Latest Clinical Evidence About Effect of Acetylcysteine on Preventing Contrast-Induced Nephropathy in Patients Undergoing Angiography: A Meta-Analysis

Angiology ◽  
2020 ◽  
pp. 000331972095016
Author(s):  
Wenchao Xie ◽  
Xiangwen Liang ◽  
Zhihai Lin ◽  
Ming Liu ◽  
Zheng Ling
Keyword(s):  
Clinical Evidence ◽  
Renal Cortex ◽  
Meta Analysis ◽  
Control Group ◽  
Acute Renal Injury ◽  
Contrast Induced Nephropathy ◽  
Renal Vasoconstriction ◽  
The Third ◽  
Hospital Acquired ◽  
Risk Ratios

Contrast-induced nephropathy (CIN) is a serious complication of angiographic procedures. It is the third most common cause of hospital acquired acute renal injury. As there are currently no approved therapies for CIN, prevention could be the best strategy to address this issue. Acetylcysteine may indirectly play an antioxidant role by inducing the synthesis of glutathione. Acetylcysteine can also reduce renal vasoconstriction induced by contrast medium stimulation by stabilizing nitric oxide and acting directly or indirectly on renal cortex and medulla microcirculation. To evaluate the effect of acetylcysteine on the prevention of CIN in patients after angiography, we systematically searched and analyzed the clinical data of patients including the incidence of CIN and change in serum creatinine (SCr) at 48 hours after angiography from selected articles. The result showed that acetylcysteine significantly reduces the incidence of CIN (risk ratios: 0.78, 95% CI: 0.68-0.90, I 2 = 37.3%) and the level of SCr (standardized mean difference: −0.53, 95% CI: −0.93 to −0.12, I 2 = 91.5%) after angiography compared with the control group. Overall, the use of acetylcysteine in patients after angiography was associated with a significant reduction of CIN and the level of SCr.

scholarly journals Meta-analysis of effect of renin–angiotensin–aldosterone system blockers on contrast-induced nephropathy

2020 ◽  
Vol 21 (2) ◽  
pp. 147032032091958
Author(s):  
Weidong Wang ◽  
Wei Qu ◽  
Dan Sun ◽  
Xiaodan Liu
Keyword(s):  
Older People ◽  
Sample Size ◽  
Meta Analysis ◽  
Control Group ◽  
Inclusion Criteria ◽  
Contrast Induced Nephropathy ◽  
Renin Angiotensin Aldosterone System ◽  
Renin Angiotensin ◽  
Increased Risk ◽  
Larger Sample

Background: The purpose of this study was to systematically evaluate the effect of renin–angiotensin–aldosterone system blockers on the incidence of contrast-induced nephropathy in patients undergoing coronary angiography or percutaneous coronary intervention. Methods: A systematic literature search of several databases was conducted to identify studies that met the inclusion criteria. A total of 12 studies with 14 trials that performed studies on a total of 4864 patients (2484 treated with renin–angiotensin–aldosterone system blockers and 2380 in the control group) were included. The primary endpoint was the overall incidence of contrast-induced nephropathy. Analyses were performed with STATA version 12.0. Results: The overall contrast-induced nephropathy incidence in renin–angiotensin–aldosterone system blocker and control groups was 10.43% and 6.81%, respectively. The pooled relative risk of contrast-induced nephropathy incidence was 1.22 (95% confidence interval: 0.81–1.84) in the renin–angiotensin–aldosterone system blocker group. An increased risk of developing contrast-induced nephropathy in the renin–angiotensin–aldosterone system blocker group was observed among older people, non-Asians, chronic users, and studies with larger sample size, and the pooled RRs and 95% confidence intervals were 2.02 (1.21–3.36), 2.30 (1.41–3.76), 1.69 (1.10–2.59) and 1.83 (1.28–2.63), respectively. Conclusions: Intervention with renin–angiotensin–aldosterone system blockers was associated with an increased risk of contrast-induced nephropathy among non-Asians, chronic users, older people, and studies with larger sample size. Large clinical trials with strict inclusion criteria are needed to confirm our results and to evaluate the effect further.

scholarly journals The Effect of Mother-Infant Skin to Skin Contact after Birth on Third Stage of Labor: A Systematic Review and Meta-Analysis

