Long-term Child Follow-up After Large Obstetric Randomized Controlled Trials for the Evaluation of Perinatal Interventions

2014 ◽  
Vol 34 (1) ◽  
pp. 11-12
Author(s):  
M.J. Teune ◽  
A.G. van Wassenaer ◽  
G.L. Malin ◽  
E. Asztalos ◽  
Z. Alfirevic ◽  
...  
Keyword(s):  
Randomized Controlled Trials ◽  
Controlled Trials ◽  
Randomized Controlled

scholarly journals Perioperative Ketamine Administration for Thoracotomy Pain

2017 ◽  
Vol 3 (20;3) ◽  
pp. 173-184 ◽  
Author(s):  
Srinivas Pyati
Keyword(s):  
Neuropathic Pain ◽  
Randomized Controlled Trials ◽  
Pain Syndrome ◽  
Route Of Administration ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Postthoracotomy Pain

Background: Of all the postsurgical pain conditions, thoracotomy pain poses a particular therapeutic challenge in terms of its prevalence, severity, and ensuing postoperative morbidity. Multiple pain generators contribute to the severity of post-thoracotomy pain, and therefore a multimodal analgesic therapy is considered to be a necessary strategy. Along with opioids, thoracic epidural analgesia, and paravertebral blocks, N-Methyl-D-Aspartate (NMDA) receptor antagonists such as ketamine have been used as adjuvants to improve analgesia. Objective: We reviewed the evidence for the efficacy of intravenous and epidural administration of ketamine in acute post-thoracotomy pain management, and its effectiveness in reducing chronic postthoracotomy pain. Study Design: Systematic literature review and an analytic study of a data subset were performed. Methods: We searched PubMed, Embase, and Cochrane reviews using the key terms “ketamine,” “neuropathic pain,” “postoperative,” and “post-thoracotomy pain syndrome.” The search was limited to human trials and included all studies published before January 2015. Data from animal studies, abstracts, and letters were excluded. All studies not available in the English language were excluded. The manuscript bibliographies were reviewed for additional related articles. We included randomized controlled trials and retrospective studies, while excluding individual case reports. Results: This systematic literature search yielded 15 randomized control trials evaluating the efficacy of ketamine in the treatment of acute post-thoracotomy pain; fewer studies assessed its effect on attenuating chronic post-thoracotomy pain. The majority of reviewed studies demonstrated that ketamine has efficacy in reduction of acute pain, but the evidence is limited on the long-term benefits of ketamine to prevent post-thoracotomy pain syndrome, regardless of the route of administration. A nested analytical study found there is a statistically significant reduction in acute post-thoracotomy pain with IV or epidural ketamine. However currently, the evidence for a role of ketamine as a preventative agent for chronic postthoracotomy pain is insufficient due to the heterogeneity of the studies reviewed with regard to the route of administration, dosage, and outcome measures. Limitations: The evidence for a role of ketamine as a preventative agent for chronic post-thoracotomy pain is insufficient due to the heterogeneity of the studies reviewed. Conclusion: The majority of randomized controlled trials reviewed show no role for ketamine in attenuating or preventing post-thoracotomy pain syndrome at variable follow-up lengths. Therefore, additional research is warranted with consideration of risk factors and long-term follow-up for chronic post-thoracotomy pain though the evidence for benefit appears clear for acute post-thoracotomy pain. Key words: Ketamine, postoperative, thoracotomy pain, post thoracotomy pain syndrome, neuropathic pain

scholarly journals Long-term effects of cemented and cementless fixations of total knee arthroplasty: a meta-analysis and systematic review of randomized controlled trials

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Cheng Chen ◽  
Yanyan Shi ◽  
Zhanpo Wu ◽  
Zengxin Gao ◽  
Youmin Chen ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Randomized Controlled Trials ◽  
Knee Arthroplasty ◽  
Radiolucent Line ◽  
Controlled Trials ◽  
Long Term Effects ◽  
Randomized Controlled ◽  
Total Knee

Abstract Background To determine the long-term effects (a minimum follow-up time 8.8 years) of cemented and cementless fixations used for total knee arthroplasty (TKA). Methods PubMed, EMBASE, Ovid, Cochrane Library, CINAHL, China National Knowledge Infrastructure and China Wangfang database were interrogated for appropriate randomized controlled trials (RCTs) through July 2020. Data were extracted and assessed for accuracy by 2 of the authors acting independently. Any controversial discrepancies were resolved after discussion with a third author. Result Eight RCTs were included with low to moderate bias risks. The cemented fixation of TKA was comparable to cementless fixation in terms of implant survival (relative risk, 1.016; 95% CI 0.978 to 1.056; P = 0.417), Knee Society (KS) knee score (standardized mean difference (SMD), − 0.107; 95% CI − 0.259 to 0.045; P = 0.168), KS function score (SMD − 0.065; 95% CI − 0.238 to 0.109; P = 0.463), KS pain score (SMD − 0.300; 95% CI − 0.641 to 0.042; P = 0.085), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score (SMD − 0.117; 95% CI − 0.307 to 0.073; P = 0.227), HSS score (SMD − 0.027; 95% CI − 0.270 to 0.217; P = 0.829), range of motion (SMD 0.061; 95% CI − 0.205 to 0.327; P = 0.652) at ≥ 8.8 years of follow-up. In terms of radiographic outcomes at ≥ 8.8 years of follow-up, the incidence of a radiolucent line in the cementless group was lower than for the cemented group (SMD 3.828; 95% CI 2.228 to 6.576; P < 0.001). However, the maximum total point motion (MTPM) of the cementless group was greater than for the cemented group (SMD − 0.739; 95% CI − 1.474 to − 0.005; P = 0.048). Conclusions Long-term follow-up verified that cementless and cemented fixation have similar prosthesis survival rates, clinical scores and mobility. However, radiography suggested that each technique had an advantage with regard to the radiolucent line and MTPM.

