scholarly journals Lamotrigine and Lithium Combination for Treatment of Rapid Cycling Bipolar Disorder: Results From Meta-analysis

2021 ◽  
Author(s):  
Zhihan Gao ◽  
Fengli Sun ◽  
Wangqiang Lv ◽  
Dong Shen ◽  
Weidong Jin
Keyword(s):  
Bipolar Disorder ◽  
Response Rate ◽  
Remission Rate ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Psychotic Symptoms ◽  
Control Group ◽  
Study Group ◽  
Rapid Cycling ◽  
Treatment Resistant

Abstract Objective: to observe effect of combination of lithium and lamotrigine in treatment for Rapid-cycling bipolar disorder(RCBD). Method: We searched both MEDLINE, EMBASE, Cochrane Library in English and CBM, CNKI, WANFANG and CSSCI in Chinese to find literature from January 1 2000 to December 31, 2020 related to combination of lithium carbonate and lamotrigine for treatment of RCBD.Results: Five comparison studies, with 265 subjects of 131 cases in study group and 134 cases in control group met the inclusion criteria and were included for the final meta-analysis. The comprehensive analysis show that study group had significant lower score of mental symptoms than that of control group (Z=2.34, P=0.02) by random model (X2=33.02, df=7, P<0.01).But these differences only were shown in PANSS (Z=5.18, P<0.01) and BPRS (Z=3.08, P<0.01).The no difference in response rate (54.9% vs 45.7%OR=1.47, 95% CI: 0.79~2.73, Z=1.21, P> 0.05,) and remission rate (47.9% vs 45.9%OR=1.05, 95% CI: 0.49~2.25, Z=0.13, P> 0.05,) were found between two groups. The response rate of lamotrigine and lithium combination was significant higher compare to monotherapy of lithium in patients with no treatment-resistant (82% V 54%, OR=4.26,95% CI: 1.65~10.99, Z=3.99, P< 0.01) by fixed effect model (X2=0.89, df=1, P>0.05, I2 =0%).Conclusion: Combination of lithium and lamotrigine have better improvement of psychotic symptoms and higher response rate in patients of RCBP with no treatment-resistant.

scholarly journals The Efficacy of Shen Shuaining Capsule on Chronic Kidney Disease: A Systematic Review and Meta-Analysis

2016 ◽  
Vol 2016 ◽  
pp. 1-11 ◽  
Author(s):  
Shanshan Wang ◽  
Jinfeng Zhang ◽  
Ming Guo ◽  
Xiaobo Lian ◽  
Miaomiao Sun ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Response Rate ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Control Group ◽  
Controlled Trials ◽  
Total Efficiency ◽  
Better Than

Objective. To evaluate the efficacy of Shen shuaining capsule on treating chronic kidney disease (CKD).Methods. All randomized controlled trials (RCTs) of Shen shuaining capsule in treating CKD were collected from CBM, CNKI, VIP, Wanfang, EMBASE, MEDLINE, PubMed, and Cochrane library clinical controlled trials database. Two reviewers independently performed analysis of the included trials according to the inclusion and exclusion criteria. The risk of bias tool was from the Cochrane Handbook version 5.1.0. The Review Manager 5.2 software was employed for data analysis. Funnel plot and Egger’s test were applied to evaluate publication bias.Results. 20 studies including 1606 participants met the inclusion criteria, most of which were of low quality. Meta-analysis indicated that Shen shuaining capsule was effective for CKD in terms of SCR, BUN, Hb, and response rate and with less adverse effects, of which SCR and BUN decreased significantly (MD = −84.72, 95% CI: −107.36, −62.07,P<0.00001) (MD = −4.30, 95% CI: −5.71, −2.89,P<0.00001); Hb and response rate increased significantly (MD = 9.94, 95% CI: 9.24, 10.64,P<0.00001) (OR = 4.25, 95% CI (3.32, 5.42),P<0.00001).Conclusion. Shen shuaining capsule significantly reduced SCR and BUN, increased HB, and improved total efficiency of the symptoms and signs in patients with CKD. Subgroup analysis found that Shen shuaining capsule group was better than control group. Due to low quality of the methodology of included studies, further high-quality researches were needed to study its efficacy and safety.

