scholarly journals Efficacy of Non-Halofuginone-Based Strategies to Prevent or Treat Cryptosporidiosis in Bovine Calves: A Systematic Review

2020 ◽  
Author(s):  
Julii Brainard ◽  
Charlotte C. Hammer ◽  
Kevin Tyler ◽  
Paul R. Hunter
Keyword(s):  
Systematic Review ◽  
Weight Gain ◽  
Kinase Inhibitors ◽  
Management Strategies ◽  
Evidence Base ◽  
High Morbidity ◽  
Case Control Studies ◽  
Nutritional Strategy ◽  
Before And After ◽  
Meta Analyses

Cryptosporidiosis is a common illness in young cattle that causes high morbidity and some mortality. A common prophylactic treatment are halofuginone products but it seems likely disease could be reduced by other other pharmacological products or some management strategies. We undertook a systematic review and meta-analyses on key outcomes for treatment of calves before and after 5 days of age with any management strategy, any nutritional strategy or any non-halofuginone product. A systematic literature search was undertaken with data extracted for outcomes = oocyst shedding, diarrhea, mortality and weight gain. Experiments had to describe results for same age animals in contemporary arms. Control animals had to be observed concurrently in planned experiments (pre-post and case-control studies were not eligible). Both randomized and other clinically controlled trials were eligible. Results were subgrouped by study design and outcomes were described in detail where at least two articles described the same treatment strategy. 55 articles were found. Significantly lower incidence of oocyst shedding, diarrhea burden and mortality was reported in many experimental arms, especially when animals started treatment before 5 days old. Weight gain was not mostly affected by treatment, however, by three weeks of age. The evidence base is at least encouraging but insufficient about paromomycin, bumped kinase inhibitors and azithromycin treatment, especially for diarrhea and oocyst shedding, given late or early. Azithromycin is the most promising of these.

scholarly journals More than 50 long-term effects of COVID-19: a systematic review and meta-analysis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Sandra Lopez-Leon ◽  
Talia Wegman-Ostrosky ◽  
Carol Perelman ◽  
Rosalinda Sepulveda ◽  
Paulina A. Rebolledo ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Management Strategies ◽  
Original Data ◽  
Long Term Effects ◽  
Pooled Prevalence ◽  
Attention Disorder ◽  
Initial Recovery ◽  
Meta Analyses

AbstractCOVID-19 can involve persistence, sequelae, and other medical complications that last weeks to months after initial recovery. This systematic review and meta-analysis aims to identify studies assessing the long-term effects of COVID-19. LitCOVID and Embase were searched to identify articles with original data published before the 1st of January 2021, with a minimum of 100 patients. For effects reported in two or more studies, meta-analyses using a random-effects model were performed using the MetaXL software to estimate the pooled prevalence with 95% CI. PRISMA guidelines were followed. A total of 18,251 publications were identified, of which 15 met the inclusion criteria. The prevalence of 55 long-term effects was estimated, 21 meta-analyses were performed, and 47,910 patients were included (age 17–87 years). The included studies defined long-COVID as ranging from 14 to 110 days post-viral infection. It was estimated that 80% of the infected patients with SARS-CoV-2 developed one or more long-term symptoms. The five most common symptoms were fatigue (58%), headache (44%), attention disorder (27%), hair loss (25%), and dyspnea (24%). Multi-disciplinary teams are crucial to developing preventive measures, rehabilitation techniques, and clinical management strategies with whole-patient perspectives designed to address long COVID-19 care.

A Systematic Review of Meta-Analyses in Special Education: Exploring the Evidence Base for High-Leverage Practices

2021 ◽  
pp. 074193252110634
Author(s):  
Gena Nelson ◽  
Sara Cothren Cook ◽  
Kary Zarate ◽  
Sarah R. Powell ◽  
Daniel M. Maggin ◽  
...  
Keyword(s):  
Systematic Review ◽  
Special Education ◽  
Students With Disabilities ◽  
Special Education Teachers ◽  
Evidence Base ◽  
Future Research ◽  
Evidence Based Practices ◽  
Intensive Instruction ◽  
Disability Categories ◽  
Meta Analyses

