scholarly journals Efficacy of 5-HT3 receptor antagonists (ondansetron) vs dopamine receptor antagonists (droperidol) for preventing postoperative nausea, vomiting and headache: a meta-analysis

Pteridines ◽  
2019 ◽  
Vol 30 (1) ◽  
pp. 146-152
Author(s):  
Xiaoyun Chen ◽  
Yinying Qin ◽  
Siying Li ◽  
Heshou Lei ◽  
Xiaoyun Wu ◽  
...  
Keyword(s):  
Dopamine Receptor ◽  
Postoperative Nausea ◽  
Fixed Effects ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Original Data ◽  
Fixed Effects Model ◽  
Receptor Antagonists ◽  
Dopamine Receptor Antagonists ◽  
Post Operative Nausea

Abstract Objective To investigate the effects of 5-hydroxytryptamine 3 receptor antagonists (ondansetron [OND]) versus dopamine receptor antagonists (droperidol [DRO]) in the prevention of postoperative nausea, vomiting (PONV) and headache by pooling data from open published studies. Methods Performed systematic electronic searches of PubMed, Embase, Google scholar and CNKI, to identify open-published prospective randomized controlled trials (RCTs) relevant to the comparison of OND versus DRO for preventing PONV and headache to be included in the present study. The pooled PONV, headache, dizziness and drowsiness were calculated based on the original data of each included study. The pooled data was presented with risk ratio (RR) and 95% confidence interval (95%CI). Results Thirteen prospective randomized clinical trials were included in this meta-analysis. The pooled PONV, post-operative nausea (PON) and positive operative vomiting (POV) were 0.67 (95%CI:0.48-0.93, p<0.05), 0.88 (95%CI:0.67-1.14, p>0.05) and 0.56 (95%CI:0.39-0.82,p<0.05) respectively for OND vs. DRO. And the overall pooled positive operative nausea and vomiting was 0.71(95%CI:0.60-0.86) by fixed effects model for OND vs. DRO. The pooled risk of postoperative headache, dizziness and drowsiness were 4.33 (95%CI:0.76-24.69, p>0.05), 0.63 (95%CI:0.21-1.87, p>0.05) and 0.48(0.28-0.81,p<0.05) respectively by fixed effect model for OND vs. DRO. Conclusion The post-operative nausea, vomiting and dizziness risks were significant decreased for patients receiving OND compared to patients receiving DRO.

Use of Statins and Breast Cancer: A Meta-Analysis of Seven Randomized Clinical Trials and Nine Observational Studies

2005 ◽  
Vol 23 (34) ◽  
pp. 8606-8612 ◽  
Author(s):  
Stefanos Bonovas ◽  
Kalitsa Filioussi ◽  
Nikolaos Tsavaris ◽  
Nikolaos M. Sitaras
Keyword(s):  
Breast Cancer ◽  
Breast Cancer Risk ◽  
Cancer Risk ◽  
Publication Bias ◽  
Observational Studies ◽  
Fixed Effects ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Sensitivity Analyses ◽  
Fixed Effects Model

Purpose A growing body of evidence suggests that statins may have chemopreventive potential against breast cancer. Laboratory studies demonstrate that statins induce apoptosis and reduce cell invasiveness in various cell lines, including breast carcinoma cells. However, the clinical relevance of these data remains unclear. The nonconclusive nature of the epidemiologic data prompted us to conduct a detailed meta-analysis of the studies published on the subject in peer-reviewed literature. Patients and Methods A comprehensive search for articles published up until 2005 was performed; reviews of each study were conducted; and data were abstracted. Before meta-analysis, the studies were evaluated for publication bias and heterogeneity. Pooled relative risk (RR) estimates and 95% CIs were calculated using the random and the fixed-effects models. Subgroup and sensitivity analyses were also performed. Results Seven large randomized trials and nine observational studies (five case-control and four cohort studies) contributed to the analysis. We found no evidence of publication bias or heterogeneity among the studies. Statin use did not significantly affect breast cancer risk (fixed effects model: RR = 1.03; 95% CI, 0.93 to 1.14; random effects model: RR = 1.02; 95% CI, 0.89 to 1.18). When the analyses were stratified into subgroups, there was no evidence that study design substantially influenced the estimate of effects. Furthermore, the sensitivity analysis confirmed the stability of our results. Conclusion Our meta-analysis findings do not support a protective effect of statins against breast cancer. However, this conclusion is limited by the relatively short follow-up times of the studies analyzed. Further studies are required to investigate the potential decrease in breast cancer risk among long-term statin users.