scholarly journals Helicobacter pyloriEradication in Idiopathic Thrombocytopenic Purpura: A Meta-Analysis of Randomized Trials

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Bum Jun Kim ◽  
Hyeong Su Kim ◽  
Hyun Joo Jang ◽  
Jung Han Kim
Keyword(s):  
Confidence Interval ◽  
Odds Ratio ◽  
Randomized Trials ◽  
Response Rate ◽  
Meta Analysis ◽  
Case Series ◽  
Cochrane Library ◽  
Control Group ◽  
Platelet Response ◽  
H Pylori

Objective.Several recent reviews of published studies have shown that the eradication ofH. pyloriinfection in patients with ITP improved thrombocytopenia in about half of the cases. However, most included studies were observational case series. We performed the first meta-analysis of randomized trials to gain a better insight into the effect ofH. pylorieradication in ITP patients.Methods.A systematic computerized search of the electronic databases including PubMed, EMBASE, Google Scholar, and Cochrane Library (up to December 2017) was conducted.Results.From six studies, a total of 241 patients (125 in eradication group and 116 in control group) were included in the meta-analysis. Patients in the eradication group showed significantly higher overall platelet response rate than those in the control group (odds ratio = 1.93, 95% confidence interval: 1.01–3.71,P=0.05). In the subgroup analysis, however, children in the eradication group failed to show statistically better response rate than those in the noneradication group (odds ratio = 1.80, 95% confidence interval: 0.88–3.65,P=0.11).Conclusions.This meta-analysis indicates thatH. pylorieradication has a significant therapeutic effect in patients with ITP. Considering the intrinsic limits in the design and sample size of the included studies, however, large randomized controlled trials are warranted to validate the therapeutic impact ofH. pylorieradication in adults as well as children with ITP.

scholarly journals Efficacy and Safety of Nilutamide in Patients with Metastatic Prostate Cancer who Underwent Orchiectomy: A Systematic Review and Metaanalysis

2019 ◽  
Vol 14 (2) ◽  
pp. 108-115 ◽  
Author(s):  
Muhammed Rashid ◽  
K. Shamshavali ◽  
Manik Chhabra
Keyword(s):  
Prostate Cancer ◽  
Overall Survival ◽  
Metastatic Prostate Cancer ◽  
Response Rate ◽  
Meta Analysis ◽  
Progression Free Survival ◽  
Cochrane Library ◽  
Control Group ◽  
Efficacy And Safety ◽  
Free Survival

Background: Prostate cancer is the sixth leading cause of death, among all cancer deaths By 2030, this burden is expected to increase with 1.7 million new cases and 499,000 new deaths. We aimed to evaluate the efficacy and safety of Nilutamide in metastatic prostate cancer (mPCa) patients who underwent orchiectomy. Methods: A comprehensive search was conducted in the Medline/PubMed and Cochrane Library. References from included studies and studies from clinicaltrials.gov were explored without language and date restrictions. We included only randomized controlled trials, comparing the safety and efficacy of Nilutamide in Metastatic Prostate Cancer (mPCa) patients who underwent orchiectomy with placebo. The outcomes of concerns were survival and the response of drug and safety.. Quality of the included studies was assessed using the Cochrane Risk of Bias Tool. Two authors were independently involved in the study selection, data extraction and quality assessment. Disagreements between the two reviewers were resolved by consulting a third reviewer. Results: A total of five out of 244 studies were included in meta-analysis involving1637 participants. Nilutamide group showed improved response rate (RR=1.77, 95%CI 1.46-2.14, p<0.00001), disease progression (RR=0.59, 95%CI 0.47-0.73, p<0.00001), complete response (RR=2.13, 95%CI 1.40-3.23, p=0.003) and clinical benefit (RR=1.23, 95%CI 1.13-1.34, p<0.00001) when compared to placebo; however, stable disease favored the control group (RR=0.80, 95%CI 0.68-0.94, p=0.007). In addition, patients on Nilutamide showed prolonged progression-free survival and overall survival. Nausea and vomiting were the most common adverse events reported in Nilutamide group. Conclusion: Evidence suggests that patients with mPCa who underwent orchiectomy receiving Nilutamide showed significant improvement in progression-free survival and overall survival response rate and clinical benefits in comparison with the placebo group.

