scholarly journals Allopurinol as add-on treatment for mania symptoms in bipolar disorder: Systematic review and meta-analysis of randomised controlled trials

2017 ◽  
Vol 210 (1) ◽  
pp. 10-15 ◽  
Author(s):  
Francesco Bartoli ◽  
Cristina Crocamo ◽  
Massimo Clerici ◽  
Giuseppe Carrà
Keyword(s):  
Systematic Review ◽  
Bipolar Disorder ◽  
Randomised Controlled Trials ◽  
Meta Analysis ◽  
Bipolar Affective Disorder ◽  
Adjunctive Treatment ◽  
Controlled Trials ◽  
Routine Practice ◽  
Moderate Effect Size ◽  
Randomised Controlled

BackgroundSince bipolar disorder seems to be associated with purinergic system dysfunction, allopurinol might be effective in treating symptoms of mania.AimsTo estimate the efficacy and tolerability of allopurinol as adjunctive treatment for mania symptoms in people with bipolar affective disorder.MethodWe conducted a systematic review and meta-analysis of randomised controlled trials (RCTs) comparing the effects of adjunctive allopurinol and placebo on mania symptom changes.ResultsFive RCTs were included in the meta-analysis. Participants with allopurinol augmentation had a significantly greater decrease in mania symptoms than those with placebo (SMD= −0.34, P = 0.007), especially in people with the most severe forms of mania. Remission rates, although based on only two studies (n = 177), were significantly higher among individuals receiving allopurinol, whereas for discontinuation and side-effects no difference was found.ConclusionsOur finding of a small to moderate effect size and overall low evidence for add-on allopurinol in reducing mania symptoms indicate that its use in routine practice needs further elucidation.

scholarly journals Behavioural sleep and circadian rhythm interventions in bipolar disorder: a systematic review of randomised controlled trials

2021 ◽  
Author(s):  
Lampros Bisdounis ◽  
kate saunders ◽  
Hannah Farley ◽  
Charlotte Lee ◽  
Niall McGowan ◽  
...  
Keyword(s):  
Systematic Review ◽  
Bipolar Disorder ◽  
Circadian Rhythm ◽  
Randomised Controlled Trials ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Randomised Controlled

A systematic review and meta-analysis of behavioural sleep and circadian rhythm intervention RCTs in bipolar disorder

scholarly journals 1586 Systematic Review and Meta-analysis of Randomised Controlled Trials of Intra-operative Surgical Drainage in Oesophagectomy

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
C S Wong ◽  
S Barman ◽  
Y Tryliskyy ◽  
D Namah ◽  
S Zino
Keyword(s):  
Systematic Review ◽  
Randomised Controlled Trials ◽  
Meta Analysis ◽  
Statistical Significance ◽  
Surgical Approaches ◽  
Controlled Trials ◽  
Routine Practice ◽  
Random Effects Models ◽  
Drain Placement ◽  
Randomised Controlled

Abstract Aim Three surgical approaches to oesophagus have been described. Drain placement in oesophagectomy remains controversial and is associated with complications. The review evaluates the effectiveness of surgically placed drain after oesophagectomy. Method Main electronic databases were searched for studies reported clinical outcomes or effects of cervical (neck), transthoracic (chest) and transabdominal drain placement. The systematic review was conducted according to PRISMA guidelines and meta-analysis was analysed using fixed and random-effects models. Results There were only two randomised controlled trials to date. Neither of these approaches (drain versus no drain) has convincing benefits in any particular oesophagectomy approach in early detection of anastomotic leakage, pleural effusion, and chylothorax nor disadvantages associated with significant morbidity and mortality and prolonged hospital stay. Conclusions Surgical drain in oesophagectomy may not confer additional benefit and routine practice of placement is surgeons preferential. The results do not reach statistical significance. Further work is required.

Do sleep interventions change sleep duration in children aged 0-5 years? A systematic review and meta-analysis of randomised controlled trials

2021 ◽  
pp. 101498
Author(s):  
LouiseJ. Fangupo ◽  
Jillian J. Haszard ◽  
Andrew N. Reynolds ◽  
Albany W. Lucas ◽  
Deborah R. McIntosh ◽  
...  
Keyword(s):  
Systematic Review ◽  
Sleep Duration ◽  
Randomised Controlled Trials ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Randomised Controlled

scholarly journals Comparative efficacy and safety of interventions for treating head lice: a protocol for systematic review and network meta-analysis