Association of risk of febrile neutropenia (FN) with docetaxel in prostate cancer (PC) patients: A meta-analysis of published phase II-III trials.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e21683-e21683
Author(s):  
Blazquez Arroyo Maria ◽  
Antonio Merida Garcia ◽  
David Lora ◽  
Brandon David Bernard ◽  
Lorente David ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Relative Risk ◽  
Phase Ii ◽  
Fixed Effects ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Bone Marrow Involvement ◽  
Risk Groups ◽  
Castration Resistant Prostate Cancer ◽  
Fixed Effects Model

e21683 Background: Reported rates of FN with docetaxel (DTX) in PC patients are variable. This creates uncertainty regard the use of granulocyte colony-stimulating factor primary prophylaxis (G-CSF) in this setting. We conducted a meta-analysis of randomized clinical trials to determine the relative risk (RR) of FN in patients receiving DTX. Methods: To perform this analysis we systematically searched in PUBMED and MEDLINE database the following terms: “DTX”, “randomized clinical trial” and “prostate cancer” only for articles published between January 1996 and August 2016. Phase II-III clinical studies comparing DTX to non-DTX control arms (best supportive care [BSC] including non-cytotoxic therapy or mitoxantrone) for PC were included. The meta-analyses were performed by computing RRs with 95% confidence intervals (CI) using fixed-effects model with the Mantel-Haenszel method. Results: Seven studies (N = 5088 patients) were included. The global incidence of FN in patients treated with DTX was 10.7%. The RR of FN was higher in patients receiving DTX compared to patients did not receive DTX (RR 16.8 [95% CI 10.7; 26.4] p < 0.0001). 6.6% of patients with metastatic castration resistant prostate cancer (CRPC) treated with DTX developed FN, the RR of FN with DTX compared to mitoxantrone was 28.6 (95% CI 5.6; 145.1). 12.4% of patients with hormone-sensitive prostate cancer (HSPC) treated with DTX developed FN, the RR of FN was 15.3 (95% CI 9.6; 24.6) compared to BSC. There was no statistically significant differences in the rate of FN according to the hormone sensitivity (HSPC vs CRPC) (p = 0.7). In most studies the use of G-CSF was at the discretion of the investigator. Conclusions: This meta-analysis shows that DTX is associated with a significant increase in the relative risk of FN in patients with PC. The effectiveness of primary prophylactic G-CSF in this setting has not been fully established. The incidence reported here does not meet the threshold recommended by ESMO and ASCO guidelines for the use of prophylactic G-CSF. Special attention should be given to high risk groups for FN, including elderly patients and those with bone marrow involvement or previous radiotherapy/chemotherapy.

Changing the Physical Activity Behavior of Adults With Fitness Trackers: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 34 (4) ◽  
pp. 418-430 ◽  
Author(s):  
Chris Lynch ◽  
Stephen Bird ◽  
Noel Lythgo ◽  
Isaac Selva-Raj
Keyword(s):  
Physical Activity ◽  
Fixed Effects ◽  
Randomized Clinical Trials ◽  
Data Extraction ◽  
Meta Analysis ◽  
Physical Activity Behavior ◽  
Step Count ◽  
Fixed Effects Model ◽  
Alternative Intervention ◽  
Positive Effect

Objective: To examine whether a fitness tracker (FT) intervention changes physical activity (PA) behavior compared to a control condition or compared to an alternative intervention. Data Source: Searches between January 01, 2010, and January 01, 2019, were conducted in PubMed, CINAHL, Cochrane CENTRAL, EMBASE, and PsycINFO. Inclusion/Exclusion Criteria: Randomized clinical trials of adults using an FT to change PA behavior were included. Nonclinical trials, studies that included the delivery of structured exercise, and/or studies that only used the FT to assess PA were excluded. Data Extraction: Extracted features included characteristics of the study population, intervention components, PA outcomes, and results. Data Synthesis: Papers were pooled in a statistical meta-analysis using a fixed effects model. Where statistical pooling was not possible, standardized mean difference (SMD) and 95% confidence intervals (CI) were calculated. Findings were presented in a narrative form and tables. Results: Of 2076 articles found, 21 were included in the review. A small yet significant positive effect (SMD = 0.25, 95% CI = 0.17-0.32; P < .01; I2 = 56.9%; P = .03) was found in step count for interventions compared to control. A small yet significant negative effect (SMD = −0.11, 95% CI = −0.20 to −0.02; P = .02; I2 = 58.2%; P = 0.03) was found in moderate-to-vigorous PA for interventions compared to an alternative intervention. Conclusion: Trackers may enhance PA interventions, as a general positive effect is found in step count compared to a control. However, there is no evidence of a positive effect when interventions are compared to an alternative intervention. It is unknown whether results are due to other intervention components and/or clinical heterogeneity.

