Gelatin tannate for acute diarrhoea and gastroenteritis in children: a systematic review and meta-analysis

2019 ◽  
pp. archdischild-2018-316385 ◽  
Author(s):  
Ivan D Florez ◽  
Javier M Sierra ◽  
Laura F Niño-Serna

ObjectiveTo determine the effectiveness and safety of gelatin tannate (GT) for reducing the duration of the acute diarrhoea and gastroenteritis (ADG) in children.DesignSystematic review and meta-analysis.Data sourcesMEDLINE, Embase, CINAHL, Cochrane Central Register of Controlled Trials, LILACS and grey literature, published from inception to October 2018. No language restrictions.Eligibility criteria for selecting studiesRandomised controlled trials in children with ADG, comparing GT with placebo.ResultsOf 797 titles identified, we included three studies (276 children). We performed a random effects model meta-analysis for the main outcome (diarrhoea duration). We did not find significant differences between GT and placebo for diarrhoea duration (mean difference (MD)=−15.85 hours; 95% CI −42.24 to 14.82, I2=92%; three studies), stool frequency at day 2 (MD=0.11 stools/day; 95% CI −0.39 to 0.62: I2=26%; two studies), diarrhoea at day 3 (risk ratio [RR]=0.46; 95% CI 0.06 to 3.47: I2=73%; two studies), vomiting (RR=1.31; 95% CI 0.95 to 1.80: I2=0%; two studies) or adverse events (RR=0.86; 95% CI 0.27 to 2.66: I2=0%; two studies). Most common adverse events included abdominal pain and nausea.ConclusionThe effect of GT was no different to placebo for mean diarrhoea duration (low certainty on the evidence) and stool frequency at day 2 (high certainty) and for the presence of diarrhoea at day 3 (very low certainty) of vomiting (moderate certainty) and of adverse events (low certainty).PROSPERO registration numberCRD42018087902.

BMJ Open ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. e039366
Author(s):  
Luda Feng ◽  
Ning Liang ◽  
Tingting Li ◽  
Qinyu Yang ◽  
Ping Jiang ◽  
...  

IntroductionIntracerebral haemorrhage (ICH) is a life-threatening condition with no effective internal treatment options. However, edaravone is a promising therapeutic agent, although its beneficial effects are inconclusive based on previous systematic reviews and meta-analyses. While several trials in the last 8 years have reported the favourable long-term functional outcomes, a few reports indicated edaravone to be associated with an increase in adverse events.Methods and analysisThis protocol was performed in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols. We will perform the comprehensive and manual search for published articles, ongoing trials, dissertations and grey literature. The following databases will be searched from inception to 23 April 2020: Medline, Embase, the Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure, Chinese scientific periodical database of VIP INFORMATION, Wanfang Data and SinoMed, with no language restrictions. All randomised controlled trials that (1) compared edaravone with placebo or no treatment, and (2) compared edaravone plus routine treatment or cointervention with routine treatment or cointervention for treating acute ICH will be included. Mortality and long-term dependency will be the primary outcomes. The incidence of adverse events will be assessed for safety evaluation. Two reviewers in pairs will independently carry out the article selection, data extraction and quality assessment. Assessment of the risk of bias and data synthesis will be performed using software Review Manager V.5.3. Finally, we will use the Grading of Recommendations Assessment, Development and Evaluation approach to evaluate the quality of the overall evidence.Ethics and disseminationThere are no ethical considerations associated with this updated systematic review and meta-analysis. The findings will be disseminated in peer-reviewed journals or conference presentations.PROSPERO registration numberCRD42019147801.


2021 ◽  
pp. 194338752110162
Author(s):  
Gaston A. Salas ◽  
Shuheng A. Lai ◽  
Francisca Verdugo-Paiva ◽  
Roberto A. Requena

Objective: The objective of this systematic review is to assess the effectiveness and safety of platelet-rich fibrin (PRF) in third molar surgery. Data Sources: A comprehensive search strategy is meant to be used in an attempt to identify all relevant randomized controlled trials (RCTs), ongoing investigation reported in specialty congresses and trials regardless of language or publication status (published, unpublished, in press and in progress). Searches will be conducted in the Cochrane Central Register of Controlled Trials (CENTRAL), PUBMED, Embase, Lilacs, the International Clinical Trials Registry Platform (ICTRP), ClinicalTrials.gov , US National Institutes of Health (NIH), grey literature and in specialized congresses and conferences. Eligibility Criteria: We will include randomized trials evaluating the effect of PRF on wound healing after third molar surgery. Two reviewers will independently screen each study for eligibility, data extraction and risk of bias assessment using Cochrane “risk of bias” tool. We will pool the results using meta-analysis and will apply the GRADE system to assess the certainty of the evidence for each outcome. Ethics and Dissemination: As researchers will not access information that could lead to the identification of an individual participant, obtaining ethical approval was waived.