2019 ◽  
Author(s):  
Fatemeh Zahra KARIMI ◽  
Hamid HEIDARIAN MIRI ◽  
Maryam SALEHIAN ◽  
Talat KHADIVZADEH ◽  
Mohaddese BAKHSHI
Keyword(s):  
Systematic Review ◽  
Postpartum Hemorrhage ◽  
Meta Analysis ◽  
Control Group ◽  
Chi Square ◽  
The Third ◽  
Skin Contact ◽  
Third Stage Of Labor ◽  
Third Stage ◽  
Skin To Skin

Background: One of the causes of postpartum hemorrhage is prolongation of third stage of labor. Mother-infant skin to skin contact (SSC) immediately after delivery is one of the non-pharmacological interventions to reduce this stage. Studies which assessed the effect of mother-infant SSC after delivery on duration of the third stage of labor reported controversial results on this issue. Therefore, this study investigated the effect of mother-infant SSC immediately after birth on the duration of third stage of labor Methods: In this systematic review and meta-analysis, the databases of PubMed, Scopus, Cochrane, SID, Magiran IranDoc and Google Scholar were searched from 2000 to 2018, using the keywords related to the objectives of this review to access randomized control trials published in Persian or English. The quality of papers was examined using Cochran's Risk of bias tool. Data was analyzed using Stata software. We used I2 index and Chi-square test to investigate heterogeneity and Egger’s and Begg’s tests to assess publications bias. Random effects model was used to combine the data. Results: Six studies were entered into the meta-analysis. The third stage of labor in SSC group was shorter than that of control group with a mean difference of -1.33 and 95% CI (-2.31 to -0.36) and this difference was statistically significant (P=0.007). Conclusion: Mother-infant SSC decreases the duration of third stage of labor. Therefore, the current study provides some evidences to use this non-pharmacological method in order to accelerate the third stage of labor and ultimately prevent postpartum hemorrhage.  

scholarly journals Renoprotective Effect of Egyptian Cape Gooseberry Fruit (Physalis peruvianaL.) against Acute Renal Injury in Rats

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Lamiaa Ali Ahmed
Keyword(s):  
Body Weight ◽  
Renal Injury ◽  
Thiobarbituric Acid ◽  
Basal Diet ◽  
Male Rats ◽  
Control Group ◽  
Acute Renal Injury ◽  
Renoprotective Effect ◽  
Physalis Peruviana ◽  
The Third

This study aimed to evaluate the renoprotective effect ofPhysalis peruvianaL. extract (PPE) on acute renal injury in rats. Adult male rats (n=36) were divided into six groups that were fed with basal diet throughout the experiment (33 days). The first group was normal group, the second and the third groups were administered orally with 100 and 150 mg PPE/kg body weight (BW) respectively, the fourth group was injected intraperitoneally with 5 mg/kg BW cisplatin once on the 28th day to induced ARI, and the fifth and sixth groups were treated like the second and the third groups and were injected with cisplatin on the 28th day. Many bioactive compounds were found in PPE. PPE did not cause any changes in the second and third groups compared to normal control group. Administration of PPE prior to cisplatin injection caused significant reduction in relative kidney weight, serum creatinine, urea, blood urea nitrogen, and significant increments in body weight, feed intake, total protein, albumin, and total globulin compared to cisplatin group. Pretreatment with PPE improved kidney histology and diminished the level of thiobarbituric acid reactive substances and enhanced other antioxidant enzymes in kidney homogenate compared to cisplatin group.

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.

Seizures and Neuropsychiatric Toxicity in Patients with Non-Metastatic CRPC Treated with New Antiandrogens: Systematic Review and Meta-Analysis

2021 ◽  
Vol 44 (4) ◽  
pp. 153-160
Author(s):  
Raquel Sopeña Sutil ◽  
Jorge Silva Ruiz ◽  
Borja Garcia Gomez ◽  
Javier Romero-Otero ◽  
Lucia Garcia-Gonzalez ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Control Group ◽  
Castration Resistant Prostate Cancer ◽  
Free Survival ◽  
Castration Resistant ◽  
History Of ◽  
Neuropsychiatric Toxicity ◽  
Grade 3 ◽  
Risk Ratios