It is crucial that special education teachers are equipped with the knowledge and skills necessary to improve outcomes for students with disabilities. Despite federal legislation and efforts of the field to identify and disseminate evidence-based practices for students with disabilities, it is uncertain whether all special education teachers provide instruction based on the best available research. To better prepare special education teachers, McLeskey et al. proposed 22 high-leverage practices (HLPs). We conducted this systematic review of meta-analyses to provide an initial investigation of the experimental evidence reporting on the effectiveness of the HLPs for students with, or at risk for, a disability. Results indicated the largest amount of evidence from meta-analyses related to intensive instruction, explicit instruction, and social skills, with few meta-analyses reporting on collaboration and assessment. The results highlighted disproportional evidence according to disability categories. Implications for future research, practice, and teacher education are discussed.

scholarly journals Systematic review of evidence underpinning non-pharmacological therapies in dementia

2018 ◽  
Vol 42 (4) ◽  
pp. 361 ◽  
Author(s):  
Richard Olley ◽  
Andrea Morales
Keyword(s):  
Systematic Review ◽  
Sleep Disturbances ◽  
Research Effort ◽  
Evidence Base ◽  
Pharmacological Therapy ◽  
Sufficient Evidence ◽  
Behavioural Treatment ◽  
Significant Research ◽  
Research Gap ◽  
Meta Analyses

Objective Dementia is one of the most common illnesses worldwide, and is one of the most important causes of disability in older people. Currently, dementia affects over 35 million people around the globe. It is expected that this number will increase to 65.7 million by 2030. Early detection, diagnosis and treatment to control the principal behaviour symptoms may help reduce these numbers and delay the progression to more advanced and dangerous stages of this disorder with resultant increase quality of life for those affected. The main goal of the present systematic literature review was to examine contemporary evidence relating to non-pharmacological therapy in the treatment of dementia. Methods To achieve the study goal, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was used. Results This study identified the five most common behaviours in patients with dementia as aggression, wandering, agitation, apathy and sleep disturbances. Two non-pharmacological therapies were the most studied treatment: music therapy and aromatherapy. Ten other non-pharmacological therapies were also identified, but these lack a sufficient evidence-base. Conclusion Although all the therapies identified could be used as part of the treatment of behavioural symptoms, there is insufficient evidence relating to the indications, appropriate use and effectiveness of these therapies to apply in each behavioural treatment. Thus, the present study has demonstrated a significant research gap. What is known about the topic? Despite the widespread use of many different types of therapies, there is limited evidence regarding the efficacy of non-pharmaceutical therapies deployed in the management of behaviours of concern manifested by some people who suffer with dementia in all its forms. What does this paper add? This systematic review examines contemporary evidence from the literature to determine whether there is an evidence base available that would underpin the use of these therapies. This report on a PRISMA systematic review of the available literature demonstrates that only two therapies have some evidence to underpin the use of these non-pharmaceutical therapies and that a significant research gap is exists. What are the implications for practitioners? The implications for practitioners is that significant research effort is required to determine the efficacy of many of the therapies that are currently deployed, and thus many of the therapies used lack an evidence base at this time.

scholarly journals Harms of Antipsychotics in Children and Young Adults: A Systematic Review Update

2018 ◽  
Vol 63 (10) ◽  
pp. 661-678 ◽  
Author(s):  
Jennifer Pillay ◽  
Khrista Boylan ◽  
Amanda Newton ◽  
Lisa Hartling ◽  
Ben Vandermeer ◽  
...  
Keyword(s):  
Systematic Review ◽  
Young Adults ◽  
Weight Gain ◽  
Meta Analysis ◽  
Extrapyramidal Symptoms ◽  
Short Term ◽  
Strength Of Evidence ◽  
Cholesterol Levels ◽  
Children And Young Adults ◽  
Meta Analyses