BMJ Open ◽  
2020 ◽  
Vol 10 (6) ◽  
pp. e036020
Author(s):  
Shuhei Murao ◽  
Hidekazu Nakata ◽  
Kazuma Yamakawa

IntroductionTranexamic acid (TXA) is a synthetic derivative of the amino acid lysine that inhibits fibrinolysis by blocking lysine-binding sites on plasminogen, which contribute to reduced bleeding, the need for transfusion and mortality. Although there is reliable evidence of the efficacy of TXA, its effects on other important outcomes, adverse events, including thrombotic events and seizure, remain uncertain.Methods and analysisWe will conduct a systematic review and meta-analysis of randomised controlled trials with the objective of evaluating the incidence of thrombotic adverse events and seizure and how the effect of TXA varies by dose and underlying disease. We will include patients with bleeding in any underlying disease. We will search MEDLINE, EMBASE and Cochrane Central Register of Controlled Trials for randomised controlled trials. The planned date of our systematic search is 1 June 2020. We will follow the recommendations of the Cochrane Collaboration and the Preferred Reporting Items for Systematic Review and Meta-Analysis statement. Subgroup and sensitivity analyses will be performed to explore residual heterogeneity and inconsistency. Meta-regression analysis will be carried out to investigate the association between the incidence of adverse events and the TXA dose. The risk of systematic errors (bias) and random errors will be assessed and the overall quality of evidence will be evaluated using the Grading of Recommendations Assessment, Development and Evaluation approach.Ethics and disseminationThis study will not involve primary data collection, and formal ethics approval will therefore not be required. We aim to publish this systematic review in a peer-review journal.Trial registration numberUMIN000039611.


BMJ Open ◽  
2018 ◽  
Vol 8 (11) ◽  
pp. e022012 ◽  
Author(s):  
Alina Rigabert ◽  
Emma Motrico ◽  
Patricia Moreno-Peral ◽  
Davinia M Resurrección ◽  
Sonia Conejo-Cerón ◽  
...  

IntroductionAlthough evidence exists for the efficacy of psychosocial interventions in preventing depression, little is known about its prevention through online interventions. The objective of this study is to conduct a systematic review and meta-analysis of randomised controlled trials assessing the effectiveness of online interventions in preventing depression in heterogeneous populations.Methods and analysisWe will conduct a systematic review and meta-analysis of randomised controlled trials that will be identified through searches of PubMed, PsycINFO, WOS, Scopus, OpenGrey, Cochrane Central Register of Controlled Trials, ClinicalTrials.gov and Australia New Zealand Clinical Trials Register . We will also search the reference lists provided in relevant studies and reviews. Experts in the field will be contacted to obtain more references. Two independent reviewers will assess the eligibility criteria of all articles, extract data and determine their risk of bias (Cochrane Collaboration Tool). Baseline depression will be required to have been discarded through standardised interviews or validated self-reports with standard cut-off points. The outcomes will be the incidence of new cases of depression and/or the reduction of depressive symptoms as measured by validated instruments. Pooled standardised mean differences will be calculated using random-effect models. Heterogeneity and publication bias will be estimated. Predefined sensitivity and subgroup analyses will be performed. If heterogeneity is relevant, random-effect meta-regression will be performed.Ethics and disseminationThe results will be disseminated through peer-reviewed publication and will be presented at a professional conference. Ethical assessment is not required as we will search and assess existing sources of literature.Trial registration numberCRD42014014804; Results.


2020 ◽  
Author(s):  
Shuheng Lai ◽  
Francisco Novillo ◽  
Geovanna Cárdenas ◽  
Francisca Verdugo ◽  
Gabriel Rada

AbstractObjectiveThe objective of this systematic review is to assess the effectiveness and safety of Hyaluronic Acid (HA) on tissue and bone regeneration after tooth extraction.Data SourcesWe will conduct a comprehensive search in Epistemonikos, PubMed/Medline, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), LILACS, the International Clinical Trials Registry Platform (ICTRP), ClinicalTrials.gov, US National Institutes of Health (NIH) and grey literature, to identify all relevant randomized controlled trials regardless of language or publication status (published, unpublished, in press and in progress).Eligibility Criteria for Selecting Studies and MethodsWe will include randomized trials evaluating the effect of HA on tissue and bone regeneration after tooth extraction. Two reviewers will independently screen each study for eligibility, data extraction, and assess the risk of bias. We will pool the results using meta-analysis and will apply the GRADE system to assess the certainty of the evidence for each outcome.Ethics and DisseminationNo ethics approval is considered necessary. The results of this review will be disseminated via peer-reviewed publications, social networks, and traditional media.PROSPERO Registration IDCRD42020150285


Author(s):  
Rocío Bravo-Jeria ◽  
María Ximena Rojas Reyes ◽  
Juan Víctor Ariel Franco ◽  
María Paz Acuña ◽  
Luz Ángela Torres López ◽  
...  

