scholarly journals Efficacy of antiepileptic drugs in glioma patients with epilepsy: a systematic review

2021 ◽  
Author(s):  
Marjolein E de Bruin ◽  
Pim B van der Meer ◽  
Linda Dirven ◽  
Martin J B Taphoorn ◽  
Johan A F Koekkoek
Keyword(s):  
Systematic Review ◽  
Treatment Failure ◽  
Cochrane Library ◽  
Seizure Freedom ◽  
Scientific Quality ◽  
Individual Outcomes ◽  
Treatment Failure Rate ◽  
Grade Ii ◽  
The Individual ◽  
Patients With Epilepsy

Abstract Background Comprehensive data on the efficacy and tolerability of AED treatment in glioma patients with epilepsy is currently lacking. In this systematic review we specifically assessed the efficacy of AEDs in patients with a grade II-IV glioma. Methods Electronic databases PubMed/MEDLINE, EMBASE, Web of Science, and Cochrane library were searched up to June 2020. Three different outcomes for both mono- and polytherapy were extracted from all eligible articles: (I) seizure freedom; (II) ≥50% reduction in seizure frequency; and (III) treatment failure. Weighted averages (WA) were calculated for outcomes at 6 and 12 months. Results A total of 66 studies were included. Regarding the individual outcomes on the efficacy of monotherapy, the highest seizure freedom rate at 6 months was with phenytoin (WA=72%) while at 12 months pregabalin (WA=75%) and levetiracetam (WA=74%) showed highest efficacy. Concerning ≥50% seizure reduction rates, levetiracetam showed highest efficacy at 6 and 12 months (WAs of 82% and 97%, respectively). However, treatment failure rates at 12 months were highest for phenytoin (WA=34%) and pregabalin (41%). When comparing the described polytherapy combinations with follow-up of ≥6 months, levetiracetam combined with phenytoin was most effective followed by levetiracetam combined with valproic acid. Conclusion Given the heterogeneous patient populations and the low scientific quality across the different studies, seizure rates need to be interpreted with caution. Based on the current limited evidence, with the ranking of AEDs being confined to the AEDs studied, levetiracetam, phenytoin and pregabalin seem to be most effective as AED monotherapy in glioma patients with epilepsy, with levetiracetam showing the lowest treatment failure rate, compared to the other AEDs studied.

scholarly journals NCMP-08. EFFICACY OF ANTIEPILEPTIC DRUGS IN GLIOMA PATIENTS WITH EPILEPSY: A SYSTEMATIC REVIEW

2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii124-ii124
Author(s):  
Marjolein de Bruin ◽  
Pim van der Meer ◽  
Linda Dirven ◽  
Martin Taphoorn ◽  
Johan Koekkoek
Keyword(s):  
Systematic Review ◽  
Valproic Acid ◽  
Web Of Science ◽  
Cochrane Library ◽  
Seizure Freedom ◽  
Common Symptom ◽  
Seizure Reduction ◽  
Weighted Averages ◽  
Grade Ii ◽  
Patients With Epilepsy

Abstract BACKGROUND Epilepsy is a common symptom in glioma patients, requiring antiepileptic drug (AED) treatment. However, comprehensive data on the efficacy and tolerability of AED treatment is currently lacking. In this systematic review we specifically assessed the efficacy of AEDs in patients with a grade II-IV glioma. METHODS Electronic databases PubMed/MEDLINE, EMBASE, Web of Science, and Cochrane library were searched up to April 2020. Three different outcomes were extracted from all eligible articles: (I) seizure freedom; (II) ≥50% reduction in seizure frequency; and (III) treatment failure. To overcome variation with respect to sample sizes, weighted averages (WA) were calculated for outcomes at 6 and 12 months. RESULT A total of 64 studies were included. For monotherapy, the 6-months seizure freedom rate was highest for phenytoin (WA=72%), whereas the 12-months seizure freedom rate was highest for pregabalin (WA=75%). For achieving ≥ 50% seizure reduction, levetiracetam was the most effective AED at 6 and 12 months, with WA of 82 and 97% respectively. Considering the provided polytherapy combinations, levetiracetam combined with phenytoin was most effective followed by levetiracetam with valproic acid. Seizure freedom rates with polytherapy at 6 months and 12 months were highest for combinations with phenytoin and topiramate, respectively. For achieving a ≥ 50% seizure reduction, combinations with perampanel were found to be the most effective at 6 and 12 months. CONCLUSION Based on the current literature, phenytoin, levetiracetam and pregabalin are most effective as AED monotherapy in glioma patients with epilepsy. Well-controlled prospective studies are needed to help further guide clinician’s treatment choices.

