scholarly journals Combination between Mifepristone and Methotrexate to Treat Ectopic Pregnancy: A Systematic Review Protocol

2021 ◽  
Author(s):  
Qiling Su ◽  
Huiyan Feng ◽  
Tian Tian ◽  
Xiaoqian Liao ◽  
Yunhui Li ◽  
...  
Keyword(s):  
Ectopic Pregnancy ◽  
Controlled Trial ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Secondary Outcome ◽  
Control Group ◽  
China National Knowledge Infrastructure ◽  
Advantages And Disadvantages ◽  
Randomized Controlled ◽  
Outcome Index

Background: In recent years, the morbidity of ectopic pregnancy and the proportion of young and childless patients have increased year by year, which makes it important to early diagnose EP, effectively save patients' lives and furthest preserve their fertility. Methotrexate and mifepristone are most widely used in conservative treatments, however, there is no accurate conclusion about which therapy is better. Therefore, the aims in this meta-analysis are, on the one hand, to systematically analyze the efficacy of mifepristone combined with methotrexate in the treatment of ectopic pregnancy through existing studies, and to draw scientific conclusions. On the other hand, to fill the gap of relevant analysis in China and abroad, to evaluate the advantages and disadvantages of inclusion trials and propose improvement measures and scientific designing schemes. Methods: Six electronic databases will be searched, including PubMed, Embase, Cochrane Library, the China National Knowledge Infrastructure(CNKI), Chinese Science and Technology Periodical Database (VIP), and Wanfang Database (WF). Literature from October 2015 to October 2020 on randomized controlled trials will be searched, without any language or publication restriction. Search terms include mifepristone, methotrexate, ectopic pregnancy, and random (free word/synonym expansion). Included in a randomized controlled trial, the treatment group was treated with mifepristone combined with methotrexate, and the control group was treated with mifepristone alone. Revman 5.4 (provided by Cochrane) will be used to evaluate the quality of the literature, and the corresponding effect model will be selected to analyze the results. The cure rate will be the main outcome index, and the remaining outcome measures after literature inclusion will be the secondary outcome indexes. Result: Only when we finish this meta-analysis can we get the result. Discussion: The results of this study will provide reliable evidence for the efficacy of mifepristone combined with methotrexate therapy in the treatment of ectopic pregnancy.

scholarly journals Impact of Adjuvant Use of Midodrine to Intravenous Vasopressors: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Ahmad Al-Abdouh ◽  
Sadam Haddadin ◽  
Atul Matta ◽  
Ahmad Jabri ◽  
Mahmoud Barbarawi ◽  
...  
Keyword(s):  
Retrospective Studies ◽  
Controlled Trial ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Control Group ◽  
Inclusion Criteria ◽  
Randomized Controlled ◽  
Icu Length Of Stay ◽  
Significant Difference ◽  
Risk Ratios

Purpose. To evaluate the efficacy and safety of midodrine use in intensive care units (ICU) to facilitate weaning off intravenous vasopressors (IVV). Methods. We searched PubMed/MEDLINE, Cochrane library, and Google Scholar (inception through October 18th, 2020) for studies evaluating adjuvant use of midodrine to IVV in the ICU. The outcomes of interest were ICU length of stay (LOS), hospital LOS, mortality, IVV reinstitution, ICU readmission, and bradycardia. Estimates were pooled using the random-effects model. We reported effect sizes as standardized mean difference (SMD) for continuous outcomes and risk ratios (RRs) for other outcomes with a 95% confidence interval (CI). Results. A total of 6 studies were found that met inclusion criteria and had sufficient data for our quantitative analysis (1 randomized controlled trial and 5 retrospective studies). A total of 2,857 patients were included: 600 in the midodrine group and 2,257 patients in the control group. Midodrine use was not associated with a significant difference in ICU LOS (SMD 0.16 days; 95% CI −0.23 to 0.55), hospital LOS (SMD 0.03 days; 95% CI −0.33 to 0.0.39), mortality (RR 0.87; 95% CI 0.52 to 1.46), IVV reinstitution (RR 0.47; 95% CI 0.17 to 1.3), or ICU readmission (RR 1.03; 95% CI 0.71 to 1.49) when compared to using only IVV. However, there were higher trends of bradycardia with midodrine use that did not reach significance (RR 7.64; 95% CI 0.23 to 256.42). Conclusion. This meta-analysis suggests that midodrine was not associated with a significant decrease in ICU LOS, hospital LOS, mortality, or ICU readmissions.