Objective: To update and extend our previous systematic review on first- (FGAs) and second-generation antipsychotics (SGAs) for treatment of psychiatric and behavioral conditions in children, adolescents, and young adults (aged ≤24 years). This article focuses on the evidence for harms. Method: We searched (to April 2016) 8 databases, gray literature, trial registries, Food and Drug Administration reports, and reference lists. Two reviewers conducted study screening and selection independently, with consensus for selection. One reviewer extracted and another verified all data; 2 reviewers independently assessed risk of bias. We conducted meta-analyses when appropriate and network meta-analysis across conditions for changes in body composition. Two reviewers reached consensus for ratings on the strength of evidence for prespecified outcomes. Results: A total of 135 studies (95 trials and 40 observational) were included, and 126 reported on harms. FGAs caused slightly less weight gain and more extrapyramidal symptoms than SGAs. SGAs as a class caused adverse effects, including weight gain, high triglyceride levels, extrapyramidal symptoms, sedation, and somnolence. They appeared to increase the risk for high cholesterol levels and type 2 diabetes. Many outcomes for individual drug comparisons were of low or insufficient strength of evidence. Olanzapine caused more short-term gains in weight and body mass index than several other SGAs. The dose of SGAs may not make a difference over the short term for some outcomes. Conclusions: Clinicians need to weigh carefully the benefit-to-harm ratio when using antipsychotics, especially when treatment alternatives exist. More evidence is needed on the comparative harms between antipsychotics over the longer term.

Timely Revisit of Proprioceptive Deficits in Adolescent Idiopathic Scoliosis: A Systematic Review and Meta-Analysis

2021 ◽  
pp. 219256822110668
Author(s):  
Kenney K. L. Lau ◽  
Karlen K. P. Law ◽  
Kenny Y. H. Kwan ◽  
Jason P. Y. Cheung ◽  
Kenneth M. C. Cheung ◽  
...  
Keyword(s):  
Systematic Review ◽  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Case Reports ◽  
Data Extraction ◽  
Meta Analysis ◽  
Detection Threshold ◽  
Mean Difference ◽  
Case Control Studies ◽  
Meta Analyses

Study Design Systematic review and meta-analysis Objectives The present review aimed to summarize the evidence regarding differences in proprioception between children with and without adolescent idiopathic scoliosis (AIS). Methods Seven electronic databases were searched from their inception to April 10, 2021. Articles were included if they involved: (1) AIS patients aged between 10 and 18 years, (2) measurements of proprioceptive abilities, and (3) comparisons with non-AIS controls. Animal studies, case reports, commentaries, conference proceedings, research protocols, and reviews were excluded. Two reviewers independently conducted literature screening, data extraction, risks of bias assessments, and quality of evidence evaluations. Relevant information was pooled for meta-analyses. Results From 432 identified citations, 11 case-control studies comprising 1121 participants were included. The meta-analyses showed that AIS participants displayed proprioceptive deficits as compared to non-AIS controls. Moderate evidence supported that AIS participants showed significantly larger repositioning errors than healthy controls (pooled mean difference = 1.27 degrees, P < .01). Low evidence substantiated that AIS participants had significantly greater motion detection threshold (pooled mean difference = 1.60 degrees, P < .01) and abnormal somatosensory evoked potentials (pooled mean difference = .36 milliseconds, P = .01) than non-AIS counterparts. Conclusions Consistent findings revealed that proprioceptive deficits occurred in AIS patients. Further investigations on the causal relationship between AIS and proprioception, and the identification of the subgroup of AIS patients with proprioceptive deficit are needed.

scholarly journals Umbrella systematic review of systematic reviews and meta-analyses on comorbid physical conditions in people with autism spectrum disorder

2020 ◽  
Vol 218 (1) ◽  
pp. 10-19 ◽  
Author(s):  
Ewelina Rydzewska ◽  
Kirsty Dunn ◽  
Sally-Ann Cooper
Keyword(s):  
Systematic Review ◽  
Autism Spectrum Disorder ◽  
Systematic Reviews ◽  
Sleep Problems ◽  
Evidence Base ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Physical Conditions ◽  
Sensory Impairments ◽  
Meta Analyses