scholarly journals O Papel da Testosterona na Melhoria do Desejo Sexual da Mulher Pós-Menopáusica: Uma Revisão Baseada na Evidência

2018 ◽  
Vol 31 (11) ◽  
pp. 680
Author(s):  
Maria Gouveia ◽  
Raquel Sanches ◽  
Sara Andrade ◽  
Sara Carmona ◽  
Carolina Ferreira
Keyword(s):  
Sexual Dysfunction ◽  
Sexual Function ◽  
Randomized Controlled Trials ◽  
Postmenopausal Women ◽  
Sexual Desire ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Randomized Controlled

Introduction: Female sexual dysfunction is a common problem, affecting more than 1/3 of women during their lives. The aim of this review is to review the evidence for the effectiveness of testosterone in sexual dysfunction in postmenopausal women, particularly in the improvement of sexual desire.Material and Methods: The authors searched in international databases National Guidelines Clearinghouse, Guidelines Finder, Cochrane Library and MEDLINE/PubMed, for guidelines, systematic reviews, meta-analysis and randomized controlled trials, published between January 2005 and February 2017, using the MeSH terms ‘testosterone’, ‘androgens’, ‘libido’, ‘sexual dysfunctions’ and ‘menopause’.Results: From a pool of 506 articles, 11 were selected: three guidelines, one systematic review with meta-analysis and seven randomized controlled trials. The selected articles showed testosterone‘s efficacy on global sexual function and improvement of sexual desire in postmenopausal women, when both are used in monotherapy or in association with other hormones. No study showed changes in hepatic enzymes or serious adverse effects.Discussion: The small sample size and short follow-up used in the included studies limits the ability to assess testosterone’s long-term benefits and effects.Conclusion: At short-term, testosterone seems to improve sexual function in postmenopausal women, particularly sexual desire. Nevertheless, more studies with larger sample size and longer follow-up are needed to understand its long-term safety and effectiveness.

Quality of Randomized Controlled Trials Published By Plastic Surgeons: Long-Term Follow-Up

2019 ◽  
Vol 43 (3) ◽  
pp. 866-873
Author(s):  
Thiago Bezerra de Morais ◽  
Daniela Francescato Veiga ◽  
Joel Veiga-Filho ◽  
Andréia Cristina Feitosa do Carmo ◽  
Rosely de Fátima Pellizzon ◽  
...  
Keyword(s):  
Randomized Controlled Trials ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Long Term Follow Up

scholarly journals Minimally Invasive Surgery in Patients With Intracerebral Hemorrhage: A Meta-Analysis of Randomized Controlled Trials

2022 ◽  
Vol 12 ◽  
Author(s):  
Duanlu Hou ◽  
Ying Lu ◽  
Danhong Wu ◽  
Yuping Tang ◽  
Qiang Dong
Keyword(s):  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Randomized Controlled Trials ◽  
Conventional Treatment ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Long Term Follow Up

Background: Minimally invasive surgery for intracerebral hemorrhage (ICH) has been evaluated in clinical trials. Although meta-analyses on this topic have been performed in the past, recent trials have added important information to the results of the comparison. However, little work has been done to compare the effect of MIS and conventional treatment on patient prognosis, especially mortality.Methods: PubMed, EMBASE, Web of Science, Ovid, China National Knowledge Infrastructure, and ClinicalTrials.gov were searched on May 1, 2021, for randomized controlled trials of MIS for spontaneous ICH. The primary outcome was defined as death at follow-up, while the secondary outcome was defined as death in different comparisons between MIS and craniotomy (CT) or medication (Me).Results: The initial search yielded 12 high-quality randomized controlled trials involving 2,100 patients. We analyzed the odds ratios (ORs) for MIS compared with conventional treatment, including Me and conventional CT. The OR and confidence intervals (CIs) of the primary and secondary outcomes were 0.62 (0.45–0.85) for MIS vs. conventional treatment. We also conducted subgroup analyses and found that the ORs and CIs for MIS compared with that of conventional treatment in the short-term follow-up were 0.58 (0.42–0.80), and, in the long-term follow-up, was 0.67 (0.46–0.98); and found that ORs were 0.68 (0.48–0.98) for MIS vs. CT and 0.57 (0.41–0.79) for MIS vs. Me.Conclusions: This meta-analysis demonstrates that certain patients with ICH benefit in short- and long-term follow-up from MIS over other treatments, including open surgery and conventional Me.Systematic Review Registration:https://www.crd.york.ac.uk/PROSPERO/.