scholarly journals A Systematic Review of the Efficacy and Safety of Didroxyprogesterone Combined with Progesterone in the Treatment of Luteal Insufficiency-Induced Abortion

2021 ◽  
Vol 5 (4) ◽  
pp. 58-63
Author(s):  
Yanjing Yang ◽  
Hongli Zhu
Keyword(s):  
Controlled Trial ◽  
Meta Analysis ◽  
Induced Abortion ◽  
Cochrane Library ◽  
Combination Group ◽  
Control Group ◽  
Efficacy And Safety ◽  
Randomized Controlled ◽  
Pubmed Database ◽  
Luteal Insufficiency

Objective: To systematically evaluate the efficacy and safety of didroxyprogesterone combined with progesterone in the treatment of luteal insufficiency abortion. Methods: We searched CNKI database, VIP database, Wanfang database, PubMed database, EMBASE database and Cochrane library database for literatures on the treatment of luteal insufficiency-induced abortion with didroxyprogesterone and progesterone. Meta-analysis was performed using Revman 5.3 software after literature extraction and further quality evaluation. Results: Ten randomized controlled trial-related articles that describe studies on a total of 1145 patients, 570 in the combination group and 575 in the control group, were included. The results of meta-analysis showed that combination therapy could improve the effective rate of fetal protection (OR = 0.14, 95% CI [0.07, 0.27], P < 0.00001). The safety of the combination group was significantly higher than that of the control group (OR = 3.09, 95% CI [1.13,8.48], P = 0.03). Conclusion: To sum up, compared with the control group, the combination of progesterone and progesterone is more effective and safer in the treatment of luteal insufficiency abortion. However, the sample size of the data is relatively small and the quality of the literature is low. This conclusion still needs to be further verified in high-quality randomized controlled trials that involve large samples.

scholarly journals The effect of rTMS in the management of pain associated with CRPS

2020 ◽  
Vol 11 (1) ◽  
pp. 363-370
Author(s):  
Min Cheol Chang ◽  
Sang Gyu Kwak ◽  
Donghwi Park
Keyword(s):  
Repetitive Transcranial Magnetic Stimulation ◽  
Controlled Trial ◽  
Meta Analysis ◽  
Pain Syndrome ◽  
Treatment Session ◽  
Cochrane Library ◽  
Exclusion Criteria ◽  
Analgesic Effects ◽  
Randomized Controlled ◽  
Before And After

AbstractBackgroundTherapeutic management of pain in patients with complex regional pain syndrome (CRPS) is challenging. Repetitive transcranial magnetic stimulation (rTMS) has analgesic effects on several types of pain. However, its effect on CRPS has not been elucidated clearly. Therefore, we conducted a meta-analysis of the available clinical studies on rTMS treatment in patients with CRPS.Materials and methodsA comprehensive literature search was conducted using the PubMed, EMBASE, Cochrane Library, and SCOPUS databases. We included studies published up to February 09, 2020, that fulfilled our inclusion and exclusion criteria. Data regarding measurement of pain using the visual analog scale before and after rTMS treatment were collected to perform the meta-analysis. The meta-analysis was performed using Comprehensive Meta-analysis Version 2.ResultsA total of three studies (one randomized controlled trial and two prospective observational studies) involving 41 patients were included in this meta-analysis. No significant reduction in pain was observed immediately after one rTMS treatment session or immediately after the entire schedule of rTMS treatment sessions (5 or 10 sessions; P > 0.05). However, pain significantly reduced 1 week after the entire schedule of rTMS sessions (P < 0.001).ConclusionrTMS appears to have a functional analgesic effect in patients with CRPS.

