scholarly journals The effect of rTMS in the management of pain associated with CRPS

2020 ◽  
Vol 11 (1) ◽  
pp. 363-370
Author(s):  
Min Cheol Chang ◽  
Sang Gyu Kwak ◽  
Donghwi Park
Keyword(s):  
Repetitive Transcranial Magnetic Stimulation ◽  
Controlled Trial ◽  
Meta Analysis ◽  
Pain Syndrome ◽  
Treatment Session ◽  
Cochrane Library ◽  
Exclusion Criteria ◽  
Analgesic Effects ◽  
Randomized Controlled ◽  
Before And After

AbstractBackgroundTherapeutic management of pain in patients with complex regional pain syndrome (CRPS) is challenging. Repetitive transcranial magnetic stimulation (rTMS) has analgesic effects on several types of pain. However, its effect on CRPS has not been elucidated clearly. Therefore, we conducted a meta-analysis of the available clinical studies on rTMS treatment in patients with CRPS.Materials and methodsA comprehensive literature search was conducted using the PubMed, EMBASE, Cochrane Library, and SCOPUS databases. We included studies published up to February 09, 2020, that fulfilled our inclusion and exclusion criteria. Data regarding measurement of pain using the visual analog scale before and after rTMS treatment were collected to perform the meta-analysis. The meta-analysis was performed using Comprehensive Meta-analysis Version 2.ResultsA total of three studies (one randomized controlled trial and two prospective observational studies) involving 41 patients were included in this meta-analysis. No significant reduction in pain was observed immediately after one rTMS treatment session or immediately after the entire schedule of rTMS treatment sessions (5 or 10 sessions; P > 0.05). However, pain significantly reduced 1 week after the entire schedule of rTMS sessions (P < 0.001).ConclusionrTMS appears to have a functional analgesic effect in patients with CRPS.

scholarly journals Combination between Mifepristone and Methotrexate to Treat Ectopic Pregnancy: A Systematic Review Protocol

2021 ◽  
Author(s):  
Qiling Su ◽  
Huiyan Feng ◽  
Tian Tian ◽  
Xiaoqian Liao ◽  
Yunhui Li ◽  
...  
Keyword(s):  
Ectopic Pregnancy ◽  
Controlled Trial ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Secondary Outcome ◽  
Control Group ◽  
China National Knowledge Infrastructure ◽  
Advantages And Disadvantages ◽  
Randomized Controlled ◽  
Outcome Index

Background: In recent years, the morbidity of ectopic pregnancy and the proportion of young and childless patients have increased year by year, which makes it important to early diagnose EP, effectively save patients' lives and furthest preserve their fertility. Methotrexate and mifepristone are most widely used in conservative treatments, however, there is no accurate conclusion about which therapy is better. Therefore, the aims in this meta-analysis are, on the one hand, to systematically analyze the efficacy of mifepristone combined with methotrexate in the treatment of ectopic pregnancy through existing studies, and to draw scientific conclusions. On the other hand, to fill the gap of relevant analysis in China and abroad, to evaluate the advantages and disadvantages of inclusion trials and propose improvement measures and scientific designing schemes. Methods: Six electronic databases will be searched, including PubMed, Embase, Cochrane Library, the China National Knowledge Infrastructure(CNKI), Chinese Science and Technology Periodical Database (VIP), and Wanfang Database (WF). Literature from October 2015 to October 2020 on randomized controlled trials will be searched, without any language or publication restriction. Search terms include mifepristone, methotrexate, ectopic pregnancy, and random (free word/synonym expansion). Included in a randomized controlled trial, the treatment group was treated with mifepristone combined with methotrexate, and the control group was treated with mifepristone alone. Revman 5.4 (provided by Cochrane) will be used to evaluate the quality of the literature, and the corresponding effect model will be selected to analyze the results. The cure rate will be the main outcome index, and the remaining outcome measures after literature inclusion will be the secondary outcome indexes. Result: Only when we finish this meta-analysis can we get the result. Discussion: The results of this study will provide reliable evidence for the efficacy of mifepristone combined with methotrexate therapy in the treatment of ectopic pregnancy.