scholarly journals EXPRESS: Stroke risk following traumatic brain injury: systematic review and meta-analysis

2021 ◽  
pp. 174749302110042
Author(s):  
Grace Mary Turner ◽  
Christel McMullan ◽  
Olalekan Lee Aiyegbusi ◽  
Danai Bem ◽  
Tom Marshall ◽  
...  
Keyword(s):  
Systematic Review ◽  
Stroke Risk ◽  
Meta Analysis ◽  
Vitamin K Antagonists ◽  
Cochrane Library ◽  
Control Group ◽  
Large Sample Size ◽  
Hazard Ratios ◽  
Increased Risk ◽  
The Cochrane Library

Aims To investigate the association between TBI and stroke risk. Summary of review We undertook a systematic review of MEDLINE, EMBASE, CINAHL, and The Cochrane Library from inception to 4th December 2020. We used random-effects meta-analysis to pool hazard ratios (HR) for studies which reported stroke risk post-TBI compared to controls. Searches identified 10,501 records; 58 full texts were assessed for eligibility and 18 met the inclusion criteria. The review included a large sample size of 2,606,379 participants from four countries. Six studies included a non-TBI control group, all found TBI patients had significantly increased risk of stroke compared to controls (pooled HR 1.86; 95% CI 1.46-2.37). Findings suggest stroke risk may be highest in the first four months post-TBI, but remains significant up to five years post-TBI. TBI appears to be associated with increased stroke risk regardless of severity or subtype of TBI. There was some evidence to suggest an association between reduced stroke risk post-TBI and Vitamin K antagonists and statins, but increased stroke risk with certain classes of antidepressants. Conclusion TBI is an independent risk factor for stroke, regardless of TBI severity or type. Post-TBI review and management of risk factors for stroke may be warranted.

scholarly journals Impact of interstitial lung disease on mortality in ANCA-associated vasculitis: A systematic literature review and meta-analysis

2021 ◽  
Vol 18 ◽  
pp. 147997312199456
Author(s):  
Peining Zhou ◽  
Jing Ma ◽  
Guangfa Wang
Keyword(s):  
Systematic Review ◽  
Interstitial Lung Disease ◽  
Confidence Interval ◽  
Lung Disease ◽  
Mortality Risk ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Control Group ◽  
Anca Associated Vasculitis ◽  
Retrospective Cohort Studies

Several retrospectivee described the association of interstitial lung disease (ILD) and ANCA-associated vasculitis (AAV). However, the relationship between the ILD and mortality in AAV patients have not been established so far. This study aims to estimate the relevance of AAV-associated-ILD (AAV-ILD) and mortality risk by conducting a systematic review and meta-analysis.A comprehensive systematic review was conducted in accordance with the guidelines of PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses). PubMed, Embase.com and the Cochrane Library (Wiley) were searched for original observational studies. Summary estimates were derived with a random-effects model and reported as risk ratio (RR), tested for publication bias and heterogeneity. Ten retrospective cohort studies were included, comprising 526 AAV-ILD patients enrolled from 1974 to 2018. Meta-analysis yielded a pooled RR of 2.90 (95% confidence interval 1.77–4.74) for death among those with AAV-ILD compared to control group. UIP pattern was associated with an even poorer prognosis in comparison to non-UIP pattern (RR 4.36, 95% confidence interval 1.14–16.78). Sensitivity analysis suggested that the meta-RR result was not skewed by a single dominant study. ILD might be associated with a higher mortality risk in AAV patients.

scholarly journals Association between serum visfatin levels and psoriasis and their correlation with disease severity: a meta-analysis

