scholarly journals Adherence to Single-Pill Versus Free-Equivalent Combination Therapy in Hypertension

Hypertension ◽  
2021 ◽  
Author(s):  
Gianfranco Parati ◽  
Sverre Kjeldsen ◽  
Antonio Coca ◽  
William C. Cushman ◽  
Jiguang Wang
Keyword(s):  
Systematic Review ◽  
Blood Pressure ◽  
Antihypertensive Therapy ◽  
Narrative Analysis ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Random Effects Models ◽  
Single Pill ◽  
Discontinue Therapy ◽  
The Cochrane Library

Poor adherence to antihypertensive therapy is a major cause of poor blood pressure (BP) control in patients with hypertension. Regimen simplification may improve adherence and BP control. This systematic review assessed whether single-pill combination (SPC) therapy led to improved adherence, persistence, and better BP control compared with free-equivalent combination (FEC) therapy in patients with hypertension. PubMed, Medline, Embase, and the Cochrane Library were searched until July 2020, in addition to manual searching of relevant congress abstracts from 2014 to 2020 for studies including adults with hypertension aged ≥18 years receiving SPC or FEC antihypertensive therapy measuring any of the following: adherence, persistence, and reductions in systolic BP and/or diastolic BP. Adherence and persistence were summarized in a narrative analysis; direct pair-wise meta-analysis was conducted to compare BP reductions with SPC therapy versus FEC therapy using fixed-effect and random-effects models. Following screening, 44 studies were included. The majority (18 of 23) of studies measuring adherence showed adherence was significantly improved in patients receiving SPCs versus FECs. Overall, 16 studies measured persistence, of which 14 showed that patients receiving SPCs had significantly improved persistence or were significantly less likely to discontinue therapy than patients receiving FECs. Systolic BP (mean difference, −3.99 [95% CI, −7.92 to −0.07]; P =0.05) and diastolic BP (−1.54 [95% CI, −2.67 to −0.41]; P =0.0076) were both significantly reduced with SPC therapy compared with FEC therapy at week 12. SPC therapy leads to improved adherence and persistence compared with FEC therapy and may lead to better BP control in patients with hypertension.

scholarly journals Incidence of injuries and illness and related risk factors in mountain biking events: A systematic review protocol

2020 ◽  
Author(s):  
Kim Buchholtz ◽  
Mike Lambert ◽  
Theresa Burgess
Keyword(s):  
Systematic Review ◽  
Systematic Reviews ◽  
Narrative Analysis ◽  
Meta Analysis ◽  
Sports Injury ◽  
Cochrane Library ◽  
Mountain Biking ◽  
True Incidence ◽  
Related Risk ◽  
The Cochrane Library

Abstract Background Cycling is a popular sport and method of transportation globally but is a significant contributor to sports injury admissions in hospital emergency units. Mountain biking events present additional challenges with remote venues, and isolated courses. Most mountain biking events will provide on-site medical care for both injury and illness occurring during races. These data are essential to understand the true incidence of injury and illness in mountain biking events as national health data may not represent these unique events specifically. Methods This review will follow the preferred reporting items for systematic reviews and meta-analysis (PRISMA) statement. Search engines PubMed, Scopus, SPORTDiscus (EBSCOhost), PEDro and the Cochrane Library will be systematically searched. Gray literature searches of Google Scholar and manual searching of reference lists and congress abstracts from cycling specific congresses will be conducted. Journal articles documenting illness and injury in adults participating in mountain bike cross-country marathon events will be included. A narrative analysis of the types, severity and area of injuries; and illness type and severity will be performed. A quantitative analysis may be performed should there be sufficient studies reported in the same format. Discussion This protocol outlines a systematic review on injury and illness in mountain biking events. Data from hospital records may not adequately represent the burden of injury and illness at events held in remote venues, especially if those treated on site do not require further hospital based treatment. This review will assist with the development of further research in this area, and in preparation of clinicians working in these types of events. Systematic review registration: This protocol has been registered with PROSPERO International prospective register of systematic reviews (No: CRD42019134586).

