scholarly journals Efficacy of medications in adult patients with trigeminal neuralgia compared to placebo intervention: a systematic review with meta-analyses

2021 ◽  
Vol 21 (5) ◽  
pp. 379
Author(s):  
Georgia M. Peterson-Houle ◽  
Magda R. AbdelFattah ◽  
Mariela Padilla ◽  
Reyes Enciso
Keyword(s):  
Systematic Review ◽  
Trigeminal Neuralgia ◽  
Adult Patients ◽  
Placebo Intervention ◽  
Meta Analyses

scholarly journals Internal jugular phlebectasia: A systematic review

2019 ◽  
Vol 10 ◽  
pp. 106 ◽  
Author(s):  
Jose A. Figueroa-Sanchez ◽  
Ana S. Ferrigno ◽  
Mario Benvenutti-Regato ◽  
Enrique Caro-Osorio ◽  
Hector R. Martinez
Keyword(s):  
Systematic Review ◽  
Natural History ◽  
Conservative Treatment ◽  
Literature Search ◽  
Jugular Vein ◽  
Adult Patients ◽  
Therapeutic Approaches ◽  
Jugular Phlebectasia ◽  
The Right ◽  
Meta Analyses

Background: Internal jugular phlebectasia (IJP), the abnormal dilatation of internal jugular vein, is generally considered a benign anomaly. However, because IJP is uncommon, little is known about its natural history, and currently, no consensus on the best treatment modality is available. Methods: The purpose of this article is to conduct a systematic review of available literature on recently reported IJP cases to understand the main characteristics of IJP and its most frequent therapeutic approaches. Following the preferred reporting items for systematic reviews and meta-analyses guidelines, literature search for IJP cases was conducted in the COCHRANE, PUBMED, EBSCOHOST, SCOPUS, OVID, and SCIELO databases. Results: A total of 97 original articles were found, with a total of 247 IJP cases reported including both pediatric and adult patients. Conclusions: To the best of our knowledge, this study is the largest systematic review analyzing all the reported cases of IJP. IJP is considered by most authors as a benign abnormality that predominantly affects the right jugular vein. It is most commonly diagnosed in children. At present, conservative treatment is preferred for pediatric but not for adult patients. Multicenter randomized prospective studies are required to further understand this rare anomaly.

scholarly journals P.151 Repeat surgery for recurrent trigeminal neuralgia: a systematic review and meta-analysis

2021 ◽  
Vol 48 (s3) ◽  
pp. S63-S63
Author(s):  
AR Rheaume ◽  
C Ostertag ◽  
M Pietrosanu ◽  
T Sankar
Keyword(s):  
Systematic Review ◽  
Pain Relief ◽  
Trigeminal Neuralgia ◽  
Meta Analysis ◽  
Repeat Surgery ◽  
Surgical Decision ◽  
Percutaneous Rhizotomy ◽  
Meta Analyses

Background: The success of repeat surgery for recurrent trigeminal neuralgia (TN)—with microvascular decompression (MVD), percutaneous rhizotomy (PR), or stereotactic radiosurgery (SRS)—is not well-studied. We performed a systematic review and meta-analysis of the literature on repeat surgery recurrent TN, focusing on the durability of pain relief and relative efficacy of MVD, PR, and SRS. Methods: A PRISMA systematic review of Medline/Embase/Pubmed identified studies of adults with unilateral idiopathic TN undergoing repeat surgery. The primary outcome of complete pain relief (CPR) at last follow-up was analyzed with a multivariate mixed-effects meta-analysis of proportions. Results: Seventy-eight studies met criteria; 61 were included in meta-analyses, containing 29/14/25 cohorts with 900/684/1353 patients undergoing MVD/PR/SRS respectively (mean age 64.7 years, 41% males). Initial CPR was 69% (74%/85%/52%). CPR at mean 39.7 month follow-up (38.3/38.8/41.0) was 48% (59%/60%/34%). Initial CPR for both MVD (CPR: 0.78 [0.70-0.85]) and PR (CPR: 0.93 [0.83-0.98]) was superior to SRS (CPR: 0.48 [0.35-0.61]). At follow-up, MVD (0.45 [0.32-0.58]) and PR (0.45 [0.30-0.60]) trended towards superior CPR versus SRS (0.25 [0.15-0.37]). Conclusions: Half of recurrent TN patients achieve good pain control 3 years after repeat surgery. MVD/PR showed superior initial pain relief and likely better long-term relief. These findings can inform surgical decision-making in this challenging population.