scholarly journals Does regular strength training cause urinary incontinence in overweight inactive women? A randomized controlled trial

2021 ◽  
Author(s):  
Kari Bø ◽  
Lene Anette H. Haakstad ◽  
Gøran Paulsen ◽  
Anne Mette Rustaden
Keyword(s):  
Randomized Controlled Trial ◽  
Urinary Incontinence ◽  
Strength Training ◽  
Short Form ◽  
Controlled Trial ◽  
Secondary Outcome ◽  
Control Group ◽  
Randomized Controlled ◽  
Sum Score ◽  
New Onset

Abstract Introduction and hypothesis Urinary incontinence (UI) is common in women who exercise. We aimed to investigate new onset UI in formerly inactive, overweight or obese women (BMI > 25) participating in three different strength training modalities compared with a non-exercising control group. Methods This was a secondary analysis of an assessor blinded randomized controlled trial investigating the effect of 12 weeks of three strength training concepts for women on muscle strength and body composition. None of the programs included pelvic floor muscle training. International Consensus on Incontinence Questionnaire Urinary Incontinence Short Form (ICIQ-UI-SF) was used to investigate primary outcome; new onset UI, and secondary outcome; ICIQ-UI-SF sum score. Suissa and Shuster’s exact unconditional test was used to analyze difference in new onset UI. Difference in ICIQ-UI-SF sum score is presented as mean with 95% CI. Results At baseline 40 out of 128 (31.2%) participants reported UI. Three out of 27, 2 out of 17, 2 out of 23, and 0 out of 21 women in the three training and control groups respectively had new onset UI. There were no statistically significant differences in new onset UI across the groups or when collapsing new onset UI in the intervention groups compared with the controls (7 out of 67 vs 0 out of 21), p = 0.124. After the intervention the control group reported worse ICIQ-UI-SF sum score than any of the training groups; mean difference − 6.6 (95% CI: −11.9, −1.27), p = 0.012, but there was no difference in change from baseline to 12 weeks between the groups p = 0.145). Conclusions There was no statistically significant change in UI after strength training.

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 Large Dosage of Chishao in Formulae for Cholestatic Hepatitis: A Systematic Review and Meta-Analysis

2014 ◽  
Vol 2014 ◽  
pp. 1-10 ◽  
Author(s):  
Xiao Ma ◽  
Ji Wang ◽  
Xuan He ◽  
Yanling Zhao ◽  
Jiabo Wang ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Cholestatic Hepatitis ◽  
Cochrane Library ◽  
Efficacy Rate ◽  
China National Knowledge Infrastructure ◽  
Randomized Controlled ◽  
Knowledge Infrastructure ◽  
Novel Treatment ◽  
Large Dosage ◽  
Biochemical Indices

Objective. To evaluate the efficacy and safety of large dosage of Chishao in formulae for treatment of cholestatic hepatitis.Methods. The major databases (PubMed, Embase, Cochrane Library, Chinese Biomedical Database Wanfang, VIP medicine information system, and China National Knowledge Infrastructure) were searched until January 2014. Randomized controlled trials (RCTs) of large dosage of Chishao in formulae that reported on publications in treatment of cholestatic hepatitis with total efficacy rate, together with the biochemical indices including alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL), and direct bilirubin (DBIL), were extracted by two reviewers. The Cochrane tool was used for the assessment of risk of bias included trials. Data were analyzed with RevMan 5.2.7 software.Results. 11 RCTs involving 1275 subjects with cholestatic hepatitis were included. Compared with essential therapy, large dosage of Chishao in formulae demonstrated more efficiently with down regulation of serum ALT, AST, TBIL, DBIL. Meanwhile, there were no obvious adverse events.Conclusion. As a promising novel treatment approach, widely using large dosage of Chishao in formulae may enhance the curative efficacy for cholestatic hepatitis. Considering being accepted by more and more practitioners, further rigorously designed clinical studies are required.