Evaluation of the Impacts of Chemotherapeutics on Odontogenesis Process: Findings from a Systematic Review

2019 ◽  
Vol 36 (03) ◽  
pp. 210-218
Author(s):  
Camila Valente Smith ◽  
Grazyelle Sebrenski da Silva ◽  
Felipe Rodolfo Pereira da Silva ◽  
José Fernando Marques Barcellos ◽  
Silvânia da Conceição Furtado
Keyword(s):  
Systematic Review ◽  
Experimental Animal ◽  
Observational Studies ◽  
Animal Studies ◽  
Direct Analysis ◽  
The Other ◽  
Cochrane Library ◽  
Oncology Patient ◽  
Therapeutic Protocol ◽  
The Individual

AbstractThis study aimed to examine and recognize the impacts of antinoplastic chemotherapeutics on the development of dental germ, employing a systematic review. A retrieving in the literature was carried out, using several medical and scientifical databases (ClinicalKey, Cochrane Library, Google Scholar, MedLine, PubMed, and ScienceDirect), by two investigators separately. In the end of this systematic search, eight articles met the required criteria for inclusion and, therefore, composed the results. Among these, four articles are about observational studies in humans, and the other four about experimental animal studies. In both cases and species, anomalies such as microdontia, hypodontia/agenesia, and root shortening were observed. The severity and frequency varied according to the nature of the chemotherapeutics applied as well as the administered dosage and the patient's age at the time of first exposure. Through the results, it was possible to show the direct impacts of chemotherapy on the odontogenesis process as well as factors such as the type of chemotherapy, the age of the individual at the time of first exposure and the dosage used. All of those should be taken into account when choosing a therapeutic protocol for an oncology patient. Besides, we observed the need for more studies in this area and that these should be standardized in order to allow an objective and direct analysis of comparable parameters, even when different approaches are used.

scholarly journals Efficacy of zinc as adjunctive pneumonia treatment in children aged 2 to 60 months in low-income and middle-income countries: a systematic review and meta-analysis

2020 ◽  
Vol 4 (1) ◽  
pp. e000662 ◽  
Author(s):  
Nick Brown ◽  
Antti Juhani Kukka ◽  
Andreas Mårtensson
Keyword(s):  
Systematic Review ◽  
Treatment Failure ◽  
Low Income ◽  
Meta Analysis ◽  
Severe Pneumonia ◽  
Risk Of Bias ◽  
Sensitivity Analyses ◽  
Cochrane Library ◽  
Middle Income ◽  
Middle Income Countries