scholarly journals Effects of right ventricular septum or His-bundle pacing versus right ventricular apical pacing on cardiac function: A systematic review and meta-analysis of randomized controlled trials

2018 ◽  
Vol 46 (9) ◽  
pp. 3848-3860 ◽  
Author(s):  
Lingfang Zhuang ◽  
Ye Mao ◽  
Liqun Wu ◽  
Wenquan Niu ◽  
Kang Chen
Keyword(s):  
Cardiac Function ◽  
Right Ventricular ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Left Ventricular ◽  
Controlled Trials ◽  
His Bundle ◽  
Randomized Controlled

Objective Recent studies have demonstrated that right ventricular apical (RVA) pacing has a deleterious impact on left ventricular function, while right ventricular septum (RVS) or His-bundle pacing (HBP) contribute to improvements in cardiac function. A meta-analysis of randomized controlled trials (RCTs) was conducted to compare the mid- and long-term effects of RVS and HB pacing versus RVA pacing on cardiac function. Methods Eligible RCTs were identified by systematically searching the electronic literature databases PubMed®, Cochrane Library, Embase® and Ovid®. Results Seventeen articles ( n = 1290 patients) were included in this meta-analysis, including 14 studies comparing the effects of RVA and RVS pacing on cardiac function and three studies comparing HBP with pacing at other sites. Compared with RVA pacing, RVS or HBP exhibited a higher left ventricular ejection fraction (LVEF) (weighted mean difference 3.28; 95% confidence interval 1.45, 5.12) at the end of follow-up. Conclusions RVS pacing exhibited a higher LVEF after long-term follow-up than RVA pacing. RVS pacing could replace the previously used RVA pacing as a better alternative with improved clinical outcomes. However, there remains a need for larger RCTs to compare the safety and efficacy of RVS with RVA pacing.

Validation of Microsimulation Models against Alternative Model Predictions and Long-Term Colorectal Cancer Incidence and Mortality Outcomes of Randomized Controlled Trials

2020 ◽  
Vol 40 (6) ◽  
pp. 815-829
Author(s):  
Jie-Bin Lew ◽  
Marjolein J. E. Greuter ◽  
Michael Caruana ◽  
Emily He ◽  
Joachim Worthington ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Randomized Controlled Trials ◽  
Fecal Occult Blood ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Incidence And Mortality ◽  
Long Term Follow Up ◽  
Microsimulation Models

Background. This study aimed to assess the validity of 2 microsimulation models of colorectal cancer (CRC), Policy1-Bowel and ASCCA. Methods. The model-estimated CRC risk in population subgroups with different health statuses, “dwell time” (time from incident precancerous polyp to symptomatically detected CRC), and reduction in symptomatically detected CRC incidence after a one-time complete removal of polyps and/or undetected CRC were compared with published findings from 3 well-established models ( MISCAN, CRC-SPIN, and SimCRC). Furthermore, 6 randomized controlled trials (RCTs) that provided screening using a guaiac fecal occult blood test (Funen trial, Burgundy trial, and Minnesota Colon Cancer Control Study [MCCCS]) or flexible sigmoidoscopy (NORCCAP, SCORE, and UKFSST) with long-term follow-up were simulated. Model-estimated long-term relative reductions of CRC incidence (RR inc) and mortality (RR mort) were compared with the RCTs’ findings. Results. The Policy1-Bowel and ASCCA estimates showed more similarities to CRC-SPIN and SimCRC. For example, overall dwell times estimated by Policy1-Bowel (24.0 years) and ASCCA (25.3) were comparable to CRC-SPIN (25.8) and SimCRC (25.2) but higher than MISCAN (10.6). In addition, ∼86% of Policy1-Bowel’s and ∼74% of ASCCA’s estimated RR inc and RR mort were consistent with the RCTs’ long-term follow-up findings. For example, at 17 to 18 years of follow-up, the MCCCS reported RR mort of 0.67 (95% confidence interval [CI], 0.51–0.83) and 0.79 (95% CI, 0.62–0.97) for the annual and biennial screening arm, respectively, and the UKFSST reported RR mort of 0.70 (95% CI, 0.62–0.79) for CRC at all sites and 0.54 (95% CI, 0.46–0.65) for distal CRC. The corresponding model estimates were 0.65, 0.74, 0.81, and 0.61, respectively, for Policy1-Bowel and 0.65, 0.70, 0.75, and 0.58, respectively, for ASCCA. Conclusion. Policy1-Bowel and ASCCA’s estimates are largely consistent with the data included for comparisons, which indicates good model validity.

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