Effectiveness of Acupuncture in Postpartum Depression: A Systematic Review and Meta-Analysis

2018 ◽  
Vol 36 (5) ◽  
pp. 295-301 ◽  
Author(s):  
Shanshan Li ◽  
Weiqiang Zhong ◽  
Wen Peng ◽  
Gaofeng Jiang
Keyword(s):  
Postpartum Depression ◽  
Rating Scale ◽  
Meta Analysis ◽  
Depression Scale ◽  
Cochrane Collaboration ◽  
Clinical Effectiveness ◽  
Effective Rate ◽  
Cochrane Library ◽  
Secondary Outcome ◽  
Control Group

Objective To assess the clinical effectiveness of acupuncture in the treatment of postpartum depression (PPD). Methods The following electronic databases were systematically searched: PubMed, Cochrane Library, SCI, Elsevier SDOL, China National Knowledge, Wan Fang database and Chinese Science and Technology Periodical Database. Only randomised controlled trials (RCTs) of acupuncture for PPD were considered. Primary outcomes were the Hamilton Rating Scale for Depression (HAMD) or the Edinburgh Postnatal Depression Scale (EPDS) scores and effective rate. Our secondary outcome was the level of oestradiol. The quality of all included trials was evaluated according to the Cochrane Collaboration. This protocol was registered in PROSPERO (CRD42016048528). Results Nine trials involving 653 women were selected. The result of this meta-analysis demonstrated that the acupuncture group had a significantly greater overall effective rate compared with the control group (seven trials, n=576, I2=24%; relative risk (RR) 1.15, 95% CI 1.06 to 1.24; P<0.001). Moreover, acupuncture significantly increased oestradiol levels compared with the control group (mean difference (MD) 36.92, 95% CI 23.14 to 50.71, P<0.001). Regarding the HAMD and EPDS scores, no difference was found between the two groups (five trials, n=276, I2=82%; MD−1.38, 95% CI −3.40 to 0.64; P=0.18; two trials, n=60, I2=16%; MD 1.08, 95% CI −1.09 to 3.26; P=0.33). Conclusions Acupuncture appears to be effective for postpartum depression with respect to certain outcomes. However, the evidence thus far is inconclusive. Further high-quality RCTs following standardised guidelines with a low risk of bias are needed to confirm the effectiveness of acupuncture for postpartum depression.

Predictive Value and Correlation of Neuron-Specific Enolase for Prognosis in Patients with Coma: A Systematic Review and Meta-Analysis

2020 ◽  
pp. 1-11
Author(s):  
Wen Ye ◽  
Yunliang Tang ◽  
Xiaoyang Dong ◽  
Gengfa Chen ◽  
Yan Yan ◽  
...  
Keyword(s):  
Predictive Value ◽  
Meta Analysis ◽  
Life Quality ◽  
Neuron Specific Enolase ◽  
Cochrane Library ◽  
Control Group ◽  
China National Knowledge Infrastructure ◽  
Clinical Prognosis ◽  
Standard Mean Difference ◽  
Disturbance Of Consciousness

<b><i>Objective:</i></b> Coma is the most serious disturbance of consciousness, which affects the life quality of patients and increases the burden of their family. Studies to assess the prognostic value of neuron-specific enolase (NSE) in patients with coma have not led to precise, generally accepted prognostic rules. The study aims to assess the correlation between NSE and prognosis of coma and the predictive value of NSE for clinical prognosis. <b><i>Methods:</i></b> A search was conducted using PubMed, Web of Science, EMBASE, Cochrane Library, China National Knowledge Infrastructure (CNKI), and WanFang Data from the establishment time of databases to December 2019. This analysis included patients with coma, regardless of how long the coma was. In total, 26 articles were retrieved and included in the review. <b><i>Results:</i></b> The meta-analysis revealed the NSE concentration of patients with coma is significantly higher than that of the control group (standard mean difference = 0.88, 95% confidence interval [CI]: 0.63–1.12, <i>p</i> &#x3c; 0.05). The pooled sensitivity and specificity of NSE in coma diagnosis was 0.5 (95% CI: 0.39–0.61) and 0.86 (95% CI: 0.71–0.94). <b><i>Conclusions:</i></b> The NSE concentration of patients with poor coma prognosis is significantly higher than that of the control group. The high NSE concentration is not necessarily a poor prognosis for coma, but low NSE concentration indicates a high probability of a good prognosis for coma.