CONSTIPATION PRECEDING PARKINSON'S DISEASE–META-ANALYSIS

2015 ◽  
Vol 86 (11) ◽  
pp. e4.193-e4 ◽  
Author(s):  
Kerala Adams-Carr ◽  
Anette Schrag ◽  
Samuel Shribman ◽  
Jonathan Bestwick ◽  
Andrew Lees ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Observational Studies ◽  
Fixed Effects ◽  
Meta Analysis ◽  
Original Data ◽  
Fixed Effects Model ◽  
Clinical Criteria ◽  
History Of ◽  
Reported Data

Constipation is a well-recognised non-motor feature of Parkinson's disease (PD) and has been reported to predate PD in a number of observational studies, in some cases by over two decades. A systematic review and meta-analysis was carried out following MOOSE criteria. The literature search was undertaken on 7 December 2014 using PubMed and the relevant search terms ‘Parkinson's disease’ and ‘Constipation’. Articles were screened for suitability and included if they met the specific criteria: observational studies with a cohort or case–control design; cases were patients with PD according to standard clinical criteria; controls were healthy or had no history of neurological disease; cohorts were representative of the general population; constipation in controls was assessed over the same time period as for patients; original data were reported. Data were extracted and combined using a fixed-effects model. Nine studies were included in the meta-analysis. Constipation was associated with an OR of 2.28 (95% confidence interval 2.10-2.46; p<0.001) for subsequent PD, offering further evidence that people with constipation are at a higher risk of developing PD and constipation may predate PD diagnosis by many years. This could have implications for our understanding of the pathogenesis of disease and planning of neuroprotective interventional trials.

Microvascular Benefits of New Antidiabetic Agents: A Systematic Review and Network Meta-Analysis of Kidney Outcomes

2020 ◽  
Author(s):  
Ashley S Cha ◽  
Yilin Chen ◽  
Katherine Fazioli ◽  
Matthew B Rivara ◽  
Emily Beth Devine
Keyword(s):  
Kidney Disease ◽  
Fixed Effects ◽  
Diabetic Kidney Disease ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Credible Interval ◽  
Qualitative Assessment ◽  
Similar Distribution ◽  
Fixed Effects Model ◽  
Diabetic Kidney

Abstract Purpose Diabetic kidney disease affects nearly one-third of US adults with prevalent type 2 diabetes mellitus. The use of new antidiabetic medications in the prevention and treatment of diabetic kidney disease is a growing area of research interest. We sought to characterize the risk of developing a composite kidney outcome among patients receiving a new antidiabetic medication of the SGLT-2i, GLP-1ra, and DPP-4i drug classes. Methods We conducted a systematic literature search in MEDLINE to identify randomized trials observing kidney safety endpoints associated with the use of new antidiabetic medications. Two independent reviewers selected the seven eligible studies for analysis. Included studies were published between 01/2013-03/2020, conducted among adults, in English full-text, and observed composite kidney outcomes. A network meta-analysis was conducted within a Bayesian framework using a fixed-effects model with uninformative priors. Results A qualitative assessment of transitivity was conducted to ensure similar distribution of potential modifiers across studies. Included studies were generally comparable in mean age, HbA1c, and mean duration of T2DM at baseline. Main Conclusions Compared to placebo, dapagliflozin was associated with the greatest reduction in risk of developing the composite kidney outcome (hazard ratio 0.53 [95% credible interval 0.43-0.66]) followed by empagliflozin, canagliflozin, semaglutide, and liraglutide. Linagliptin did not show a significant reduction in risk of the outcome. Limitations This analysis was limited by the scarcity of data for kidney safety endpoints in large, randomized clinical trials. Although the heterogeneity statistic was low, there are slight differences in study design and baseline demographic characteristics across trials.

