD=0.31,95%CI 0.05 to 0.58,P=0.019)and MAL-AOU(SMD=0.59,95%CI 0.15 to1.04,P=0.009),but not for wrist MAS(SMD=-0.12,95%CI -0.43 to 0.19,P=0.434) or BI(SMD=0.51,95%CI -0.65 to 1.66,P=0.392).Conclusion: NMES application has beneficial impacts on upper extremity motor function in patients with stroke. This study suggests that NMES ought to be applied as a beneficial rehabilitation means in improving the upper function.

scholarly journals The efficiency and safety of recombinant factor VIIa for bleeding in patients without haemophilia: a meta-analysis of 12 randomized controlled trials

2020 ◽  
Author(s):  
Ying Zhang ◽  
Yuting Wang ◽  
Youfa Zhou ◽  
Jian Li ◽  
Haiyan Zhou
Keyword(s):  
Randomized Controlled Trials ◽  
Recombinant Factor Viia ◽  
Factor Viia ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Vein Thrombosis ◽  
Randomized Controlled ◽  
Number Of Patients ◽  
Deep Vein

Abstract Background: Despite widely use of recombinant factor VIIa (rFVIIa) for bleeding in patients without haemophilia, its efficiency and safety remain unclear. Therefore, we carried out a meta-analysis on this topic. Methods: We searched Cochrane Library, Web of Science, PubMed and Embase, from January 2008 to July 2019 for randomized controlled trials on the topic. The results of this work are synthesized and reported in accordance with the PRISMA statement. Results: Twelve trials met our inclusion criteria. rFVIIa over 200ug/kg reduced red blood cell (RBC) transfusions within 24 h by 232.34ml (95% confidence interval [CI]; -410.31 to -54.37). rFVIIa did not significantly reduce 30-day mortality (relative risk [RR], 1.00; 95%CI, 0.82-1.21), total thromboembolic events (RR, 1.13; 95%CI, 0.94-1.36), myocardial infarction (RR, 1.37; 95%CI, 0.92-2.05), deep vein thrombosis (RR, 0.83; 95%CI, 0.52–1.33), ICU staying (RR, 0.40; 95%CI, -1.28 to 2.07) and number of patients transfused RBC (RR, 0.94; 95%CI, 0.83-1.08). However, rFVIIa may increase the incidence of arterial thrombotic events (RR, 1.38; 95%CI, 1.08–1.77). Conclusion: rFVIIa over 200ug/kg reduced RBC transfusions for bleeding in patients without haemophilia. However, it may increase the risk of arterial thrombotic events.

scholarly journals Butorphanol effectively prevents etomidate-induced myoclonus: a pooled analysis of 788 patients

2018 ◽  
Vol 47 (1) ◽  
pp. 353-360
Author(s):  
Yu Zhu ◽  
Chengmao Zhou ◽  
Qixiong He
Keyword(s):  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Pooled Analysis ◽  
Cochrane Library ◽  
Control Group ◽  
Controlled Trials ◽  
Anesthesia Induction ◽  
Randomized Controlled

Objective To evaluate the efficacy of pre-injection of butorphanol on etomidate-induced myoclonus during anesthesia induction. Methods Randomized controlled trials (RCTs) of the ability of butorphanol to prevent etomidate-induced myoclonus were collected by searching PubMed, Cochrane Library, CNKI, and WanFang databases, from the day of database establishment until May 2017. The literature was screened independently by two evaluators, and the data were then extracted and independently evaluated. Finally, meta-analysis was performed by using RevMan 5.2 software. Results Eight RCTs were analyzed. The results of meta-analysis showed that: 1. compared with the control group, butorphanol was effective in preventing etomidate-induced myoclonus [RR = 0.15, 95% CI: 0.11, 0.21]; 2. butorphanol was effective in preventing mild, moderate, and severe etomidate-induced myoclonus [RR = 0.40, 95% CI: 0.25, 0.63; RR = 0.15, 95% CI: 0.08, 0.27; and RR = 0.04, 95% CI: 0.01, 0.09]; 3. butorphanol did not increase the incidence of dizziness and nausea associated with etomidate. Conclusions Butorphanol could reduce the incidence and degree of etomidate-induced myoclonus. Notably, it did not increase the incidence of dizziness and nausea associated with etomidate.

scholarly journals Effects of effective acute anti-hypertensive therapy on ischemic stroke prognosis: a meta-analysis of randomized controlled trials

2020 ◽  
Author(s):  
Zhaokai Li ◽  
Yingxu Ma ◽  
Gan Huang ◽  
Guogang Zhang
Keyword(s):  
Ischemic Stroke ◽  
Randomized Controlled Trials ◽  
Functional Outcome ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Control Group ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Hypertensive Therapy ◽  
Outcome Mortality

Abstract Background: Although multiple randomized controlled trials (RCTs) and meta-analyses have been conducted on the issue of acute phase anti-hypertensive therapies for ischemic stroke (IS) patients, many studies have failed to enhance blood pressure (BP) decrease after these treatments. The effects of effective acute anti-hypertensive therapies on IS prognosis are still unclear.Methods: Published literature was systematically searched in PubMed, Embase and Cochrane Library. Multiple RCTs that included IS patients, in which there was a significant BP decrease in the anti-hypertensive intervention group compared with the control group within 72 h after the onset of stroke, were identified. A meta-analysis was conducted to assess the effects of such therapy on the functional outcome, mortality, and multiple severe adverse events (SAEs) of IS patients.Results: Eight RCTs were included in this study, with a total of 9427 IS patients. According to this meta-analysis, with significant BP differences between the treatment and control groups within 72 h from stroke onset, effective acute anti-hypertensive therapy has a neutral effect on multiple IS prognostic factors, including functional outcome (RR 1.03, 95% CI 0.93-1.13), mortality (RR 1.10, 95% CI 0.89-1.35), and multiple SAEs.Conclusions: Based on current studies, effective acute anti-hypertensive therapy did not improve the prognosis of IS patients, including functional outcome, mortality, and SAEs. There is no evidence that such therapy is beneficial in clinical practice.

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