scholarly journals Whether stoma support rods have application value in loop enterostomy: a systematic review and meta-analysis

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Rui Du ◽  
Jiajie Zhou ◽  
Feng Wang ◽  
Dongliang Li ◽  
Guifan Tong ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Control Group ◽  
Inclusion Criteria ◽  
Randomized Controlled ◽  
Total Incidence ◽  
The Difference ◽  
Effect Of Support ◽  
Experimental Group

Abstract Purpose The purpose of the systematic review and meta-analysis is to analyze the application value of the stoma support rods in loop enterostomy. Methods The studies on the application of stoma rods in loop enterostomy published from January 2000 to January 2020 were searched in the databases of PubMed, Embase, Cochrane library, and Clinical trials. All randomized controlled trials (RCTs) and cohort studies that observed the value of stoma rods were included according to inclusion criteria. The RevMan5.3 software was used for statistical analysis. Results A total of 1131 patients with loop enterostomy in six studies were included in this study; there were 569 cases in the experimental group and 562 cases in the control group. All six studies analyzed the effect of support rods on the incidence of stoma retraction; the meta-analysis showed that in a total of 32 patients, stoma retraction occurred, with a total incidence of about 2.8% in 1131 patients. The incidence of stoma retraction in the rod group was not significantly lower than that in the non-rod group, and the difference was not statistically significant (OR = 0.65, 95% CI 0.32~1.32, I2 = 0%, P = 0.23), and the studies were homogeneous. The incidences of stoma necrosis (OR = 6.41, 95% CI 2.22~18.55, I2 = 0%, P = 0.0006), peristomal dermatitis (OR = 2.93, 95% CI 2.01~4.27, I2 = 0%, P < 0.00001), and mucocutaneous separation (OR = 2.14, 95% CI 1.03~4.47, I2 = 0%, P = 0.04) were significantly increased in the rod group. Conclusions It is not recommended to routinely use stoma support rods in the clinical practice.

Efficacy of Bimodal High-Voltage Monopulsed Current in the Treatment of Pressure Ulcer: A Systematic Review

2020 ◽  
Author(s):  
Zhiwei ZHANG ◽  
Bojun LI ◽  
Zhichao WANG ◽  
Lina WU ◽  
Lili SONG ◽  
...  
Keyword(s):  
Treatment Group ◽  
Pressure Ulcer ◽  
High Voltage ◽  
Meta Analysis ◽  
Descriptive Analysis ◽  
Cochrane Library ◽  
Control Group ◽  
Randomized Controlled ◽  
Randomized Controlled Studies ◽  
Significant Difference

Background: We aimed to systematically evaluate the efficacy of high-voltage pulsed current (HVPC) in the treatment of pressure ulcer. Methods: We searched the databases of PubMed, Cochrane Library, Elsevier and EMBASE to identify randomized controlled studies on the application of HVPC in pressure ulcer treatment, up to January 2019. Two authors independently screened the literature according to the inclusion and exclusion criteria, extracted the data and evaluated the quality. RevMan 5.3 software was used for statistical analysis. Four randomized controlled trials involving a total of 176 patients were included in the study. Results: Meta-analysis showed that the percentage of wound area reduction in the HVPC treatment group was higher than that in the control group (95%CI 24.59, 47.76, P<0.001). Descriptive analysis showed that there was no significant difference in wound healing between the HVPC treatment group and the control group. One study reported that there was contact dermatitis, and the rest of the studies reported no adverse events. Conclusion: Compared with the conventional therapy, the combination with HVPC therapy can reduce the area of pressure ulcers more effectively. However, due to the small number of the studies included in this evaluation, the conclusions need to be verified by more high-quality studies.

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