scholarly journals Comparing Clinical Outcomes of Piperacillin-Tazobactam Administration and Dosage Strategies in Critically Ill Adult Patients: A Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Sarah Fawaz ◽  
Stephen Barton ◽  
Shereen Nabhani-Gebara
Keyword(s):  
Systematic Review ◽  
Clinical Outcomes ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Intermittent Infusion ◽  
Adult Patients ◽  
Prolonged Infusion ◽  
Dosing Regimens ◽  
Meta Analyses ◽  
Antibiotic Dosing

Abstract Background: Recently, continuous administration of piperacillin-tazobactam has been proposed as a valuable alternative to traditional intermittent administration especially in critically ill patients. However, antibiotic dosing remains a challenge for clinicians as antibiotic dosing regimens are usually determined in non-critically-ill hospitalized adult patients. The aim was to conduct a systematic review to identify and highlight studies comparing clinical outcomes of piperacillin tazobactam dosing regimens, continuous/prolonged infusion vs intermittent infusion in critically ill patients. Meta-analyses were performed to assess the overall effect of dosing regimen on clinical efficacy. Methods: Studies were identified systematically through searches of PubMed and Science Direct, in compliance with PRISMA guidelines. Following the systematic literature review, meta-analyses were performed using Review Manager. Results: Twenty-three studies were included in the analysis involving 3828 critically ill adult participants in total (continuous/prolonged infusion = 2197 and intermittent infusion = 1631) from geographically diverse regions. Continuous/prolonged resulted in significantly: higher clinical cure rates (OR 1.56, 95% C.I 1.28-1.90, P = 0 .0001), lower mortality rates (OR 0.68, 95% C.I 0.55-0.84, P = 0 .0003), higher microbiological success rates (OR 1.52, 95% C.I 1.10-2.11, P = 0.01) and decreasing the length of hospital stay (OR -1.27, 95% C.I -2.45—0.08, P = 0.04) in critically ill patients. Conclusion: There is a significant level of evidence that clinical outcome in critically ill patients is improved in patients receiving piperacillin-tazobactam via continuous/prolonged infusion. Therefore, this alternative infusion strategy could be recommended in clinical practice.

scholarly journals Optimal Pharmacological Management and Prevention of Glucocorticoid-Induced Osteoporosis (GIOP): Protocol for a Systematic Review and Network Meta-Analysis

2019 ◽  
Author(s):  
Jiawen Deng ◽  
Emma Huang ◽  
Zachary Silver ◽  
Elena Zheng ◽  
Kyra Kavanaugh ◽  
...  
Keyword(s):  
Systematic Review ◽  
Vertebral Fracture ◽  
Bone Loss ◽  
Risk Of Bias ◽  
Adult Patients ◽  
List Type ◽  
Mineral Density ◽  
Mean Differences ◽  
Meta Analyses