Efficacy and safety of therapeutic anticoagulation for the treatment of isolated calf muscle vein thrombosis - a systematic review and meta-analysis

VASA ◽  
2016 ◽  
Vol 45 (6) ◽  
pp. 478-485 ◽  
Author(s):  
Xu-Chen Huang ◽  
Xu-Hua Hu ◽  
Xiao-Ran Wang ◽  
Chao-Xi Zhou ◽  
Gui-Ying Wang
Keyword(s):  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Meta Analysis ◽  
Small Sample ◽  
Calf Muscle ◽  
Cochrane Library ◽  
Efficacy And Safety ◽  
Vein Thrombosis ◽  
Randomized Controlled ◽  
Therapeutic Anticoagulation

Abstract. Background: Diverse treatment suggestions range from monitoring with duplex examinations to therapeutic anticoagulation (TA) for managing isolated calf muscle vein thrombosis (ICMVT). However, the small sample sizes and low-level evidence provided by most studies in the literature mean that the benefits of promising new treatment protocols are unclear. Hence, this meta-analysis is intended to assess the efficacy and safety of TA for patients with ICMVT. Patients and methods: Articles comparing TA with no anticoagulation (NA) or no therapeutic anticoagulation (NTA) in patients with ICMVT were collected from PubMed, the Cochrane Library, EMBASE, and Web of Science. The risk ratio (RR) and 95 % confidence interval (95 % CI) were generated for each outcome of interest. The data were pooled using a random-effects or fixed-effects model to evaluate differences in outcomes between the TA and control groups. Results: Five of 377 initially identified papers were included. One randomized controlled trial, one non-randomized controlled trial and three retrospective cohort studies (a total of 744 patients, 390 in the TA group and the remaining 354 in the NA or NTA group) were included in this meta-analysis. The occurrence of thrombosis progression was significantly less frequent in those who received TA compared with those receiving NTA (RR = 0.33, 95 % CI 0.20 to 0.54, p < 0.01). The rate of complete recanalization was higher, albeit not significantly, in the TA group than in the NTA group (RR = 1.96, 95 % CI 1.01 to 3.80, p = 0.05). None of the pooled outcomes were significantly different when comparing the TA and NA groups. Conclusions: This study suggests that TA may result in a significant reduction in the rate of thrombosis progression and a marginally significant increase in the rate of complete recanalization for patients with ICMVT. Further studies are needed to confirm these findings and clarify whether the benefits of TA outweigh the potential harm.

scholarly journals Yiqi Yangyin Huoxue Method in Treating Diabetic Retinopathy: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Chen Ou ◽  
Yi Jing Yang ◽  
Qing Hua Peng
Keyword(s):  
Diabetic Retinopathy ◽  
Methodological Quality ◽  
Controlled Trial ◽  
Meta Analysis ◽  
Knowledge Network ◽  
Fluorescence Angiography ◽  
Cochrane Library ◽  
Assessment Data ◽  
Beneficial Effects ◽  
Randomized Controlled

Objective. To evaluate the efficacy of Yiqi Yangyin Huoxue method in the treatment of diabetic retinopathy (DR) with meta-analysis. Method. A randomized controlled trial of Yiqi Yangyin Huoxue method in the treatment of diabetic retinopathy in PubMed, Medline, Cochrane Library, Weipu Journal, China Knowledge Network, and Wanfang database was conducted. Two reviewers independently extracted data and methodological quality assessment. Data analysis was performed using Rev Man 5.3 software for statistical analysis. Results. A total of 10 randomized controlled trials, including 661 patients, were included. The results showed that Yiqi Yangyin Huoxue method could significantly improve the vision [risk ratio (RR)=1.32, 95% confidence interval (CI) (1.18, 1.47), P<0.00001] and change the eye fundus [RR=1.23, 95% CI (1.10, 1.37), P=0.0002], fundus fluorescence angiography (FFA) [RR=1.33, 95% CI (1.11, 1.60), P=0.002], traditional Chinese medicine syndromes [RR=1.31, 95% CI (1.15, 1.49), P<0.0001], and hemorheological parameters [mean difference (MD) =-0.37, 95% CI (-0.41, -0.32), P<0.00001]. Conclusion. Yiqi Yangyin Huoxue method showed beneficial effects for DR on improving vision, eye fundus, FFA, TCM syndromes, and hemorheological parameters.