2021 ◽  
Vol 49 (3) ◽  
pp. 030006052110023
Author(s):  
Qian Zou ◽  
Jiawei Si ◽  
Yatao Guo ◽  
Jiayu Yu ◽  
Huijuan Shi
Keyword(s):  
Body Mass Index ◽  
Meta Analysis ◽  
Severity Index ◽  
Cochrane Library ◽  
Control Group ◽  
Inclusion Criteria ◽  
Subgroup Analyses ◽  
Mean Differences ◽  
The Cochrane Library ◽  
Psoriasis Severity

Objective To determine the association between serum visfatin levels and psoriasis and to evaluate the correlation between serum visfatin levels and the severity of psoriasis. Methods The electronic databases PubMed®, Embase® and the Cochrane Library were searched for articles published from inception to 1 May 2020. Data were extracted and then standard mean differences (SMDs) and 95% confidence intervals (CIs) were calculated for pooled estimates. Results A total of 11 studies met the inclusion criteria and were included (448 patients diagnosed with psoriasis and 377 controls). This meta-analysis demonstrated that patients with psoriasis had significantly higher levels of visfatin than the controls (SMD = 0.90, 95% CI 0.52, 1.28). Subgroup analyses showed that differences in serum visfatin levels between the patient group and the control group were associated with ethnicity, Psoriasis Area and Severity Index (PASI) and body mass index. Additionally, a meta-analysis of correlations showed that visfatin levels in patients with psoriasis were positively correlated with PASI ( r = 0.51, 95% CI 0.14, 0.75). Conclusions This meta-analysis showed that serum visfatin levels in patients with psoriasis were significantly higher than those in the controls and a positive correlation between serum visfatin levels and psoriasis severity was observed.

scholarly journals Effects of exercise-based pulmonary rehabilitation on adults with asthma: a systematic review and meta-analysis

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Zhenzhen Feng ◽  
Jiajia Wang ◽  
Yang Xie ◽  
Jiansheng Li
Keyword(s):  
Quality Of Life ◽  
Pulmonary Rehabilitation ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Control Group ◽  
Life Questionnaire ◽  
Asthma Control Questionnaire ◽  
Clinical Trial Registration ◽  
Domain Scores

Abstract Background Pulmonary rehabilitation (PR) has been proposed as an effective method for many respiratory diseases. However, the effects of exercise-based PR on asthma are currently inconclusive. This review aimed to investigate the effects of exercise-based PR on adults with asthma. Methods The PubMed, Embase, Cochrane Library, Web of Science, International Clinical Trials Registry Platform and ClinicalTrials.gov databases were searched from inception to 31 July 2019 without language restriction. Randomized controlled trials (RCTs) investigating the effects of exercise-based PR on adults with asthma were included. Study selection, data extraction and risk of bias assessment were performed by two investigators independently. Meta-analysis was conducted by RevMan software (version 5.3). Evidence quality was rated by the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system. Results Ten literatures from nine studies (n = 418 patients) were identified. Asthma quality of life questionnaire total scores (MD = 0.39, 95% CI: 0.02 to 0.76) improved significantly in the experimental group compared to control group, including activity domain scores (MD = 0.58, 95% CI: 0.21 to 0.94), symptom domain scores (MD = 0.52, 95% CI: 0.19 to 0.85), emotion domain scores (MD = 0.53, 95% CI: − 0.03 to 1.09) and environment domain scores (MD = 0.56, 95% CI: 0.00 to 1.11). Both the 6-min walk distance (MD = 34.09, 95% CI: 2.51 to 65.66) and maximum oxygen uptake (MD = 4.45, 95% CI: 3.32 to 5.58) significantly improved. However, improvements in asthma control questionnaire scores (MD = − 0.25, 95% CI: − 0.51 to 0.02) and asthma symptom-free days (MD = 3.35, 95% CI: − 0.21 to 6.90) were not significant. Moreover, there was no significant improvement (MD = 0.10, 95% CI: − 0.08 to 0.29) in forced expiratory volume in 1 s. Nonetheless, improvements in forced vital capacity (MD = 0.23, 95% CI: 0.08 to 0.38) and peak expiratory flow (MD = 0.39, 95% CI: 0.21 to 0.57) were significant. Conclusions Exercise-based PR may improve quality of life, exercise tolerance and some aspects of pulmonary function in adults with asthma and can be considered a supplementary therapy. RCTs of high quality and large sample sizes are required. Clinical trial registration: The review was registered with PROSPERO (The website is https://www.crd.york.ac.uk/prospero/, and the ID is CRD42019147107).