scholarly journals Comparison of Intravenous Dexmedetomidine versus Esmolol for Attenuation of Hemodynamic Response to Tracheal Intubation after Rapid Sequence Induction: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 2019 ◽  
pp. 1-9
Author(s):  
Zhao Li ◽  
Li Xu ◽  
Jinwei Zheng ◽  
Qingxiu Wang
Keyword(s):  
Systematic Review ◽  
Blood Pressure ◽  
Tracheal Intubation ◽  
Meta Analysis ◽  
Rapid Sequence Induction ◽  
Hemodynamic Response ◽  
Cochrane Library ◽  
Rapid Sequence ◽  
Sequence Induction ◽  
The Cochrane Library

The present study aims to investigate whether intravenous dexmedetomidine shows superiority to esmolol for hemodynamic response to tracheal intubation after rapid sequence induction. In the present meta-analysis, PubMed, EMBASE, and the Cochrane Library were searched for trials comparing dexmedetomidine with esmolol for the attenuation of the hemodynamic response to intubation. Ten trials were selected in the present meta-analysis. Compared to esmolol, the use of dexmedetomidine maintains stable heart rates (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) at 1 min, 3 min, and 5 min after tracheal intubation. Dexmedetomidine causes less hemodynamic response to tracheal intubation after rapid sequence induction compared with esmolol.

scholarly journals Incidence of injuries and illness and related risk factors in mountain biking events: A systematic review protocol

2020 ◽  
Author(s):  
Kim Buchholtz ◽  
Mike Lambert ◽  
Theresa Burgess
Keyword(s):  
Systematic Review ◽  
Systematic Reviews ◽  
Narrative Analysis ◽  
Meta Analysis ◽  
Sports Injury ◽  
Cochrane Library ◽  
Mountain Biking ◽  
True Incidence ◽  
Related Risk ◽  
The Cochrane Library

Abstract Background Cycling is a popular sport and method of transportation globally but is a significant contributor to sports injury admissions in hospital emergency units. Mountain biking events present additional challenges with remote venues, and isolated courses. Most mountain biking events will provide on-site medical care for both injury and illness occurring during races. These data are essential to understand the true incidence of injury and illness in mountain biking events as national health data may not represent these events specifically. Methods This review will follow the preferred reporting items for systematic reviews and meta-analysis (PRISMA) statement. Search engines PubMed, Scopus, CINAHL (EBSCOhost), PEDro and the Cochrane Library will be systematically searched. Gray literature searches of Google Scholar and manual searching of reference lists and congress abstracts from cycling specific congresses will be conducted. Journal articles documenting illness and injury in adults participating in mountain bike cross-country marathon events will be included. A narrative analysis of the types, severity and area of injuries; and illness type and severity will be performed. A quantitative analysis will be performed should there be sufficient studies reported in the same format. Discussion This protocol outlines a systematic review on injury and illness in mountain biking events. Data from hospital records may not adequately represent the burden of injury and illness at events held in remote venues, especially if those treated on site do not require further hospital based treatment. This review will assist with the development of further research in this area, and in preparation of clinicians working in these types of events. Systematic review registration: This protocol has been registered with PROSPERO International prospective register of systematic reviews (No: CRD42019134584).

Selective Serotonin Reuptake Inhibitors (SSRIs) and Serotonin Norepinephrine Reuptake Inhibitors (SNRIs) During Pregnancy and the Risk for Autism spectrum disorder (ASD) and Attention deficit hyperactivity disorder (ADHD) in the Offspring: a True Effect or a Bias? A Systematic Review & Meta-Analysis

2021 ◽  
Vol 19 ◽  
Author(s):  
Regina Leshem ◽  
Benjamin Bar-Oz ◽  
Orna Diav-Citrin ◽  
Siham Gbaly ◽  
Jessica Soliman ◽  
...  
Keyword(s):  
Systematic Review ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Meta Analysis ◽  
Autism Spectrum ◽  
Cochrane Library ◽  
Point Estimate ◽  
Unmeasured Confounding ◽  
Random Effects Models ◽  
Hyperactivity Disorder ◽  
The Cochrane Library