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.

scholarly journals The Effectiveness of Technology-Based Interventions for Reducing Loneliness in Older Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2021 ◽  
Vol 12 ◽  
Author(s):  
Wenjing Jin ◽  
Yihong Liu ◽  
Shulin Yuan ◽  
Ruhai Bai ◽  
Xuebin Li ◽  
...  
Keyword(s):  
Older Adults ◽  
Rating Scale ◽  
Assessment Tool ◽  
Controlled Trial ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Current Evidence ◽  
Cochrane Library ◽  
Control Groups ◽  
Randomized Controlled

Objective: To systematically analyze the effectiveness of technology-based interventions for reducing loneliness in older adults.Methods: We searched relevant electronic databases from inception to April 2021, which included Cochrane Library, PubMed, Web of Science, SpringerLink, EMBASE, CNKI, and Wanfang. The following criteria were used: (i) study design—randomized controlled trial (RCT) designs, (ii) people—older adults (aged ≥ 60 years), (iii) intervention—technology-based interventions in which a core component involved the use of technology to reduce loneliness in older adults; and (iv) outcome—reduction of loneliness level in terms of rating scale scores. Two reviewers independently identified eligible studies, extracted data, and assessed the risk of bias in the included studies. A third reviewer resolved any conflicts. The Cochrane Collaboration's bias assessment tool was used to evaluate the risk of bias for the included studies, and Review Manager 5.4 software was used for the meta-analysis. A random effects model was adopted to measure estimates of loneliness reduction, and standard mean differences (SMD) with a 95% confidence interval (CI) were calculated for each intervention-control contrast, and the I2 statistic was applied to examine heterogeneity.Results: A total of 391 participants from six RCTs were included in the review. Of these, three studies were rated as low-quality, and the remaining three were rated as moderate-quality studies. The meta-analysis showed that the evidence regarding the effects on loneliness of technology-based interventions compared with control groups was uncertain, and suggested that technology-based interventions resulted in little to no difference in loneliness reduction compared to control groups (SMD = −0.08, 95% CI −0.33 to 0.17, p = 0.53). Two types of technology-based interventions were identified: smartphone-based video calls and computer-based training with Internet usage. The subgroup analysis found low-quality evidence to support the effectiveness of both intervention types (SMD = −0.01, 95% CI −0.25 to 0.24, p = 0.95, and SMD = −0.38, 95% CI −0.19, 0.64, p = 0.47, respectively).Conclusions: We found no current evidence to support that technology-based interventions were effective compared to different control conditions in reducing loneliness in older adults. This suggests that more research is needed to investigate the effects of technology-based interventions on loneliness in older adults.

scholarly journals 5-HT3 receptor antagonists for the prevention of postoperative shivering: a meta-analysis

2016 ◽  
Vol 44 (6) ◽  
pp. 1174-1181 ◽  
Author(s):  
Chengmao Zhou ◽  
Yu Zhu ◽  
Zhen Liu ◽  
Lin Ruan
Keyword(s):  
Relative Risk ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Comparable Efficacy ◽  
Controlled Trials ◽  
Receptor Antagonists ◽  
Exclusion Criteria ◽  
Randomized Controlled ◽  
Significant Difference ◽  
The Cochrane Library

Objective We evaluated the efficacy of 5-HT3 receptor antagonists for the prevention of postoperative shivering. Methods We searched PubMed, the Cochrane Library, EMBASE and Web of Knowledge to find randomized controlled trials (RCT) of 5-HT3 receptor antagonists for the prevention of postoperative shivering. Two researchers independently screened studies, extracted data, and assessed quality in accordance with the inclusion and exclusion criteria, and then conducted a meta-analysis using RevMan 5.2. Results Ultimately, 14 RCTs that included 980 patients were included in the analysis. We found that: 1) the incidence of shivering was significantly lower in 5-HT3 groups than placebo groups (relative risk, [RR] = 0.48, 95% confidence interval [CI] 0.40 – 0.58); 2) there was no significant difference in the incidence of shivering between 5-HT3 groups and meperidine groups (RR = 0.89, 95% CI 0.60 – 1.34). Conclusion 5-HT3 receptor antagonists appear to prevent postoperative shivering, with a broadly comparable efficacy to meperidine.