Introduction: Recently, enzalutamide, apalutamide, and darolutamide have shown benefits in metastasis-free survival in non-metastatic castration-resistant prostate cancer (nmCRPC) patients compared to placebo. Previous evidence about the safety profile of these new androgens is limited. This meta-analysis studies seizure and neuropsychiatric effects of new anti-androgens compared to placebo in nmCRPC patients. Methods: PubMed and Cochrane databases were systematically reviewed until 1 March 2020 by 2 independent researchers using a pre-specified search strategy. Placebo-compared randomized controlled trials (RCTs) of nmCRPC patients treated with new anti-androgens providing data on neuropsychiatric events and seizures were included. Variables were seizure, headache, mental impairment, and dizziness. Pooled risk ratios (RR) were calculated using the Mantel-Hansel random effects model and Review Manager v5.3 software. Results: After systematic review, 3 eligible RCTs were selected that included 4,104 patients; 2,687 comprised the treatment group and 1,417 the control group. No significant increase in RR for seizures was registered with the new anti-androgens compared to placebo (RR 1.96; 95% confidence interval [CI] 0.40–9.61). However, 2 trials excluded patients with risk factors or a history of seizures. There was also no significant increase RR for grade ≥3 seizures (RR 2.50; 95% CI 0.12–52.02). RR for suffering dizziness (any grade) was 1.57 (95% CI 1.07–2.32) with the new anti-androgens, but no significant differences were found in the other study regarding neuropsychiatric events or grade ≥3 events. Conclusions: New anti-androgens (i.e., enzalutamide, apalutamide, and darolutamide) are acceptably safe in terms of seizures and neuropsychiatric toxicity compared to placebo in patients with nmCRPC.

Effect of Alprostadil on the Prevention of Contrast-Induced Nephropathy: A Meta-Analysis of 36 Randomized Controlled Trials

Angiology ◽  
2019 ◽  
Vol 70 (7) ◽  
pp. 594-612 ◽  
Author(s):  
Jian Xie ◽  
Mingyang Jiang ◽  
Yunni Lin ◽  
Huachu Deng ◽  
Lang Li
Keyword(s):  
Cystatin C ◽  
Meta Analysis ◽  
Coronary Intervention ◽  
Control Group ◽  
Contrast Induced Nephropathy ◽  
Percutaneous Coronary ◽  
Intrarenal Blood Flow ◽  
And Control ◽  
Experimental Group ◽  
Different Doses

Contrast-induced nephropathy (CIN) is the third leading cause of acquired acute renal injury in hospitalized patients. Alprostadil plays a role in the maintenance and redistribution of intrarenal blood flow and the excretion of electrolytes and water. However, the effectiveness of alprostadil in preventing CIN remains controversial. Thirty-six articles with a total of 5495 patients were included in this study. Both groups (experimental group and control group) received standard hydration therapy. In the experimental group, patients received different doses of alprostadil. Serum creatinine (SCr), blood urea nitrogen (BUN), estimated glomerular filtration rate (eGFR), cystatin C, creatinine clearance rate (CCr), and β2-microglobulin (β2-MG) were measured at 24, 48, and 72 hours after contrast media injection. The incidence of CIN in the experimental group was significantly lower than that in the control group (6.56% vs 16.74%). The level of SCr, cystatin C, BUN, and β2-MG in the experimental group was lower than those in the control group; CCr and eGFR in the experimental group were higher than those in the control group. This study demonstrated that alprostadil may reduce the incidence of CIN in patients undergoing coronary angiogram and/or percutaneous coronary intervention.

scholarly journals Efficacy of Acupuncture for Psychological Symptoms Associated with Opioid Addiction: A Systematic Review and Meta-Analysis

2014 ◽  
Vol 2014 ◽  
pp. 1-13 ◽  
Author(s):  
Zhang Boyuan ◽  
Chen Yang ◽  
Cheng Ke ◽  
Shen Xueyong ◽  
Liu Sheng
Keyword(s):  
Clinical Evidence ◽  
Randomized Clinical Trials ◽  
Psychological Symptoms ◽  
Meta Analysis ◽  
Opioid Addiction ◽  
Anxiety And Depression ◽  
Control Group ◽  
Significant Difference ◽  
Chinese And English