BackgroundDespite advances in vaccination and case management, pneumonia remains the single largest contributor to early child mortality worldwide. Zinc has immune-enhancing properties, but its role in adjunctive treatment of pneumonia in low-income and middle-income countries (LMICs) is controversial and research still active.MethodsSystematic review and meta-analysis of randomised controlled trials of zinc and placebo in pneumonia in children aged 2 to 60 months in LMICs. Databases included MEDLINE, the Cochrane Library, EMBASE, LILACS, SciELO, the WHO portal, Scopus, Google Scholar and ClinicalTrials.gov. Inclusion criteria included accepted signs of pneumonia and clear measure of outcome. Risk of bias was independently assessed by two authors. ORs with 95% CI were used for calculating the pooled estimate of dichotomous outcomes including treatment failure and mortality. Time to recovery was expressed as HRs. Sensitivity analyses considering risk of bias and subgroup analyses for pneumonia severity were performed.ResultsWe identified 11 trials published between 2004 and 2019 fulfilling the a priori defined criteria, 7 from South Asia and 3 from Africa and 1 from South America. Proportional treatment failure was comparable in both zinc and placebo groups when analysed for all patients (OR 0.95 (95% CI 0.80 to 1.14)) and only for those with severe pneumonia (OR 0.93 (95% CI 0.75 to 1.14)). No difference was seen in mortality between zinc and placebo groups (OR 0.64 (95% CI 0.31 to 1.31)). Time to recovery from severe pneumonia did not differ between the treatment and control groups for patients with severe pneumonia (HR 1.01 (95% CI 0.89 to 1.14)). Removal of four studies with high risk of bias made no difference to the conclusions.ConclusionThere is no evidence that adjunctive zinc treatment improves recovery from pneumonia in children in LMICs.Trial registration numberCRD42019141602.

scholarly journals Short-course vasoconstrictors are adequate for esophageal variceal bleeding after endoscopic variceal ligation: A systematic review and meta-analysis

2021 ◽  
Vol 104 (3) ◽  
pp. 003685042110317
Author(s):  
Jen-Hao Yeh ◽  
Gin-Ho Lo ◽  
Ru-Yi Huang ◽  
Chih-Wen Lin ◽  
Wen-Lun Wang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Treatment Failure ◽  
Variceal Bleeding ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Endoscopic Variceal Ligation ◽  
Esophageal Variceal ◽  
Esophageal Variceal Bleeding ◽  
Short Course ◽  
Significant Difference

Endoscopic variceal ligation (EVL) with vasoconstrictors has been recommended for acute esophageal variceal bleeding. However, the optimal duration of vasoconstrictors after EVL is controversial. This systematic review and meta-analysis was conducted to explore the efficacy of short-course vasoconstrictors (≤3 days) versus standard combination (3–5 days). A comprehensive literature review was conducted using the PubMed, Embase, and Cochrane library databases with subsequent meta-analysis. The primary outcomes were 5-day rebleeding, mortality, and treatment failure rates. A risk ratio (RR) with 95% confidence interval is used for outcome comparison. Nine randomized studies with 838 patients were included. The initial hemostasis (96.8% vs 97.4%, p = 0.919), 5-day rebleeding (11.2% vs 8.3%, RR = 1.05, 95% CI = 0.62–1.76), mortality (0 vs 1.3%, RR = 0.48, 95% CI = 0.10–2.39), and treatment failure (7.4% vs 5.9%, RR = 1.10, 95% CI = 0.48–2.49) were similar in both groups. Subgroup analysis suggested EVL alone had no significant difference of 5-day re-bleeding (15.9% vs 7.1%, RR = 2.25, 95% CI = 0.87–5.77), mortality (0 vs 0.7%, RR = 0.71, 95% CI = 0.08–6.03), treatment failure (9.6% vs 6.7%, RR = 1.43, 95% CI = 0.54–3.75) compared to standard combination. Clinical heterogeneity was found for the rebleeding rate for the subgroup during sensitivity analysis. EVL with short-course vasoconstrictors is highly efficacious for esophageal variceal bleeding. Further studies are required to determine the genuine need of subsequent vasoconstrictor after successful EVL.

scholarly journals Haploidentical/Mismatched Hematopoietic Stem Cell Transplantation for Nonresponders to Immunosuppressive Therapy Compared with First-Line Rabbit Antithymocyte Immunoglobulin Treatment Against Acquired Severe Aplastic Anemia