Background and Objective: An inconsistent association between exposure to SSRIs and SNRIs and the risk for ASD and ADHD in the Offspring was observed in observational studies. Some suggest that the reported association might be due to unmeasured confounding. We aimed to study this association and to look for sources of bias by performing a systematic review and meta-analysis. Methods: Medline, Embase, and the Cochrane Library were searched up to June 2019 for studies reporting on ASD and ADHD in the Offspring following exposure during pregnancy. We followed the PRISMA 2009 guidelines for data selection and extraction. Outcomes were pooled using random-effects models and odds ratios (OR), and 95% confidence intervals (CI) were calculated for each outcome using the adjusted point estimate of each study. Results: Eighteen studies were included in the meta-analysis. We found an association between SSRIs/SNRIs prenatal use and the risk for ASD and ADHD (OR=1.42, 95% CI: 1.23–1.65, I2=58%; OR=1.26, 95% CI: 1.07-1.49, I2=48%, respectively). Similar findings were obtained in women who were exposed to SSRIs/SNRIs before pregnancy, representing statistically significant association with ASD (OR=1.39, 95% CI: 1.24-1.56, I2=33%) and ADHD (OR=1.63, 95% CI: 1.50-1.78, I2=0%) in the Offspring, although they were not exposed to those medications in utero. Conclusions: Although we found an association between exposure to SSRIs/SNRIs during pregnancy and the risk for ASD and ADHD, an association with those disorders was also present for exposure pre-pregnancy, suggesting that the association might be due to unmeasured confounding. We are aiming to further assess the role of potential unmeasured confounding in the estimation of the association and perform a network meta-analysis.

scholarly journals EXPRESS: Stroke risk following traumatic brain injury: systematic review and meta-analysis

2021 ◽  
pp. 174749302110042
Author(s):  
Grace Mary Turner ◽  
Christel McMullan ◽  
Olalekan Lee Aiyegbusi ◽  
Danai Bem ◽  
Tom Marshall ◽  
...  
Keyword(s):  
Systematic Review ◽  
Stroke Risk ◽  
Meta Analysis ◽  
Vitamin K Antagonists ◽  
Cochrane Library ◽  
Control Group ◽  
Large Sample Size ◽  
Hazard Ratios ◽  
Increased Risk ◽  
The Cochrane Library

Aims To investigate the association between TBI and stroke risk. Summary of review We undertook a systematic review of MEDLINE, EMBASE, CINAHL, and The Cochrane Library from inception to 4th December 2020. We used random-effects meta-analysis to pool hazard ratios (HR) for studies which reported stroke risk post-TBI compared to controls. Searches identified 10,501 records; 58 full texts were assessed for eligibility and 18 met the inclusion criteria. The review included a large sample size of 2,606,379 participants from four countries. Six studies included a non-TBI control group, all found TBI patients had significantly increased risk of stroke compared to controls (pooled HR 1.86; 95% CI 1.46-2.37). Findings suggest stroke risk may be highest in the first four months post-TBI, but remains significant up to five years post-TBI. TBI appears to be associated with increased stroke risk regardless of severity or subtype of TBI. There was some evidence to suggest an association between reduced stroke risk post-TBI and Vitamin K antagonists and statins, but increased stroke risk with certain classes of antidepressants. Conclusion TBI is an independent risk factor for stroke, regardless of TBI severity or type. Post-TBI review and management of risk factors for stroke may be warranted.

scholarly journals Long-term oncologic outcomes of transanal TME compared with transabdominal TME for rectal cancer: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Jae Young Moon ◽  
Min Ro Lee ◽  
Gi Won Ha
Keyword(s):  
Rectal Cancer ◽  
Meta Analysis ◽  
Disease Free Survival ◽  
Distant Recurrence ◽  
Oncologic Outcomes ◽  
Cochrane Library ◽  
Transanal Total Mesorectal Excision ◽  
Random Effects Models ◽  
The Cochrane Library