scholarly journals Efficacy and safety of tofacitinib for the treatment of chronic plaque psoriasis: a systematic review and meta-analysis

2019 ◽  
Vol 47 (6) ◽  
pp. 2342-2350 ◽  
Author(s):  
Fangyuan Tian ◽  
Zhaoyan Chen ◽  
Ting Xu
Keyword(s):  
Plaque Psoriasis ◽  
Adverse Reactions ◽  
Inflammatory Diseases ◽  
Controlled Trial ◽  
Meta Analysis ◽  
Janus Kinase ◽  
Cochrane Library ◽  
Efficacy And Safety ◽  
Chronic Plaque Psoriasis ◽  
Randomized Controlled

Background Tofacitinib is an oral Janus kinase (JAK) inhibitor that targets JAK1 and JAK3, and thus regulates immune response. Therefore, tofacitinib is used to treat immune-mediated inflammatory diseases such as chronic plaque psoriasis. The objective of this study was to systematically assess the efficacy and safety of tofacitinib in treating chronic plaque psoriasis. Objective To systematically review the efficacy and safety of tofacitinib in the treatment of chronic plaque psoriasis, we performed a meta-analysis to evaluate the efficacy and safety of tofacitinib in patients with chronic plaque psoriasis. Methods Databases including PubMed, Embase, and The Cochrane Library were searched for randomized controlled trials about the efficacy and safety of tofacitinib in treating chronic plaque psoriasis from inception to August 2017 (PROSPERO Code No: CRD42017076587). Results Six articles (seven randomized controlled trial studies) involving 3743 patients were included. The meta-analysis results showed that for efficacy, tofacitinib (5 mg or 10 mg) compared with placebo can significantly improve the Physician’s Global Assessment response, PASI75, and PASI90 after treatment. For safety, the incidence of adverse reactions was statistically significantly higher for tofacitinib compared with placebo. Conclusion Treatment of chronic plaque psoriasis with tofacitinib is effective, but there may be more adverse reactions.

scholarly journals Treatment of Laryngoceles: What Is the Progress over the Last Two Decades?

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Karol Zelenik ◽  
Lucia Stanikova ◽  
Katarina Smatanova ◽  
Michal Cerny ◽  
Pavel Kominek
Keyword(s):  
Case Reports ◽  
Controlled Trial ◽  
Meta Analysis ◽  
Demographic Data ◽  
Surgical Techniques ◽  
Case Series ◽  
Cochrane Library ◽  
External Approach ◽  
Randomized Controlled ◽  
The Cochrane Library

Objectives. To review surgical techniques used in the treatment of laryngoceles over the last two decades and point out developments and trends.Materials and Methods. PubMed, the Cochrane Library, and the JBI Library of Systematic Reviews were searched using the term “laryngocele.” Demographic data, type of laryngocele, presence of a laryngopyocele, type of treatment and need for a tracheotomy were assessed.Results. Overall, data on 86 patients were analyzed, culled from 50 articles, of which 41 were case reports and 9 were case series. No single systematic review or meta-analysis or randomized controlled trial has been published on the topic. Altogether, 71 laryngoceles in 63 patients met the criteria for further analysis focusing on surgical treatment. An external approach was selected in 25/29 (86.2%) cases of combined laryngoceles. Microlaryngoscopic resection using a CO2laser was performed in three cases and endoscopic robotic surgery in one case. The majority of patients with an internal laryngocele, 31/42 (73.8%), were treated using the microlaryngoscopy approach.Conclusions. Microlaryngoscopy involving the use of a CO2laser has become the main therapeutic procedure for the treatment of internal laryngoceles during the past 20 years. An external approach still remains the main therapeutic approach for the treatment of combined laryngoceles.