BackgroundComorbid physical conditions may be more common in people with autism spectrum disorder (ASD) than other people.AimsTo identify what is and what is not known about comorbid physical conditions in people with ASD.MethodWe undertook an umbrella systematic review of systematic reviews and meta-analyses on comorbid physical conditions in people with ASD. Five databases were searched. There were strict inclusion/exclusion criteria. We undertook double reviewing for eligibility, systematic data extraction and quality assessment. Prospective PROSPERO registration: CRD42015020896.ResultsIn total, 24 of 5552 retrieved articles were included, 15 on children, 1 on adults, and 8 both on children and adults. Although the quality of included reviews was good, most reported several limitations in the studies they included and considerable heterogeneity. Comorbid physical conditions are common, and some are more prevalent than in the general population: sleep problems, epilepsy, sensory impairments, atopy, autoimmune disorders and obesity. Asthma is not. However, there are substantial gaps in the evidence base. Fewer studies have been undertaken on other conditions and some findings are inconsistent.ConclusionsComorbid physical conditions occur more commonly in people with ASD, but the evidence base is slim and more research is needed. Some comorbidities compound care if clinicians are unaware, for example sensory impairments, given the communication needs of people with ASD. Others, such as obesity, can lead to an array of other conditions, disadvantages and early mortality. It is essential that potentially modifiable physical conditions are identified to ensure people with ASD achieve their best outcomes. Heightening clinicians’ awareness is important to aid in assessments and differential diagnoses, and to improve healthcare.

scholarly journals Etiology and Surgical Management of Cervical Spinal Epidural Abscess (SEA):: A Systematic Review

2018 ◽  
Vol 8 (4_suppl) ◽  
pp. 59S-67S ◽  
Author(s):  
Geoffrey Stricsek ◽  
Justin Iorio ◽  
Yusef Mosley ◽  
Srinivas Prasad ◽  
Joshua Heller ◽  
...  
Keyword(s):  
Systematic Review ◽  
Epidural Abscess ◽  
Management Strategies ◽  
Spinal Epidural Abscess ◽  
Systematic Analysis ◽  
The Past ◽  
Search Terms ◽  
Meta Analyses ◽  
Spinal Epidural ◽  
Early Surgical Intervention

Study Design: Systematic analysis and review. Objective: Evaluation of the presentation, etiology, management strategies (including both surgical and nonsurgical options), and neurological functional outcomes in patients with cervical spinal epidural abscess (SEA). Methods: The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) criteria were used to create a framework based on which articles pertaining to cervical SEA were chosen for review following a search of the Ovid and PubMed databases using the search terms “epidural abscess” and “cervical.” Included studies needed to have at least 4 patients aged 18 years or older, and to have been published within the past 20 years. Results: Database searches yielded 521 potential articles in PubMed and 974 potential articles in Ovid. After review, 11 studies were ultimately identified for inclusion in this systematic review. Surgery appears to be a well-tolerated management strategy with limited complications for patients with cervical SEA. However, the quantity of data comparing medical and surgical treatment of cervical SEA is limited and the bulk of the data is derived from low quality studies. Conclusion: Data reporting was heterogeneous among studies making it difficult to draw discrete conclusions. Early surgical intervention may be appropriate in selected patients with cervical epidural abscess, but it is not clear what distinguishes these patients from those who are successfully managed nonoperatively.

scholarly journals Adiposity and the risk of rheumatoid arthritis: a systematic review and meta-analysis of cohort studies

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Tomoya Ohno ◽  
Dagfinn Aune ◽  
Alicia K. Heath
Keyword(s):  
Rheumatoid Arthritis ◽  
Systematic Review ◽  
Waist Circumference ◽  
Cohort Studies ◽  
Meta Analysis ◽  
Case Control Studies ◽  
Rheumatoid Arthritis Risk ◽  
Random Effects Models ◽  
Relative Risks ◽  
Meta Analyses