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 5508-5508
Author(s):  
Limin Liu ◽  
Xiuli Wang ◽  
Song Jin ◽  
Lin Hao ◽  
Yanming Zhang ◽  
...  
Keyword(s):  
Treatment Failure ◽  
Immunosuppressive Therapy ◽  
Conflicts Of Interest ◽  
Chronic Gvhd ◽  
Unrelated Donor ◽  
Hematopoietic Stem ◽  
Similar Treatment ◽  
Treatment Failure Rate ◽  
Grade Ii ◽  
Immunoglobulin Treatment

Abstract We treated 86 patients with SAA, 31 patients who failed to respond to previous therapy underwent haploidentical hematopoietic SCT (haplo-HSCT, n=26) or mismatched unrelated donor HSCT (MMUD-HSCT, n=5). The other 55 patients were treated with immunosuppressive therapy (IST). At 6 months post-treatment, the treatment failure rates of HSCT and IST groups were 19.35% and 29.09% (P=0.320). Hematopoietic recovery time was shorter in the HSCT group than IST group (P > 0.05). The estimated OS at 3 years was 79.2% ± 7.7% in HSCT group and 89.7% ± 4.4% in the IST group (P=0.058). The estimated failure-free survival (FFS) at 3 years was 79.2% ± 7.7% in the HSCT group and 62.9% ± 8.0% in the IST group (P=0.391). The estimated FFS at 3 years in SAA that had progressed from non-SAA (NSAA) of HSCT was 71.6% ± 14.0% and 16.7% ± 13.6% of IST (P=0.021). Within the HSCT group, 38.71% of the patients developed grade II-IV acute GVHD, and 18.52% of the patients experienced moderate-severe chronic GVHD. These results suggest that haplo-HSCT/MMUD-HSCT and IST have similar treatment failure rate, OS and FFS. haplo-HSCT/MMUD-HSCT might provide a better chance of FFS than IST for SAA that had progressed from NSAA. Disclosures No relevant conflicts of interest to declare.

scholarly journals Subpectoral versus suprapectoral biceps tenodesis yields similar clinical outcomes: a systematic review

2021 ◽  
pp. jisakos-2020-000543
Author(s):  
John W Belk ◽  
Stephen G Thon ◽  
John Hart ◽  
Eric C McCarty, Jr. ◽  
Eric C McCarty
Keyword(s):  
Systematic Review ◽  
Treatment Failure ◽  
Clinical Outcomes ◽  
Biceps Brachii ◽  
Biceps Tendon ◽  
Risk Of Bias ◽  
Cochrane Library ◽  
Biceps Tenodesis ◽  
Patient Reported ◽  
Long Head

ImportanceArthroscopic suprapectoral biceps tenodesis (ABT) and open subpectoral biceps tenodesis (OBT) are two surgical treatment options for relief of long head of the biceps tendon (LHBT) pathology and superior labrum anterior to posterior (SLAP) tears. There is insufficient knowledge regarding the clinical superiority of one technique over the other.ObjectiveTo systematically review the literature in order to compare the clinical outcomes and safety of ABT and OBT for treatment of LHBT or SLAP pathology.Evidence reviewA systematic review was performed by searching PubMed, the Cochrane Library and Embase to identify studies that compared the clinical efficacy of ABT versus OBT. The search phrase used was: (bicep OR biceps OR biceps brachii OR long head of biceps brachii OR biceps tendinopathy) AND (tenodesis). Patients were assessed based on the American Shoulder and Elbow Surgeons Score, the visual analogue scale, the Single Assessment Numeric Evaluation, Constant-Murley Score, clinical failure, range of motion, bicipital groove pain and strength. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed, and both the Cochrane Collaboration’s and Risk of Bias in Non-randomised Studies - of Interventions (ROBINS-I) risk of bias tools were used to evaluate risk of bias.FindingsEight studies (one level I, seven level III) met inclusion criteria, including 326 patients undergoing ABT and 381 patients undergoing OBT. No differences were found in treatment failure rates or patient-reported outcome scores between groups in any study. One study found OBT patients to experience significantly increased range of shoulder forward flexion when compared with ABT patients (p=0.049). Two studies found ABT patients to experience significantly more postoperative stiffness when compared with OBT patients (p<0.05).ConclusionsPatients undergoing ABT and OBT can be expected to experience similar improvements in clinical outcomes at latest follow-up without differences treatment failure or functional performance. ABT patients may experience an increased incidence of stiffness in the early postoperative period.Level of evidenceIII.

