scholarly journals 496 Perioperative Utility of Tranexamic Acid in Oncological Breast Surgery: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
K Y Chan ◽  
S Keogh ◽  
A Grealish ◽  
A Merrigan ◽  
S Tormey
Keyword(s):  
Tranexamic Acid ◽  
Quantitative Data ◽  
Breast Surgery ◽  
Low Cost ◽  
Meta Analysis ◽  
Cochrane Collaboration ◽  
Therapeutic Index ◽  
Surgical Morbidity ◽  
Evidence Quality ◽  
Haematoma Formation

Abstract Background Tranexamic acid (TXA) is a synthetic anti-fibrinolytic agent used in various surgical procedures to achieve haemostasis and reduce blood loss. Recently TXA has seen an increase in perioperative utility as a result of its ease of administration, high therapeutic index and low cost. Its safety and effectiveness in oncological breast surgery (OBS) remain understudied. Method PubMed, EMBASE, SCOPUS and other relevant sources were searched for studies investigating the effect of TXA in OBS, published up to October 2020. Primary outcomes of interest were local wound effects. Estimates of effect, when quantitative data was available, were pooled with a random effects model to estimate summary hazard ratios and 95% confidence intervals. Qualitative data was reported using descriptive statistics. Evidence quality was assessed using the Cochrane Collaboration tool. Results 7 studies involving 1844 patients were included. Quantitative data was available for: mean total drainage volume, duration of drain in-situ and rates of seroma and haematoma formation. A significant reduction in rate of haematoma formation (OR 0.40, 95% CI 0.18-0.89, P = 0.02, I2=28%) was observed in the TXA group. There were no significant differences in the other outcomes. There was no significant increase in rates of adverse events. Conclusions Trends were observed in the present meta-analysis, although TXA did not appear to significantly alter the OBS outcomes. Current studies are insufficiently powered to isolate the effects of TXA on surgical morbidity. Further large prospective studies are needed to assess complications and determine the ideal dosage regime. At this juncture, prophylactic TXA in OBS cannot be recommended.

scholarly journals Misoprostol for prevention and treatment of postpartum haemorrhage: A systematic review

Curationis ◽  
2013 ◽  
Vol 36 (1) ◽  
Author(s):  
Kabelo M. Olefile ◽  
Oswell Khondowe ◽  
Doreen M’Rithaa
Keyword(s):  
Postpartum Haemorrhage ◽  
Low Cost ◽  
Meta Analysis ◽  
Cochrane Collaboration ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Routes Of Administration ◽  
Prevention And Treatment ◽  
Highly Effective ◽  
Randomised Controlled

Background: Postpartum haemorrhage (PPH) is a leading cause of maternal mortality especially in the developing world. Misoprostol, a highly effective drug is highly effective in inducing uterine contractions and has been proposed as a low-cost, easy-to-use intervention for PPH.Objective: This study assessed evidence of the effectiveness of misoprostol for the prevention and treatment of PPH.Method: Databases searched included MEDLINE, PUBMED, CINHAL, Google Scholar, Cochrane Central Register of Controlled Trials (CENTRAL) and EMBASE. Reference lists and conference proceedings were also searched for more studies. Three studies included in the meta-analysis were limited to randomised controlled trials (RCT). Two reviewers independently screened all articles for methodological quality using a standardised instrument adapted from the Cochrane Collaboration website. Data were entered in Review Manager 5.1 software for analysis.Results: Three trials (n = 2346) compared misoprostol to a placebo. Misoprostol was shown not to be effective in reducing PPH (risk ratios [RR] 0.65; 95% confidence interval [CI] 0.40–1.06). Only one trial reported on the need for a blood transfusion (RR 0.14; 95% CI 0.02–1.15). Shivering (RR 2.75; 95% CI 2.26–3.34) and pyrexia (RR 5.34; 95% CI 2.86–9.96) were significantly more common with misoprostol than with a placebo.Conclusion: The use of misoprostol was not associated with any significant reduction in the incidence of PPH. Therefore, in order to verify the efficacious use of misoprostol in the treatment of PPH, specialised investigations of its dose and routes of administration for clinically significant effects and acceptable side effects are warranted.

scholarly journals Tranexamic acid use in breast surgery: a systematic review and meta-analysis