ABSTRACTIntroductionGlucocorticoid (GC) administration is an effective therapy commonly used in the treatment of autoimmune and inflammatory diseases. However, the use of GC can give rise to serious complications. The main detrimental side effect of GC therapy is significant bone loss, resulting in glucocorticoid-induced osteoporosis (GIOP).There are a variety of treatments available for preventing and managing GIOP; however, without clearly defined guidelines, it can be very difficult for physicians to choose the optimal therapy for their patients. Previous network meta-analyses (NMAs) and meta-analyses did not include all available RCT trials, or only performed pairwise comparisons. We present a protocol for a NMA that incorporates all available RCT patient data to provide the most comprehensive ranking of all available GIOP treatments in terms of their ability to increase bone mineral density (BMD) and decrease fracture incidences among adult patients undergoing GC treatments.Methods and AnalysisWe will search MEDLINE, EMBASE, PubMed, Web of Science, CINAHL, CENTRAL and Chinese literature sources (CNKI, CQVIP, Wanfang Data, Wanfang Med Online) for randomized controlled trials (RCTs) which fit our criteria. RCTs that evaluate different antiresorptive regimens taken by adult patients undergoing GC therapy during the study or had taken GC for at least 3 months in the year prior to study commencement with lumbar spine BMD, femoral neck BMD, total hip BMD, vertebral fracture incidences and/or non-vertebral fracture incidences as outcomes will be selected.We will perform title/abstract and full-text screening as well as data extraction in duplicate. Risk of bias (ROB) will be evaluated in duplicate for each study, and the quality of evidence will be examined using CINeMA in accordance to the GRADE framework. We will use R and gemtc to perform the NMA. We will report BMD results as weighted mean differences (WMDs) and standardized mean differences (SMDs), and we will report fracture incidences as odds ratios. We will use the surface under the cumulative ranking curve (SUCRA) scores to provide numerical estimations of the rankings of interventions.Ethics and DisseminationThe study will not require ethical approval. The findings of the NMA will be disseminated in a peer-reviewed journal and presented at conferences. We aim to produce the most comprehensive quantitative analysis regarding the management of GIOP. Our analysis should be able to provide physicians and patients with an up-to-date recommendation for pharmacotherapies in reducing incidences of bone loss and fractures associated with GIOP.Systematic Review RegistrationInternational Prospective Register for Systematic Reviews (PROSPERO) — CRD42019127073ARTICLE SUMMARYStrengths and limitations of this studyLiterature search in Chinese databases will likely yield huge amounts of new RCT evidence regarding GIOPReporting change in BMD outcomes as standardized mean differences allow the pooling of absolute and percentage change data, increasing the number of RCT trials includedOnly RCTs will be included, quality of trials and networks will be evaluated using Risk of Bias and GRADEOlder trials may report inaccurate results due to outdated procedures and hardwareChinese clinicians may not use the same procedures and practices as Western clinicians

scholarly journals Effectiveness of Hydrocolloid Dressings for Treating Pressure Ulcers in Adult Patients: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 17 (21) ◽  
pp. 7881
Author(s):  
Magdalena Sylwia Kamińska ◽  
Anna Maria Cybulska ◽  
Karolina Skonieczna-Żydecka ◽  
Katarzyna Augustyniuk ◽  
Elżbieta Grochans ◽  
...  
Keyword(s):  
Systematic Review ◽  
Pressure Ulcers ◽  
Meta Analysis ◽  
Random Effect ◽  
Cochrane Collaboration ◽  
Adult Patients ◽  
Therapeutic Effects ◽  
Study Selection ◽  
Meta Analyses ◽  
The Cochrane Collaboration

The aim of this study was to assess the effectiveness of hydrocolloid dressings in the treatment of grade I, II, III, and IV pressure ulcers in adult patients. We compared the therapeutic effects of hydrocolloids and alternative dressings in pressure ulcer treatment. We conducted a systematic review, using a literature search only in English, from database inception until 20 April 2020, to identify randomized trials comparing various types of dressings applied in the healing of pressure ulcers. The databases were PubMed, Embase, and Cumulative Index to Nursing and Allied Health Literature (CINAHL). The study selection was performed independently by two reviewers. Data were extracted based on the guidelines included in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol. The risk of bias in the included studies was assessed using a standardized critical appraisal instrument developed by the Cochrane Collaboration. Random-effect meta-analysis of data from three or more studies was performed using meta-analysis software (Comprehensive Meta-Analysis V3, Biostat, New Jersey, USA). A total of 1145 records were identified, of which 223 were qualified after further verification, of which eight were finally included in further analysis. Hydrocolloid dressings were not superior to control therapeutics (p = 0.839; Z = 0.203; CI 95%: 0.791–1.334). They were not associated with higher healing rates (p = 0.718; Z = 0.361; OR: 0.067; CI 95%: 0.297–0.431), nor did they decrease the incidence of adverse events compared with control therapeutics (p = 0.300; Z = −1.036; OR: 0.067; CI 95%: 0.394–1.333). In the above cases, Egger’s test also did not indicate publication bias (t value = 0.779, p = 0.465; t value = 1.198, p = 0.442; t value = 0.834, p = 0.465, respectively). The present meta-analysis shows that hydrocolloid dressings are not significantly better than alternative ones in the healing of pressure ulcers in adult patients.