scholarly journals Relationship between social capital and the experience of dental carie: systematic review and meta-analysis

2021 ◽  
Vol 69 ◽  
Author(s):  
Aline Amaro DAMASCENO ◽  
Antônio Carlos PEREIRA ◽  
Andreza Maria Luzia Baldo de SOUZA ◽  
Luciane Miranda GUERRA ◽  
Denise de Fatima Barros CAVALCANTE ◽  
...  
Keyword(s):  
Systematic Review ◽  
Social Capital ◽  
Meta Analysis ◽  
Final Analysis ◽  
Cochrane Library ◽  
Caries Experience ◽  
P Value ◽  
The Individual ◽  
High Level ◽  
The Cochrane Library

ABSTRACT Objective Understanding the individual and collective behavior of individuals about their oral health conditions is important to prevent and control of dental caries. This study aimed to seek evidence of the relationship between social capital and caries experience. Methods Using a systematic review with meta-analysis, we searched articles in PubMed, ISI Web of Knowledge, LILACS, IBECS, BBO, SCIELO, The Cochrane Library and MEDLINE databases. Studies with humans, of all ages and languages, published until July 2019, which related social capital to the caries experience, were included in this review. Results We identified 1163 articles evaluated considering inclusion and exclusion criteria, leaving 5 articles selected to compose the study sample, and only 3 included in the meta-analysis. In the final analysis p value was significant (p <0.001), showing that both social cohesion and neighborhood empowerment are associated with the caries experience. In the random model, the individual has 2.39 chances of not having the caries disease. The results reinforce the importance of community social capital in the caries experience of individuals. Conclusions The high level of community social capital is directly related to lower caries experience rates.

scholarly journals Operationalisation of gender and migration in epidemiological research – a systematic review

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
L Wandschneider ◽  
S Batram-Zantvoort ◽  
O Razum ◽  
C Miani
Keyword(s):  
Systematic Review ◽  
Gender Roles ◽  
Latin American ◽  
Gender Effects ◽  
Macro Level ◽  
Cochrane Library ◽  
Gender Perspective ◽  
Epidemiological Research ◽  
And Gender ◽  
The Individual

Abstract Background Gender as a social construct contributes to determine who migrates and which migration-related risks and opportunities emerge in all phases of the migration trajectory. Simultaneously, migration influences the individual as well as societal definition and perception of gender roles. An explicit gender perspective beyond biological sex in migration-related epidemiological research would contribute to adequately analyse, assess and interpret the health situation of migrants. Methods The systematic review synthesises how gender is conceptualised, operationalised and used for interpretation in migration-related epidemiological research. We search PubMed, Embase, CINAHL, the Cochrane Library, EconLit and PsycINFO as well as the reference lists of the included studies. Eligible studies actively aim to understand, identify or explain the influence of gender on health. Results 20 cross-sectional studies met the eligibility criteria. The majority of studies analysed gender effects on mental health (e.g. depression) and sexual health (e.g. risk behaviour). The majority of the study population is made up of male sexual minorities with Latin American background living in the USA. Gender is mainly operationalised through gender roles, attitudes and gender-based discrimination. These dimensions are mostly conceptualised at the individual level, only a minority of studies applies meso- or macro-level indicators to measure structural gender effects. Discussion We identified research gaps with regard to macro-level mechanisms of gender, immigrant populations in Europe and interactions of migration and gender in epidemiological research. The majority is restricted to sex- or sexual orientation related issues, but this systematic review helps to identify good practice examples that may contribute to the development of a guideline on how to integrate a gender perspective in migration-related epidemiological research. Systematic Review Registration: PROSPERO CRD42019124698