ABSTRACTObjectiveTo determine the relative impact of the use of chloroquine and hydroxychloroquine on outcomes important to patients with COVID 19.DesignThis is the protocol of a living systematic review.Data sourcesWe will conduct searches in PubMed/Medline, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), trial registries, grey literature and in a centralised repository in L·OVE (Living OVerview of Evidence). L·OVE is a platform that maps PICO questions to evidence from Epistemonikos database. In response to the COVID-19 emergency, L·OVE was adapted to expand the range of evidence it covers and customised to group all COVID-19 evidence in one place. The search will cover the period until the day before submission to a journal.Eligibility criteria for selecting studies and methodsWe will follow a common protocol for multiple parallel systematic reviews, already published and submitted to PROSPERO (awaiting ID allocation).We will include randomised controlled trials evaluating the effect of chloroquine and hydroxychloroquine — as monotherapy or in combination with other drugs — versus placebo or no treatment in patients with COVID-19. Randomised trials evaluating chloroquine and hydroxychloroquine in infections caused by other coronaviruses, such as MERS-CoV and SARS-CoV, and non-randomised studies in COVID-19 will be searched in case no direct evidence from randomised trials is found, or if the direct evidence provides low- or very low-certainty for critical outcomes.Two reviewers will independently screen each study for eligibility, extract data, and assess the risk of bias. We will perform random-effects meta-analyses and use GRADE to assess the certainty of the evidence for each outcome.A living, web-based version of this review will be openly available during the COVID-19 pandemic. We will resubmit it if the conclusions change or there are substantial updates.Ethics and disseminationNo ethics approval is considered necessary. The results of this review will be widely disseminated via peer-reviewed publications, social networks and traditional media.


2020 ◽  
Vol 2020 ◽  
pp. 1-16 ◽  
Author(s):  
He Cai ◽  
Junyu Chen ◽  
Nirmala K. Panagodage Perera ◽  
Xing Liang

Objective. The aim of this study was to evaluate the overall effects of herbal mouthwashes as supplements to daily oral hygiene on plaque and inflammation control compared with placebos and chlorhexidine (CHX) mouthwashes in the treatment of gingivitis. Methods. PubMed, EMBASE, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, and grey literature databases were searched. Only randomised controlled trials (RCTs) comparing herbal mouthwashes with placebos or CHX in the daily oral hygiene of patient with gingivitis were included to compare the effect of different mouthwashes on plaque and inflammation control. Results. A total of 13 studies satisfied the eligibility criteria, and 11 studies were included in meta-analyses. Significant differences were observed in favour of herbal mouthwashes compared with placebos in both plaque- and inflammation-related indices (Quigley-Hein Plaque Index, QHPI: WMD = −0.61, 95% CI (−0.80, −0.42), P<0.001; Gingival Index, GI: −0.28 (−0.51, −0.06), P=0.01; Modified Gingival Index, MGI: −0.59 (−1.08, −0.11), P=0.02; Gingival Bleeding Index, GBI: −0.06 (−0.09, −0.04), P<0.001). No significant difference was found between herbal and CHX mouthwashes. Conclusions. Herbal mouthwashes have potential benefits in plaque and inflammation control as supplements to the daily oral hygiene of patients with gingivitis. Although no difference was observed between herbal and CHX mouthwashes in the selected studies, further high-quality RCTs are needed for more firm support before advising patients with gingivitis about whether they can use herbal mouthwashes to substitute for CHX mouthwashes or not (PROSPERO registration number: CRD42019122841).


2020 ◽  
Author(s):  
Geovanna Cárdenas ◽  
Francisco Novillo ◽  
Shuheng Lai ◽  
Héctor Fuenzalida ◽  
Francisca Verdugo ◽  
...  

ABSTRACTObjectiveThe objective of this systematic review is to assess the impact of oxymetazoline in patients with moderate to severe rosacea.Data SourcesWe will conduct a comprehensive search in PubMed/Medline, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), Lilacs, the International Clinical Trials Registry Platform (ICTRP), ClinicalTrials.gov, US National Institutes of Health (NIH) and grey literature, to identify all relevant randomized controlled trials regardless of language or publication status (published, unpublished, in press and in progress).Eligibility criteria for selecting studies and methodsWe will include randomized trials evaluating the effect of oxymetazoline in patients with moderate to severe rosacea. Two reviewers will independently screen each study for eligibility, data extraction, and assess the risk of bias. We will pool the results using meta-analysis and will apply the GRADE [1] system to assess the certainty of the evidence for each outcome.Ethics and DisseminationNo ethics approval is considered necessary. The results of this review will be widely disseminated via peer-reviewed publications, social networks and traditional media.Protocol and RegistrationThis protocol was adapted to the specificities of the question assessed in this review and registered to PROSPERO with the ID CRD42020150262.


BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e035978
Author(s):  
Justin Lee ◽  
Ahmed Negm ◽  
Ryan Peters ◽  
Eric K C Wong ◽  
Anne Holbrook

ObjectivesPrevention of falls and fall-related injuries is a priority due to the substantial health and financial burden of falls on patients and healthcare systems. Deprescribing medications known as ‘fall-risk increasing drugs’ (FRIDs) is a common strategy to prevent falls. We conducted a systematic review to determine its efficacy for the prevention of falls and fall-related complications.DesignSystematic review and meta-analysis.Data sourcesMEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, CINAHL and grey literature from inception to 1 August 2020.Eligibility criteria for selecting studiesRandomised controlled trials of FRID withdrawal compared with usual care evaluating the rate of falls, incidence of falls, fall-related injuries, fall-related fractures, fall-related hospitalisations or adverse effects related to the intervention in adults aged ≥65 years.Data extraction and synthesisTwo reviewers independently performed citation screening, data abstraction, risk of bias assessment and certainty of evidence grading. Random-effects models were used for meta-analyses.ResultsFive trials involving 1305 participants met eligibility criteria. Deprescribing FRIDs did not change the rate of falls (rate ratio (RaR) 0.98, 95% CI 0.63 to 1.51), the incidence of falls (risk difference 0.01, 95% CI −0.06 to 0.09; relative risk 1.04, 95% CI 0.86 to 1.26) or rate of fall-related injuries (RaR 0.89, 95% CI 0.57 to 1.39) over a follow-up period of 6–12 months. No trials evaluated the impact of deprescribing FRIDs on fall-related fractures or hospitalisations.ConclusionThere is a paucity of robust high-quality evidence to support or refute that a FRID deprescribing strategy alone is effective at preventing falls or fall-related injury in older adults. Although there may be other reasons to deprescribe FRIDs, our systematic review found that it may result in little to no difference in the rate or risk of falls as a sole falls reduction strategy.PROSPERO registration numberCRD42016040203.


BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e040906
Author(s):  
Xinyu Zhao ◽  
Lihui Meng ◽  
Youxin Chen

ObjectiveTo give a comprehensive efficacy and safety ranking of different therapeutic regimens of ranibizumab for neovascular age-related macular degeneration (nAMD).DesignA systematic review and network meta-analysis.MethodsThe PubMed, Embase, Cochrane Central Register of Controlled Trials, and other clinical trial registries were searched up to 1 October 2019 to identify related randomised controlled trials (RCT) of different regimens of ranibizumab for nAMD. The primary efficacy outcome was the changes of best-corrected visual acuity (BCVA) at 1 year, the primary safety outcome was the incidence of severe ocular adverse events. Secondary outcomes such as changes of central retinal thickness (CRT) were evaluated. We estimated the standardised mean difference (SMD), ORs, 95% CIs, the surface under the cumulative ranking curves and the mean ranks for each outcome using network meta-analyses with random effects by Stata 14.0.ResultsWe identified 26 RCTs involving 10 821 patients with nAMD randomly assigned to 21 different therapeutic regimens of ranibizumab or sham treatment. Ranibizumab 0.5 mg (treat and extend, T&E) is most effective in terms of changes of BCVA (letters, SMD=21.41, 95% CI 19.86 to 22.95) and three or more lines of BCVA improvement (OR=2.83, 95% CI 1.27 to 4.38). However, it could not significantly reduce retreatment times compared with monthly injection (SMD=−0.94, 95% CI −2.26 to 0.39). Ranibizumab 0.5 mg (3+pro re nata)+non-steroidal anti-inflammatory drugs (NSAIDs) is most effective in reducing CRT and port delivery system of ranibizumab (100 mg/mL) could reduce the number of retreatment most significantly. All regimes have no more risk of severe ocular complications (including vitreous haemorrhage, rhegmatogenous retinal detachment, endophthalmitis, retinal tear and retinal pigment epithelium tear) or cardiocerebral vascular complications.ConclusionsRanibizumab 0.5 mg (T&E) is most effective in improving the visual outcome. The administration of topical NSAIDs could achieve additional efficacy in CRT reduction and visual improvement. Both interventions had acceptable risks of adverse events.


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