2021 ◽  
Vol 5 ◽  
pp. 12-12
Author(s):  
Alec Anthony Winder ◽  
Patrick McQuillan ◽  
Birgit Dijkstra
Keyword(s):  
Systematic Review ◽  
Tranexamic Acid ◽  
Breast Surgery ◽  
Meta Analysis

scholarly journals Comparison of the Efficacy of Melasma Treatments: A Network Meta-Analysis of Randomized Controlled Trials

2021 ◽  
Vol 8 ◽  
Author(s):  
Yi Liu ◽  
Shanshan Wu ◽  
Haixuan Wu ◽  
Xuelei Liang ◽  
Dechao Guo ◽  
...  
Keyword(s):  
Systematic Review ◽  
Side Effects ◽  
Tranexamic Acid ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Therapeutic Index ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Efficacy And Safety ◽  
Randomized Controlled

Background: Melasma is an acquired pigmentation disorder with challenges in treatment because of its refractory nature and high risk of recurrence.Objectives: This study aimed to compare the efficacy and side effects of 14 common therapies for melasma using a systematic review and network meta-analysis (NMA).Methods: The PubMed, Embase, and Cochrane Library databases were searched till December 2020 using the melasma area and severity index as a therapeutic index. A total of 59 randomized controlled trials (RCTs) met the inclusion criteria and were selected.Results: The ranking of relative efficacy compared with placebo in descending order was Q-switched Nd:Yag 1,064-nm laser (QSND), intense pulsed light, ablative fractional laser (AFL), triple combined cream (TCC), topical vitamin C, oral tranexamic acid (oTA), peeling, azelaic acid, microneedles (MNs), topical tranexamic acid (tTA), tretinoin, picosecond laser, hydroquinone (HQ), and non-AFL. Moreover, QSND was more effective than HQ and tTA against melasma. The ranking of percentage (%) of side effects in ascending order for each of 14 therapies with more than 80 participants was tretinoin (10.1%), oTA (17.6%), HQ (18.2%), AFL (20.0%), QSND (21.5%), TCC (25.7%), tTA (36.75%), peeling (38.0%), and MN (52.3%). Taking both efficacy and safety into consideration, TCC was found to be the most favorable selection among the topical drugs for melasma. QSND and AFL were still the best ways to treat melasma among photoelectric devices. oTA as system administration was a promising way recommended for melasma. Among 31 studies, 87% (27/31) studies showed that the efficacy of combination therapies is superior to that of single therapy. The quality of evidence in this study was generally high because of nearly 50% of split-face RCTs.Conclusions: Based on the published studies, this NMA indicated that QSND, AFL, TCC, and oTA would be the preferred ways to treat melasma for dermatologists. However, more attention should be paid to the efficacy and safety simultaneously during the clinical application. Most of the results were in line with those of the previous studies, but a large number of RCTs should be included for validation or update.Systematic Review Registration: identifier: CRD42021239203.

scholarly journals AB001. SOH21AS026. Perioperative utility of tranexamic acid in oncological breast surgery: a systematic review and meta-analysis

2021 ◽  
Vol 5 ◽  
pp. AB001-AB001
Author(s):  
Kin Yik Chan ◽  
Shane Keogh ◽  
Andrea Grealish ◽  
Anne Merrigan ◽  
Shona Tormey
Keyword(s):  
Systematic Review ◽  
Tranexamic Acid ◽  
Breast Surgery ◽  
Meta Analysis

Tranexamic Acid in Gastrointestinal Bleeding: A Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Joanna C. Dionne ◽  
Simon JW Oczkowski ◽  
Beverley J. Hunt ◽  
Massimo Antonelli ◽  
Marije Wijnberge ◽  
...  
Keyword(s):  
Systematic Review ◽  
Gastrointestinal Bleeding ◽  
Tranexamic Acid ◽  
Meta Analysis

Effect of Tranexamic Acid in Subarachnoid Haemorrhage. A Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Jean-Baptiste Bouillon-Minois ◽  
Carolyne Croizier ◽  
Julien S. Baker ◽  
Farès Moustafa ◽  
Jeannot Schmidt ◽  
...  
Keyword(s):  
Systematic Review ◽  
Subarachnoid Haemorrhage ◽  
Tranexamic Acid ◽  
Meta Analysis

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.

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