Abstract Background Transanal total mesorectal excision (TaTME) appears to have favorable surgical and pathological outcomes. However, the evidence on survival outcomes remains unclear. We performed a meta-analysis to compare long-term oncologic outcomes of TaTME with transabdominal TME for rectal cancer. Methods PubMed, EMBASE, and the Cochrane Library were searched. Data were pooled, and overall effect size was calculated using random-effects models. Outcome measures were overall survival (OS), disease-free survival (DFS), and local and distant recurrence. Results We included 11 nonrandomized studies that examined 2,143 patients for the meta-analysis. There were no significant differences between the two groups in OS, DFS, and local and distant recurrence with a RR of 0.65 (95% CI 0.39–1.09, I2 = 0%), 0.79 (95% CI 0.57–1.10, I2 = 0%), 1.14 (95% CI 0.44–2.91, I2 = 66%), and 0.75 (95% CI 0.40–1.41, I2 = 0%), respectively. Conclusion In terms of long-term oncologic outcomes, TaTME may be an alternative to transabdominal TME in patients with rectal cancer. Well-designed randomized trials are warranted to further verify these results.

Appendectomy Does Not Increase the Risk of Future Emergence of Parkinson’s Disease: A Meta-analysis

2021 ◽  
pp. 000313482198903
Author(s):  
Mitsuru Ishizuka ◽  
Norisuke Shibuya ◽  
Kazutoshi Takagi ◽  
Hiroyuki Hachiya ◽  
Kazuma Tago ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Random Effects Models ◽  
Significant Difference ◽  
The Cochrane Library ◽  
The Impact ◽  
The Relationship ◽  
Observation Period

Objective To explore the impact of appendectomy history on emergence of Parkinson’s disease (PD). Background Although there are several studies to investigate the relationship between appendectomy history and emergence of PD, the results are still controversial. Methods We performed a comprehensive electronic search of the literature (the Cochrane Library, PubMed, and the Web of Science) up to April 2020 to identify studies that had employed databases allowing comparison of emergence of PD between patients with and those without appendectomy history. To integrate the impact of appendectomy history on emergence of PD, a meta-analysis was performed using random-effects models to calculate the risk ratio (RR) and 95% confidence interval (CI) for the selected studies, and heterogeneity was analyzed using I2 statistics. Results Four studies involving a total of 6 080 710 patients were included in this meta-analysis. Among 1 470 613 patients with appendectomy history, 1845 (.13%) had emergences of PD during the observation period, whereas among 4 610 097 patients without appendectomy history, 6743 (.15%) had emergences of PD during the observation period. These results revealed that patients with appendectomy history and without appendectomy had almost the same emergence of PD (RR, 1.02; 95% CI, .87-1.20; P = .83; I2 = 87%). Conclusion This meta-analysis has demonstrated that there was no significant difference in emergence of PD between patients with and those without appendectomy history.

scholarly journals Lumbar Roll Usage While Sitting Reduces the Forward Head Posture in Healthy Individuals: A Systematic Review with Meta-Analysis

2021 ◽  
Vol 18 (10) ◽  
pp. 5171
Author(s):  
Yusuke Handa ◽  
Kenya Okada ◽  
Hiroshi Takasaki
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Grade System ◽  
Cochrane Library ◽  
Forward Head Posture ◽  
Quality Of Evidence ◽  
Head Posture ◽  
Head Extension ◽  
The Cochrane Library

This systematic review and meta-analysis investigated whether the use of a lumbar roll reduced forward head posture (FHP) while sitting among individuals with or without musculoskeletal disorders. EMBASE, MEDLINE, and the Cochrane Library were systematically searched from their inception to August 2020. The quality of evidence for variables used in the meta-analysis was determined using the GRADE system. Five studies satisfied the criteria for data analysis. All studies included individuals without any spinal symptoms. Data from five studies on neck angle showed a statistically significant (p = 0.02) overall effect (standardized mean difference (SMD) = 0.77), indicating a lesser neck flexion angle while sitting with a lumbar roll than without it. Data from two studies on head angle showed a statistically significant (p = 0.04) overall effect (SMD = 0.47), indicating a lesser head extension angle while sitting with a lumbar roll than without it. In each meta-analysis, the quality of evidence was very low in the GRADE system. The use of a lumbar roll while sitting reduced FHP among individuals without spinal symptoms.