scholarly journals Cardiovascular and Renal Outcomes of Renin–Angiotensin System Blockade in Adult Patients with Diabetes Mellitus: A Systematic Review with Network Meta-Analyses

PLoS Medicine ◽  
2016 ◽  
Vol 13 (3) ◽  
pp. e1001971 ◽  
Author(s):  
Ferrán Catalá-López ◽  
Diego Macías Saint-Gerons ◽  
Diana González-Bermejo ◽  
Giuseppe M. Rosano ◽  
Barry R. Davis ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Systematic Review ◽  
Renin Angiotensin System ◽  
Adult Patients ◽  
Angiotensin System ◽  
Renin Angiotensin ◽  
Renal Outcomes ◽  
Patients With Diabetes ◽  
Meta Analyses

scholarly journals Safety profile of superior petrosal vein (the vein of Dandy) sacrifice in neurosurgical procedures: a systematic review

2018 ◽  
Vol 45 (1) ◽  
pp. E3 ◽  
Author(s):  
Vinayak Narayan ◽  
Amey R. Savardekar ◽  
Devi Prasad Patra ◽  
Nasser Mohammed ◽  
Jai D. Thakur ◽  
...  
Keyword(s):  
Systematic Review ◽  
Trigeminal Neuralgia ◽  
Case Series ◽  
Intracerebral Hematoma ◽  
Neurosurgical Procedures ◽  
Petrosal Vein ◽  
Peduncular Hallucinosis ◽  
Superior Petrosal Vein ◽  
The Difference ◽  
Meta Analyses

OBJECTIVEWalter E. Dandy described for the first time the anatomical course of the superior petrosal vein (SPV) and its significance during surgery for trigeminal neuralgia. The patient’s safety after sacrifice of this vein is a challenging question, with conflicting views in current literature. The aim of this systematic review was to analyze the current surgical considerations regarding Dandy’s vein, as well as provide a concise review of the complications after its obliteration.METHODSA systematic review was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A thorough literature search was conducted on PubMed, Web of Science, and the Cochrane database; articles were selected systematically based on the PRISMA protocol and reviewed completely, and then relevant data were summarized and discussed.RESULTSA total of 35 publications pertaining to the SPV were included and reviewed. Although certain studies report almost negligible complications of SPV sectioning, there are reports demonstrating the deleterious effects of SPV obliteration when achieving adequate exposure in surgical pathologies like trigeminal neuralgia, vestibular schwannoma, and petroclival meningioma. The incidence of complications after SPV sacrifice (32/50 cases in the authors’ series) is 2/32 (6.2%), and that reported in various case series varies from 0.01% to 31%. It includes hemorrhagic and nonhemorrhagic venous infarction of the cerebellum, sigmoid thrombosis, cerebellar hemorrhage, midbrain and pontine infarct, intracerebral hematoma, cerebellar and brainstem edema, acute hydrocephalus, peduncular hallucinosis, hearing loss, facial nerve palsy, coma, and even death. In many studies, the difference in incidence of complications between the SPV-sacrificed group and the SPV-preserved group was significant.CONCLUSIONSThe preservation of Dandy’s vein is a neurosurgical dilemma. Literature review and experiences from large series suggest that obliterating the vein of Dandy while approaching the superior cerebellopontine angle corridor may be associated with negligible complications. However, the counterview cannot be neglected in light of some series showing an up to 30% complication rate from SPV sacrifice. This review provides the insight that although the incidence of complications due to SPV obliteration is low, they can happen, and the sequelae might be worse than the natural history of the existing pathology. Therefore, SPV preservation should be attempted to optimize patient outcome.

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