scholarly journals The diagnostic value of EBV-DNA and EBV-related antibodies detection for nasopharyngeal carcinoma: a meta-analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Weixing Liu ◽  
Gui Chen ◽  
Xin Gong ◽  
Yingqi Wang ◽  
Yaoming Zheng ◽  
...  
Keyword(s):  
Nasopharyngeal Carcinoma ◽  
Test Performance ◽  
Meta Analysis ◽  
Diagnostic Value ◽  
Cochrane Library ◽  
Control Group ◽  
Summary Receiver Operating Characteristic ◽  
Ebv Dna ◽  
The Difference ◽  
Sensitivity Specificity

Abstract Background Numerous individual studies have investigated the diagnostic value of EBV-DNA, EA-IgA, VCA-IgA, EBNA1-IgA and Rta-IgG detection for nasopharyngeal carcinoma (NPC), but the conclusions remain controversial. This meta-analysis aimed to determine the value of EBV-DNA, EA-IgA, VCA-IgA, EBNA1-IgA and Rta-IgG detection in the diagnosis of NPC. Methods PROSPERO registration number: CRD42019145532. PubMed, EMBASE, Cochrane Library, and Chinese data libraries (Wanfang, CNKI, and CBM) were searched up to January 2019. The pooled sensitivity, specificity, and positive likelihood, negative likelihood, and diagnostic odds ratios were conducted in this meta-analysis. Summary receiver operating characteristic curves evaluated the test-performance global summary. Publication bias was examined by Deek’s funnel plot asymmetry test. Results Forty-seven studies with 8382 NPC patients (NPC group) and 15,089 individuals without NPC (Control group) were included in this meta-analysis. The sensitivity, specificity, positive likelihood (+ LR), negative likelihood (-LR), DOR and AUC of EBV-DNA in diagnosis of NPC were: 0.76 (95% CI 0.73–0.77), 0.96 (95% CI 0.95–0.97), 14.66 (95% CI 9.97–21.55), 0.19 (95% CI 0.13–0.28), 84 (95% CI 50.45–139.88), 0.96 (SE: 0.001), and 0.55 (95% CI 0.54–0.57), 0.96 (95% CI 0.96–0.97), 12.91 (95% CI 9.55–17.45), 0.35 (95% CI 0.29–0.43), 39.57 (95% CI 26.44–59.23), 0.94 (SE: 0.002) for the EA-IgA, and 0.85 (95% CI 0.84–0.85), 0.89 (95% CI 0.88–0.89), 6.73 (95% CI5.38–8.43), 0.17 (95% CI 0.12–0.23), 43.03 (95% CI 31.51–58.76), 0.93 (SE: 0.007) for the VCA-IgA, and 0.86 (95% CI 0.85–0.88), 0.87 (95% CI 0.88–0.90), 7.55 (95% CI 5.79–9.87), 0.16 (95% CI 0.13–0.19), 50.95 (95% CI 34.35–75.57), 0.94 (SE: 0.008) for the EBNA1-IgA, and 0.70 (95% CI 0.69–0.71), 0.94 (95% CI 0.94–0.95), 9.84 (95% CI 8.40–11.54), 0.25 (95% CI 0.21–0.31), 40.59 (95% CI 32.09–51.35), 0.95 (SE: 0.005) for the Rta-IgG. The EBV-DNA had larger AUC compared with other EBV-based antibodies (P < 0.05), while the difference between EA-IgA, VCA-IgA, EBNA1-IgA and Rta-IgG was not statistically significant (P > 0.05). Conclusions EBV-DNA, VCA-IgA, EBNA1-IgA and Rta-IgG detection have high accuracy in early diagnosis NPC. In addition, EBV-DNA detection has the higher diagnosis accuracy in NPC. On the other hand, EA-IgA is suitable for the diagnosis but not NPC screening.