This review systematically assessed the clinical evidence for and against acupuncture as a treatment for psychological symptoms associated with opioid addiction. The database was accessed from MEDLINE and China Knowledge Resource Integrated Database. We included all randomized clinical trials published in Chinese and English regardless of their controls. Meta-analysis was performed using the RevMan software, version 5.2. We conducted a literature search of 16 databases from their inception to January 2014. Four studies from Western countries did not report any clinical gains in the treatment of psychological symptoms associated with opioid addiction. 10 of 12 studies from China have reported positive findings regarding the use of acupuncture to treat the psychological symptoms associated with opioid addiction. The methodological quality of the included studies was poor. The meta-analysis indicated that there was a significant difference between the treatment group and the control group for anxiety and depression associated with opioid addiction, although groups did not differ on opioid craving. This review and meta-analysis could not confirm that acupuncture was an effective treatment for psychological symptoms associated with opioid addiction. However, considering the potential of acupuncture demonstrated in the included studies, further rigorous randomized controlled trials with long followup are warranted.

The effects of Cyclosporin-A (CYA) on the Ultrastructure of Gingival Mast Cells (GMC) in Behcet's disease (BD)

1990 ◽  
Vol 48 (3) ◽  
pp. 358-359
Author(s):  
Oktay Arda ◽  
Ulkü Noyan ◽  
Selgçk Yilmaz ◽  
Mustafa Taşyürekli ◽  
İsmail Seçkin ◽  
...  
Keyword(s):  
Unknown Etiology ◽  
Control Group ◽  
Target Cells ◽  
Gingival Hyperplasia ◽  
Cellular Activity ◽  
Direct Relation ◽  
Immune Disease ◽  
Genital Ulceration ◽  
Functional Changes ◽  
The Third

Turkish dermatologist, H. Beheet described the disease as recurrent triad of iritis, oral aphthous lesions and genital ulceration. Auto immune disease is the recent focus on the unknown etiology which is still being discussed. Among the other immunosupressive drugs, CyA included in it's treatment newly. One of the important side effects of this drug is gingival hyperplasia which has a direct relation with the presence of teeth and periodontal tissue. We are interested in the ultrastructure of immunocompetent target cells that were affected by CyA in BD.Three groups arranged in each having 5 patients with BD. Control group was the first and didn’t have CyA treatment. Patients who had CyA, but didn’t show gingival hyperplasia assembled the second group. The ones displaying gingival hyperplasia following CyA therapy formed the third group. GMC of control group and their granules are shown in FIG. 1,2,3. GMC of the second group presented initiation of supplementary cellular activity and possible maturing functional changes with the signs of increased number of mitochondria and accumulation of numerous dense cored granules next to few normal ones, FIG. 4,5,6.

Meta-Analysis of the Third Session Client--Therapist Working Alliance

2006 ◽  
Author(s):  
Georgiana S. Tryon ◽  
Sasha M. Collins ◽  
Elizabeth Felleman
Keyword(s):  
Working Alliance ◽  
Meta Analysis ◽  
The Third

THE EFFECT OF APPLYING DEMONSTRATION METHOD ON STUDENTS’ ACHIEVEMENT IN SPEAKING SKILL AT THE THIRD GRADE OF SMK PAB 3 MEDAN ESTATE

2015 ◽  
Vol 4 (2) ◽  
Author(s):  
Meryanti Napitupulu And Anni Holila Pulungan
Keyword(s):  
High School ◽  
Control Group ◽  
Vocational High School ◽  
Control Groups ◽  
Speaking Test ◽  
The Third ◽  
Speaking Skill ◽  
The Subject ◽  
And Control ◽  
Experimental Group

This study was conducted as an attempt to discover the effect of applying Demonstration Method on students’ achievement in speaking skill. It was an experimental research. The subject was students of Grade XII, Vocational High School (Sekolah Menengah Kejuruan: SMK), which consisted of 79 students. The research was divided into two groups: experimental and control groups. The instrument used to collect the data was speaking test. To obtain the reliability of the test, the writer applied Kuder Richardson 21 formula. The result of the reliability was 0.7, and it was found that the test was reliable. The data were analyzed by using t-test formula. The analysis showed that the scores of the students in the experimental group were significantly higher than the scores of the students in the control group at the level of significant m = 0.05 with the degree of freedom (df) 77, t-observed value 8.9 > t-table value 1.99. The findings indicate that using Demonstration Method significantly affected the students’ achievement in speaking skill. So, English teachers are suggested to use Demonstration Method in order to improve students’ achievement in speaking skill.

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