scholarly journals Statin and Post-Cardiac Surgery Atrial Fibrillation Prevention: Systematic Review and Meta-analysis

2021 ◽  
Author(s):  
Federico Oliveri ◽  
Andrea Bongiorno ◽  
Sara Compagnoni ◽  
Alessandro Fasolino ◽  
Francesca Gentile ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Cardiac Surgery ◽  
Fixed Effects ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
P Value ◽  
Fixed Effects Model ◽  
Significant Difference ◽  
Pre Treatment ◽  
Study Participants

Introduction: Postoperative atrial fibrillation (POAF) is a frequently reported complication of cardiac surgery, leading to increased in-hospital and long-term mortality rates. Many studies have suggested using statins to protect against POAF. Thus, we aim to investigate if statin pre-treatment may effectively lower the incidence of POAF. Method: We performed a systematic literature search of PubMed for potential studies between January 2006 and August 2021. Principal inclusion criteria were: randomized clinical trials study design; statin-naive patients; total study participants ≥ 50 units. We used the fixed-effects model to obtain the odds ratio (OR) and 95% confidence interval (CI) for each analyzed intervention. Results: Overall, statin pre-treatment reduced the incidence of POAF compared to placebo (OR 0.71; 95% CI: 0.60-0.85, p-value < 0.00001). Analyzing subclasses, atorvastatin was associated with lower incidence of POAF (OR 0.54; 95% CI: 0.41-0.70, p-value = 0.002), but rosuvastatin was not (OR 0.90; 95% CI: 0.71-1.14, p-value = 0.38). Selecting studies with ≥ 199 patients, results were divergent. There was not statistically significant difference between statin pre-treatment and placebo (OR 0.89; 95% CI: 0.74-1.09, p-value = 0.26), as well as for atorvastatin (OR 0.74; 95% CI: 0.54-1.03, p-value = 0.08) and rosuvastatin (OR 0.87; 95% CI: 0.68-1.12, p-value = 0,29). Conclusion: Statin pre-treatment before cardiac surgery is not associated with a significant reduction in POAF occurrence. Thus, based upon our results and considering possible renal complications, we discourage statin pre-treatment in preventing POAF.

A Systematic Review and Meta-Analysis about the Effect of Bisphosphonates on the Risk of Skeletal-Related Event in Men with Prostate Cancer

2020 ◽  
Vol 20 (13) ◽  
pp. 1604-1612
Author(s):  
Congcong Wu ◽  
Hua Jiang ◽  
Jianghua Chen
Keyword(s):  
Prostate Cancer ◽  
Fixed Effects ◽  
Data Extraction ◽  
Controlled Trial ◽  
Meta Analysis ◽  
Control Group ◽  
Fixed Effects Model ◽  
Related Event ◽  
Mineral Density ◽  
Skeletal Related Event

Background: Although the adjuvant therapy of bisphosphonates in prostate cancer is effective in improving bone mineral density, it is still uncertain whether bisphosphonates could decrease the risk of Skeletal- Related Event (SRE) in patients with prostate cancer. We reviewed and analyzed the effect of different types of bisphosphonates on the risk of SRE, defined as pathological fracture, spinal cord compression, radiation therapy to the bone, surgery to bone, hypercalcemia, bone pain, or death as a result of prostate cancer. Methods: A systemic literature search was conducted on PubMed and related bibliographies. The emphasis during data extraction was laid on the Hazard Ratio (HR) and the corresponding 95% Confidence Interval (CI) from every eligible Randomized Controlled Trial (RCT). HR was pooled with the fixed effects model, and preplanned subgroup analyses were performed. Results: 5 RCTs (n = 4651) were included and analyzed finally after screening 51 articles. The meta-analysis of all participants showed no significant decrease in the risk of SRE when adding bisphosphonates to control group (HR = 0.968, 95% CI = 0.874 - 1.072, p = 0.536) with low heterogeneity (I2 = 0.0% (d.f. = 4) p = 0.679). There was no significant improvement on SRE neither in the subgroups with Metastases (M1) or Castration-Sensitive Prostate Cancer (CSPC) (respectively HR = 0.968, 95% CI = 0.874 - 1.072, p = 0.536, I2 = 0.0% (d.f. = 4) p = 0.679; HR = 0.954, 95% CI = 0.837 - 1.088, p = 0.484, I2 = 0.0% (d.f. = 3) p = 0.534). Conclusion: Our study demonstrated that bisphosphonates could not statistically significantly reduce the risk of SRE in patients with prostate cancer, neither in the subgroups with M1 or CSPC.