scholarly journals Allostatic Load and Its Impact on Health: A Systematic Review

2020 ◽  
Vol 90 (1) ◽  
pp. 11-27 ◽  
Author(s):  
Jenny Guidi ◽  
Marcella Lucente ◽  
Nicoletta Sonino ◽  
Giovanni A. Fava
Keyword(s):  
Systematic Review ◽  
Allostatic Load ◽  
Current Knowledge ◽  
Integrated Approach ◽  
Cochrane Library ◽  
Physical And Mental Health ◽  
Clinical Criteria ◽  
Manual Search ◽  
Individual Ability ◽  
The Individual

<b><i>Introduction:</i></b> Allostatic load refers to the cumulative burden of chronic stress and life events. It involves the interaction of different physiological systems at varying degrees of activity. When environmental challenges exceed the individual ability to cope, then allostatic overload ensues. Allostatic load is identified by the use of biomarkers and clinical criteria. <b><i>Objective:</i></b> To summarize the current knowledge on allostatic load and overload and its clinical implications based on a systematic review of the literature. <b><i>Methods:</i></b> PubMed, PsycINFO, Web of Science, and the Cochrane Library were searched from inception to December 2019. A manual search of the literature was also performed, and reference lists of the retrieved articles were examined.<b><i></i></b>We considered only studies in which allostatic load or overload were adequately described and assessed in either clinical or non-clinical adult populations. <b><i>Results:</i></b> A total of 267 original investigations were included. They encompassed general population studies, as well as clinical studies on consequences of allostatic load/overload on both physical and mental health across a variety of settings. <b><i>Conclusions:</i></b> The findings indicate that allostatic load and overload are associated with poorer health outcomes. Assessment of allostatic load provides support to the understanding of psychosocial determinants of health and lifestyle medicine. An integrated approach that includes both biological markers and clinimetric criteria is recommended.

scholarly journals Is There an Association between Temporomandibular Disorders and Articular Eminence Inclination? A Systematic Review

Diagnostics ◽  
2020 ◽  
Vol 11 (1) ◽  
pp. 29
Author(s):  
Xiao-Chuan Fan ◽  
Diwakar Singh ◽  
Lin-Sha Ma ◽  
Eva Piehslinger ◽  
Xiao-Feng Huang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cohort Studies ◽  
Temporomandibular Disorders ◽  
Case Control ◽  
Cochrane Library ◽  
Scientific Quality ◽  
Articular Eminence ◽  
Case Control Studies ◽  
Clinical Methods ◽  
Newcastle Ottawa Scale

(1) Background: In order to determine the correlation between the inclination of articular eminence (AEI) and the development of temporomandibular disorders (TMDs), a systematic review was performed. (2) Methods: A systematic literature research was conducted between 1946 and January 2020, based on the following electronic databases: PubMed, Cochrane Library, Embase, Medline, Scope, SciELO, and Lilacs. Observational studies, analytical case-control studies, and cohort studies written in English were identified. The articles were selected and analyzed by two authors independently. The PICO format was used to analyze the studies and the Newcastle-Ottawa Scale (NOS) was used to verify the quality of the evidence. (3) Results: Sixteen articles were included in this review, ten case-control studies and six cohort studies. Eight articles (50%) established a positive relation between AEI and TMDs and eight (50%) did not. The scientific quality was medium-low, mainly influenced by the exposure to the risk of bias and the lack of clinical methods with adequate consistency and sensitivity on the diagnosis of TMDs. (4) Conclusions: It is controversial to establish a causal relationship between the TMDs and the AEI in the field of stomatology, due to limited and inconclusive evidence. However, it is suggested that the AEI defined by some specific methods may be associated with some special pathological stages of TMDs. High-quality prospective studies are required to draw any definitive conclusions.

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