Abstract Several studies have investigated associations between overweight/obesity and risk of developing rheumatoid arthritis, however, the evidence is not entirely consistent, and previous meta-analyses mainly included case–control studies, which can be affected by various biases. We therefore conducted a systematic review and meta-analysis of cohort studies on adiposity and risk of rheumatoid arthritis. Relevant studies were identified by searching PubMed and Embase databases. Random effects models were used to estimate summary relative risks (RRs) and 95% confidence intervals (CIs) for rheumatoid arthritis in relation to different measures of adiposity. Thirteen cohort studies (10 publications) were included. The summary RR per 5 kg/m2 increase in body mass index (BMI) was 1.11 (95% CI 1.05–1.18, I2 = 50%), but the association was restricted to women (1.15, 95% CI 1.08–1.21, I2 = 17%) and not observed in men (0.89, 95% CI 0.73–1.09, I2 = 58%). The summary RR per 5 kg/m2 increment in BMI at age 18 years was 1.17 (95% CI 1.01–1.36, I2 = 26%, n = 3), and per 10 cm increase in waist circumference was 1.13 (95% CI 1.02–1.25, I2 = 44%, n = 2). Higher BMI in middle age, BMI at age 18 years, and waist circumference were associated with increased rheumatoid arthritis risk, suggesting adiposity could be targeted for primary prevention.

scholarly journals Considering the methodological limitations in the evidence base of antidepressants for depression: a reanalysis of a network meta-analysis

BMJ Open ◽  
2019 ◽  
Vol 9 (6) ◽  
pp. e024886 ◽  
Author(s):  
Klaus Munkholm ◽  
Asger Sand Paludan-Müller ◽  
Kim Boesen
Keyword(s):  
Systematic Review ◽  
Clinical Study ◽  
Effect Size ◽  
Meta Analysis ◽  
Evidence Base ◽  
Risk Of Bias ◽  
Depression Symptom ◽  
Meta Analyses ◽  
The Impact ◽  
Clinical Study Reports

ObjectivesTo investigate whether the conclusion of a recent systematic review and network meta-analysis (Ciprianiet al) that antidepressants are more efficacious than placebo for adult depression was supported by the evidence.DesignReanalysis of a systematic review, with meta-analyses.Data sources522 trials (116 477 participants) as reported in the systematic review by Ciprianiet aland clinical study reports for 19 of these trials.AnalysisWe used the Cochrane Handbook’s risk of bias tool and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to evaluate the risk of bias and the certainty of evidence, respectively. The impact of several study characteristics and publication status was estimated using pairwise subgroup meta-analyses.ResultsSeveral methodological limitations in the evidence base of antidepressants were either unrecognised or underestimated in the systematic review by Ciprianiet al. The effect size for antidepressants versus placebo on investigator-rated depression symptom scales was higher in trials with a ‘placebo run-in’ study design compared with trials without a placebo run-in design (p=0.05). The effect size of antidepressants was higher in published trials compared with unpublished trials (p<0.0001). The outcome data reported by Ciprianiet aldiffered from the clinical study reports in 12 (63%) of 19 trials. The certainty of the evidence for the placebo-controlled comparisons should be very low according to GRADE due to a high risk of bias, indirectness of the evidence and publication bias. The mean difference between antidepressants and placebo on the 17-item Hamilton depression rating scale (range 0–52 points) was 1.97 points (95% CI 1.74 to 2.21).ConclusionsThe evidence does not support definitive conclusions regarding the benefits of antidepressants for depression in adults. It is unclear whether antidepressants are more efficacious than placebo.

scholarly journals Network meta-analyses for EGFR mutation-positive non-small-cell lung cancer: systematic review and overview of methods and shortcomings

2020 ◽  
Vol 9 (17) ◽  
pp. 1179-1194
Author(s):  
Carl Samuelsen ◽  
Ingolf Griebsch
Keyword(s):  
Lung Cancer ◽  
Systematic Review ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Kinase Inhibitors ◽  
Egfr Mutation ◽  
Small Cell ◽  
Future Research ◽  
Small Cell Lung ◽  
Meta Analyses

Aim: To perform a review of network meta-analyses (NMAs) for the first-line treatment of EGFR mutation-positive non-small-cell lung cancer, and to provide an overview of methodological approaches and potential shortcomings. Materials & methods: We conducted a systematic review of NMAs and evaluated their methodologies, including inclusion/exclusion criteria, information sources, results and outcomes, and statistical methodologies. Results: We identified ten published NMAs using five archetypical network structures. Despite similar objectives, there was substantial variability in the number of trials included in each NMA and in the relative treatment efficacy of the tyrosine kinase inhibitors. Conclusion: We identified methodological issues to explain differences in the findings, criteria for inclusion in NMAs and the degree of lumping of treatments. These factors should be given particular consideration in future research.

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