scholarly journals Effect of somatometric parameters on the prevalence and severity of varicocele: a systematic review and meta-analysis

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Runqing Li ◽  
Junjie Liu ◽  
Yushan Li ◽  
Quanxian Wang
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Cochrane Library ◽  
China National Knowledge Infrastructure ◽  
Random Effects Models ◽  
Knowledge Infrastructure ◽  
Regression Test ◽  
Mean Differences ◽  
Q Statistic ◽  
The Relationship

Abstract Background Published studies have shown contradictory results regarding the relationship between somatometric parameters and varicoceles. We performed a systematic review and meta-analysis to investigate the possible effects of age, height, weight, and body mass index (BMI) on the presence and severity of varicoceles. Methods Databases including EMBASE, MEDLINE, PubMed, Cochrane Library, China National Knowledge Infrastructure (CNKI), Web of Science, and Google Scholar were systematically searched to identify relevant articles published up to March 2020. Two researchers independently identified eligible articles and extracted data. Cochran’s Q statistic and I2 statistics were used to assess heterogeneity. Meta-analysis was performed using StataSE 12.0 software (StataCorp LP, USA). Random-effects models were used to obtain the weighted mean differences (WMDs) and 95% confidence intervals (CIs). Publication bias was assessed using Begg’s funnel plot and Egger’s regression test. Results The search strategy produced 272 articles, of which 18 articles were eligible according to the inclusion/exclusion criteria. A total of 56,325 patients with varicocele and 1,334,694 patients without varicocele were included in the meta-analysis to evaluate the effect of somatometric parameters on the presence and severity of varicocele. The overall results demonstrated that the presence of varicoceles was significantly associated with height (WMD = 1.41, 95% CI = 1.07 to 1.74, P < 0.001) and inversely correlated with BMI (WMD = − 1.35, 95% CI = -1.67 to − 1.03, P < 0.001) but not with age (WMD = -0.93, 95% CI = -2.19 to 0.33, P = 0.149) or weight (WMD = 0.24, 95% CI = -2.24 to 2.72, P = 0.850). The severity of varicocele was inversely correlated with increased BMI but not with age. Conclusion The presence of varicoceles was significantly associated with height and inversely correlated with BMI.

What Types of Exercise Are More Effective in Reducing Obesity and Blood Pressure for Middle-Aged Women? A Systematic Review With Meta-Analysis

2021 ◽  
pp. 109980042110154
Author(s):  
Seong-Hi Park ◽  
Chul-Gyu Kim
Keyword(s):  
Systematic Review ◽  
Blood Pressure ◽  
Metabolic Syndrome ◽  
Body Weight ◽  
Waist Circumference ◽  
Meta Analysis ◽  
Physical Activities ◽  
Risk Of Bias ◽  
Cochrane Library ◽  
Middle Aged

Background: A systematic review was performed to identify the types of physical activities effective as interventions in preventing metabolic syndrome in middle-aged women. Methods: Electronic databases (MEDLINE, EMBASE, the Cochrane Library, and CINAHL) served as the data sources. Cochrane’s Risk of Bias 2 was applied to assess the risk of bias of the randomized controlled trials. Meta-analyses were performed on selected studies using Review Manager 5.3. Thirty-one trials enrolling 2,202 participants were included. Results: Compared to controls, the effects of physical activity were indicated by pooled mean differences, which were −0.57 kg for body weight, −0.43 kg/m2 for body mass index, −1.63 cm for waist circumference, −4.89 mmHg for systolic blood pressure (BP), and −2.71 mmHg for diastolic BP. The effects were greater on the measurements of waist circumference and BP than on body weight and BMI. The types of physical activities were further analyzed according to sub-groups. Only aerobic exercise did not affect body weight and resistance exercise did not significantly change any results. Contrarily, combined exercises significantly reduced measurements of waist circumference and BP. Conclusion: This review can provide valuable information for research and implementation of measures to prevent metabolic syndrome in middle-aged women.

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