scholarly journals Intravenous dexmedetomidine during spinal anaesthesia for caesarean section: A meta-analysis of randomized trials

2017 ◽  
Vol 45 (3) ◽  
pp. 924-932 ◽  
Author(s):  
Zeqing Bao ◽  
Chengmao Zhou ◽  
Xianxue Wang ◽  
Yu Zhu
Keyword(s):  
Caesarean Section ◽  
Spinal Anaesthesia ◽  
Randomized Trials ◽  
Meta Analysis ◽  
Relevant Literature ◽  
Nausea And Vomiting ◽  
Cochrane Library ◽  
Control Group ◽  
Efficacy And Safety ◽  
The Cochrane Library

Objective To evaluate the efficacy and safety of spinal anaesthesia using dexmedetomidine for caesarean section. Methods PubMed, The Cochrane Library, and CNKI were searched for relevant literature. Results The incidence of nausea and vomiting in the dexmedetomidine group was significantly lower than that in the control group (OR = 0.21, 95% CI: 0.12–0.35, P < 0.00001). No difference was found in the incidence of pruritus between the two groups (OR = 1.21, 95% CI: 0.36–4.09, P = 0.76).The dexmedetomidine group had a higher incidence of bradycardia than did the control group (OR = 2.20, 95% CI: 1.02–4.77, P = 0.05). The incidence of shivering in the dexmedetomidine group was significantly lower than that in the control group (OR = 0.20, 95% CI: 0.13–0.32, P < 0.00001). The incidence of hypotension was not different between the two groups (OR = 0.88, 95% CI: 0.49–1.56, P = 0.65). Conclusion Dexmedetomidine can decrease the incidence of nausea, vomiting, bradycardia, and shivering with spinal anaesthesia during caesarean section.

The Safety and Efficacy Evaluation of Dexmedetomidine for Procedural Sedation and Postoperative Behaviors in Pediatric Populations: A Systematic Review and Meta-analysis

2021 ◽  
pp. 106002802110098
Author(s):  
Linguang Gan ◽  
Xiaohong Zhao ◽  
Xiangjian Chen
Keyword(s):  
Pediatric Population ◽  
Meta Analysis ◽  
Procedural Sedation ◽  
Cochrane Library ◽  
Control Group ◽  
High Dose ◽  
Efficacy Evaluation ◽  
Safety And Efficacy ◽  
Ovid Medline ◽  
Pediatric Populations

Background: This study systematically evaluated the safety and efficacy of dexmedetomidine for procedural sedation and postoperative behaviors in a pediatric population as well as whether the results met the information required to draw conclusions. Objective: To evaluate the safety and efficacy evaluation of dexmedetomidine for procedural sedation and postoperative behaviors in a pediatric population. Methods: PubMed, Cochrane library, Web of Science and Ovid MEDLINE were searched to obtain randomized controlled trials (RCTs) comparing dexmedetomidine with control medicine and comparing different doses of dexmedetomidine. Results: There were a total of 16 RCTs for a total of 3240 patients. Dexmedetomidine slowed down the heart rate (HR; mean difference: −13.27; 95% CI: −16.41 to 10.14; P < 0.001) and reduced postoperative delirium (risk ratio [RR]: 0.31; 95% CI: 0.20-0.50; P < 0.001), the number of pain patients (RR: 0.48; 95% CI: 0.30-0.75; P = 0.002), and desaturation (RR: 0.34; 95% CI: 0.13-0.89; P = 0.03) compared with the control group. The limitation was that it was difficult to determine the range of low- and high-dose dexmedetomidine. Conclusion and Relevance: Dexmedetomidine slowed down intraoperative HR within the normal range, which might reduce myocardial oxygen consumption. It reduced postoperative pain and postoperative complications: delirium and desaturation. Dexmedetomidine showed no dose-dependent increase in the procedural sedation time of pediatric patients. Clinically, dexmedetomidine can improve pediatric procedural sedation and postoperative behavior, and it can be considered as a related medicine for safety in pediatric surgery.

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