scholarly journals Statin use and clinical outcomes in patients with COVID-19: An updated systematic review and meta-analysis

2021 ◽  
pp. postgradmedj-2020-139172
Author(s):  
Rimesh Pal ◽  
Mainak Banerjee ◽  
Urmila Yadav ◽  
Sukrita Bhattacharjee
Keyword(s):  
Clinical Outcomes ◽  
Observational Studies ◽  
Fixed Effects ◽  
Controlled Trial ◽  
Meta Analysis ◽  
Adverse Outcomes ◽  
Fixed Effects Model ◽  
Adjusted Risk ◽  
Risk Estimates ◽  
Statin Use

PurposeObservations studies have shown that prior use of statins is associated with a reduced risk of adverse clinical outcomes in patients with COVID-19. However, the available data are limited, inconsistent and conflicting. Besides, no randomised controlled trial exists in this regard. Hence, the present meta-analysis was conducted to provide an updated summary and collate the effect of statin use on clinical outcomes in COVID-19 using unadjusted and adjusted risk estimates.MethodsPubMed, Scopus and Web of Science databases were systematically searched using appropriate keywords till December 18 2020, to identify observational studies reporting clinical outcomes in COVID-19 patients using statins versus those not using statins. Prior and in-hospital use of statins were considered. Study quality was assessed using the Newcastle-Ottawa Scale. Unadjusted and adjusted pooled odds ratio (OR) with 95% CIs were calculated.ResultsWe included 14 observational studies pooling data retrieved from 19 988 patients with COVID-19. All the studies were of high/moderate quality. Pooled analysis of unadjusted data showed that statin use was not associated with improved clinical outcomes (OR 1.02; 95% CI 0.69 to 1.50, p=0.94, I2=94%, random-effects model). However, on pooling adjusted risk estimates, the use of statin was found to significantly reduce the risk of adverse outcomes (OR 0.51; 95% CI 0.41 to 0.63, p<0.0005, I2=0%, fixed-effects model).ConclusionsStatin use is associated with improved clinical outcomes in patients with COVID-19. Individuals with multiple comorbidities on statin therapy should be encouraged to continue the drug amid the ongoing pandemic.

scholarly journals Association between early bronchiolitis and the development of childhood asthma: a meta-analysis

BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e043956
Author(s):  
Guizuo Wang ◽  
Dong Han ◽  
Zhengdong Jiang ◽  
Manxiang Li ◽  
Shumei Yang ◽  
...  
Keyword(s):  
Early Life ◽  
Fixed Effects ◽  
Late Onset ◽  
Meta Analysis ◽  
Later Life ◽  
Analysis Data ◽  
Fixed Effects Model ◽  
Case Control Studies ◽  
Increased Risk ◽  
Registration Number

ObjectiveEarly life bronchiolitis has been hypothesised to be associated with the subsequent risk of persistent wheezing or asthma. However, the link remains controversial. The objective of our study was to evaluate the association between bronchiolitis before 2 years of age and the late-onset wheezing/asthma.DesignSystematic review and meta-analysis.MethodsPubMed, Embase and Web of Science databases were systematically searched for studies published between 1955 and January 2020. Meanwhile, we also checked through the reference lists of relevant articles to see whether these references included reports of other studies that might be eligible for the review. Cohort and case–control studies assessing the association between early-life bronchiolitis and late-onset wheezing/asthma were included in this meta-analysis. Data were extracted by two independent reviewers. Results were pooled using a random-effects model or fixed-effects model according to the heterogeneity among studies.Results32 original articles with 292 844 participants, which met the criteria, were included in this meta-analysis. Bronchiolitis before 2 years of age was associated with an increased risk of subsequent wheezing/asthma (relative risk=2.46, 95% CI 2.14 to 2.82, p<0.001). After categorising studies into different groups based on age at the end of follow-up, geographical region and study quality, the association still remained significant.ConclusionsThe meta-analysis indicates an association between bronchiolitis before 2 years of age and the wheezing/asthma in later life. Well-designed and highly standardised prospective studies that better address bias due to potential confounding factors are needed to validate the risk identified in our meta-analysis.PROSPERO registration numberCRD42018089453.

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