2021 ◽  
Vol 5 (1) ◽  
pp. e001129
Author(s):  
Bill Stevenson ◽  
Wubshet Tesfaye ◽  
Julia Christenson ◽  
Cynthia Mathew ◽  
Solomon Abrha ◽  
...  
Keyword(s):  
Systematic Review ◽  
Randomised Controlled Trials ◽  
Meta Analysis ◽  
Grey Literature ◽  
Risk Of Bias ◽  
Controlled Trials ◽  
Head Lice ◽  
Efficacy And Safety ◽  
Randomised Controlled ◽  
Meta Analyses

BackgroundHead lice infestation is a major public health problem around the globe. Its treatment is challenging due to product failures resulting from rapidly emerging resistance to existing treatments, incorrect treatment applications and misdiagnosis. Various head lice treatments with different mechanism of action have been developed and explored over the years, with limited report on systematic assessments of their efficacy and safety. This work aims to present a robust evidence summarising the interventions used in head lice.MethodThis is a systematic review and network meta-analysis which will be reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement for network meta-analyses. Selected databases, including PubMed, Embase, MEDLINE, Web of Science, CINAHL and Cochrane Central Register of Controlled Trials will be systematically searched for randomised controlled trials exploring head lice treatments. Searches will be limited to trials published in English from database inception till 2021. Grey literature will be identified through Open Grey, AHRQ, Grey Literature Report, Grey Matters, ClinicalTrials.gov, WHO International Clinical Trials Registry and International Standard Randomised Controlled Trials Number registry. Additional studies will be sought from reference lists of included studies. Study screening, selection, data extraction and assessment of methodological quality will be undertaken by two independent reviewers, with disagreements resolved via a third reviewer. The primary outcome measure is the relative risk of cure at 7 and 14 days postinitial treatment. Secondary outcome measures may include adverse drug events, ovicidal activity, treatment compliance and acceptability, and reinfestation. Information from direct and indirect evidence will be used to generate the effect sizes (relative risk) to compare the efficacy and safety of individual head lice treatments against a common comparator (placebo and/or permethrin). Risk of bias assessment will be undertaken by two independent reviewers using the Cochrane Risk of Bias tool and the certainty of evidence assessed using the Grading of Recommendations, Assessment, Development and Evaluations guideline for network meta-analysis. All quantitative analyses will be conducted using STATA V.16.DiscussionThe evidence generated from this systematic review and meta-analysis is intended for use in evidence-driven treatment of head lice infestations and will be instrumental in informing health professionals, public health practitioners and policy-makers.PROSPERO registration numberCRD42017073375.

scholarly journals Corticosteroid Injection Alone or Combined with Surgical Excision of Keloids versus Other Therapies Including Ionising Radiotherapy: A Systematic Review and Meta-Analysis of Randomised Controlled Trials

2021 ◽  
Vol 2 (2) ◽  
pp. 41-54
Author(s):  
Ru Wang ◽  
Patricia L. Danielsen ◽  
Magnus S. Ågren ◽  
Janine Duke ◽  
Fiona Wood ◽  
...  
Keyword(s):  
Systematic Review ◽  
Randomised Controlled Trials ◽  
Corticosteroid Injection ◽  
Meta Analysis ◽  
Interferon Α ◽  
Surgical Removal ◽  
Controlled Trials ◽  
Intralesional Corticosteroid ◽  
Intralesional Injections ◽  
Randomised Controlled

Keloid scars are difficult to manage and remain a therapeutic challenge. Corticosteroid therapy alone or ionising radiation (radiotherapy) alone or combined with surgery are first-line treatments, but the scientific justification for these treatments is unclear. The aim of this systematic review and meta-analysis of randomised controlled trials (RCTs) is to assess the effects of intralesional corticosteroid injection in treating keloids or preventing their recurrence after surgical removal. Searches for RCTs were conducted through the MEDLINE, EMBASE, EBSCO and Cochrane databases from January 1974 to September 2017. Two authors independently reviewed study eligibility, extracted data, analysed the results, and assessed methodological quality. Sixteen RCTs that included more than 814 patients were scrutinised. The quality of evidence for most outcomes was moderate to high. In 10 RCTs, corticosteroid intralesional injections were compared with 5-fluorouracil, etanercept, cryosurgery, botulinum toxin, topical corticosteroid under a silicone dressing, and radiotherapy. Corticosteroid intralesional injections were more effective than radiotherapy (RR 3.3, 95% CI: 1.4–8.1) but equipotent with the other interventions. In conjunction with keloid excision, corticosteroid treatment was compared with radiotherapy, interferon α-2b and verapamil. In two RCTs, there were fewer keloid recurrences (RR 0.43, 95% CI: 0.21–0.89) demonstrated with adjuvant radiotherapy than with corticosteroid injections. More high-quality, large-scale RCTs are required to establish the effectiveness of corticosteroids and other therapies in keloid management.

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