scholarly journals A Systematic Review of the Efficacy and Safety of Didroxyprogesterone Combined with Progesterone in the Treatment of Luteal Insufficiency-Induced Abortion

2021 ◽  
Vol 5 (4) ◽  
pp. 58-63
Author(s):  
Yanjing Yang ◽  
Hongli Zhu
Keyword(s):  
Controlled Trial ◽  
Meta Analysis ◽  
Induced Abortion ◽  
Cochrane Library ◽  
Combination Group ◽  
Control Group ◽  
Efficacy And Safety ◽  
Randomized Controlled ◽  
Pubmed Database ◽  
Luteal Insufficiency

Objective: To systematically evaluate the efficacy and safety of didroxyprogesterone combined with progesterone in the treatment of luteal insufficiency abortion. Methods: We searched CNKI database, VIP database, Wanfang database, PubMed database, EMBASE database and Cochrane library database for literatures on the treatment of luteal insufficiency-induced abortion with didroxyprogesterone and progesterone. Meta-analysis was performed using Revman 5.3 software after literature extraction and further quality evaluation. Results: Ten randomized controlled trial-related articles that describe studies on a total of 1145 patients, 570 in the combination group and 575 in the control group, were included. The results of meta-analysis showed that combination therapy could improve the effective rate of fetal protection (OR = 0.14, 95% CI [0.07, 0.27], P < 0.00001). The safety of the combination group was significantly higher than that of the control group (OR = 3.09, 95% CI [1.13,8.48], P = 0.03). Conclusion: To sum up, compared with the control group, the combination of progesterone and progesterone is more effective and safer in the treatment of luteal insufficiency abortion. However, the sample size of the data is relatively small and the quality of the literature is low. This conclusion still needs to be further verified in high-quality randomized controlled trials that involve large samples.

Shuanghuanglian Injection for Viral Pneumonia: A Protocol for Meta-analysis

2021 ◽  
Author(s):  
YANG YUAN ◽  
Quan Zheng ◽  
Mingjun Hu ◽  
Zhilin Si ◽  
Shuncheng Xie ◽  
...  
Keyword(s):  
Systematic Review ◽  
Fixed Effects ◽  
Financial Burden ◽  
Controlled Trial ◽  
Meta Analysis ◽  
Viral Pneumonia ◽  
Biomedical Literature ◽  
Cochrane Library ◽  
Outcome Indicators ◽  
Randomized Controlled

Abstract Background:Viral pneumonia is inflammation (irritation and swelling) of the lungs due to infection with a virus. Rapidly progressing viral pneumonia is associated with considerable mortality, representing a severe threat and imparting a substantial financial burden worldwide.Specific treatments for the viral pneumonia were not yet determined. Recently, Shuanghuanglian injection of Traditional Chinese Medicine was used to treat viral pneumonia. However,there is no systematic reviews have evaluated its efficacy and safety for viral pneumonia.Methods:We search four English databases ( Pubmed, Web of Science, Embase, and the Cochrane library) and four Chinese databases (China National Knowledge Infrastructure, Wanfang Database, Chinese Biomedical Literature Database, Chinese Science and Technology Periodical Database) for all randomized controlled trial of Shuanghuanglian injection for the treatment of viral pneumonia until 11st of December , 2020. Two reviewers individually extracted data from the included randomized controlled trials (RCTs). Data will be synthesized by either the fixed-effects or random-effects model according to a heterogeneity test, Methodological quality assessment and risk of bias will be assessed using the Cochrane bias risk tool. Meta-analysis will be performed using RevMan5.3.5 software provided by the Cochrane Collaboration.Results: Viral pneumonia has become a disease with substantial mortality. A systematic review assessing the beneficial and harmful effects of Shuanghuanglian injection for viral pneumonia is needed. This study will compare the different outcome indicators of various studies directly and indirectly.This analysis will provide a high-quality synthesis of effectiveness and safety of Shuanghuanglian injection treatment for viral pneumonia.The main outcome indicators include: Outcomes will include mortality, cure rate, efficacy or adverse events confirmed by imaging diagnosis. Systematic review registration: INPLASY2020120047.

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