The Effects of Evening-Primrose Oil on Menopausal Symptoms: A Systematic Review and Meta-analysis of Randomized Controlled Trials

2020 ◽  
Vol 16 (4) ◽  
pp. 265-276
Author(s):  
Karen Christelle ◽  
Maryam Mohd Zulkfili ◽  
Norhayati Mohd Noor ◽  
Nani Draman
Keyword(s):  
Systematic Review ◽  
Postmenopausal Women ◽  
Meta Analysis ◽  
Cochrane Collaboration ◽  
Menopausal Symptoms ◽  
Musculoskeletal Symptoms ◽  
Vasomotor Symptoms ◽  
Evening Primrose Oil ◽  
Evening Primrose ◽  
Meta Analyses

Background: Evening primrose oil (EPO) has been a treatment option for reducing menopausal symptoms, but evidence for its use is inadequate. Objective: The study aimed to determine the effectiveness of EPO in treating menopausal symptoms among peri and postmenopausal women. Study design: This is a systematic review with meta-analyses of randomised clinical trials (RCTs). Methods: We searched CENTRAL, Medline, Embase and trial registries for relevant RCTs. The methodology and reporting were carried out grounded on references from the Cochrane collaboration and the preferred reporting items for systematic reviews and meta-analyses statement. Review Manager version 5.3.5 was used to perform all the statistical analyses. Results: Five RCTs, recruiting a total of 402 peri and postmenopausal women were identified. EPO did not reduce the frequency of daily vasomotor symptoms (MD 0.01 episodes, 95% CI -0.54 to 0.57, P=0.960), frequency of daytime hot flash episodes (MD -0.51 episodes, 95% CI -2.05 to 1.03, P=0.510), frequency of night sweat episodes (MD 0.33 episodes, 95% CI -0.48 to 1.13, P=0.430) and severity of vasomotor symptoms (SMD -0.45, 95% CI -1.56 to 0.66, P=0.420) in comparison to control. EPO was associated with a minimal reduction in the severity of overall menopausal symptoms in comparison to control (SMD -1.18; 95% CI-2.18 to -0.18, P=0.02). There were insufficient data to pool results for musculoskeletal symptoms, mood, sexuality, sleeping disorders and quality of life. Conclusion: EPO may reduce the severity of overall menopausal symptoms but is not effective to reduce the frequency and severity of vasomotor symptoms. The evidence quality ranged from very low to moderate. Further research is needed to enhance related evidence.

scholarly journals Evaluation of Preeclampsia Results after Use of Metformin in Gestation: Systematic Review and Meta-analysis

2018 ◽  
Vol 40 (11) ◽  
pp. 713-721 ◽  
Author(s):  
Iramar Nascimento ◽  
Guilherme Dienstmann ◽  
Matheus de Souza ◽  
Raquel Fleig ◽  
Carla Hoffmann ◽  
...  
Keyword(s):  
Systematic Review ◽  
Treatment Time ◽  
Meta Analysis ◽  
Cochrane Collaboration ◽  
Eligibility Criteria ◽  
Time Segment ◽  
Meta Analyses ◽  
The Cochrane Collaboration ◽  
Lower Correlation

Objective Does the use of metformin have an influence on the outcomes of preeclampsia (PE)? Sources of Data The descriptors pregnancy, metformin, treatment, and preeclampsia associated with the Boolean operators AND and OR were found in the MEDLINE, LILACS, Embase and Cochrane databases. A flowchart with exclusion criteria and inclusion strategy using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol, and eligibility criteria was used. Data were extracted regarding the type of study, the applied dosage, treatment time, segment, bias risks, and the Patient, Intervention, Comparison and Outcome (PICO) strategy to identify the quality of the study. Selection of Studies Total number of journals in the initial search (n = 824); exclusions from repeated articles on different search engines (n = 253); exclusions after reading the titles, when the title had no correlations with the proposed theme (n = 164); exclusions due to incompatibility with the criteria established in the methodological analysis (n = 185), exclusion of articles with lower correlation with the objective of the present study (n = 187); and final bibliographic selection (n = 35). Data Collection At first, a systematic review of the literature was performed. Subsequently, from the main selection, randomized and non-randomized trials with metformin that presented their results in absolute and relative numbers of PE outcomes were selected. The variables were treated statistically in the meta-analysis with the Review Manager software (RevMan), version 5.3. Copenhagen: Nordic Cochrane Centre, The Cochrane Collaboration. Denmark in the Hovedistaden region. Synthesis of Data The study showed that metmorfin presented greater preventive effects for pregnancy-induced hypertension and was less effective for PE. Conclusion Metformin may gain place in preventive treatments for PE, once the dosages, the gestational age, and treatment time are particularly evaluated. A methodological strategy with an improved perspective of innovative and/or carefully progressive dosages during pregnancy to avoid side effects and the possibility of maternal-fetal risks is suggested.

Simultaneous compared to interval administration of mifepristone and misoprostol for medical abortion up to 10+0 weeks' gestation: a systematic review with meta-analyses

2020 ◽  
pp. bmjsrh-2019-200448
Author(s):  
Mia Schmidt-Hansen ◽  
Jonathan Lord ◽  
Elise Hasler ◽  
Sharon Cameron
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Cochrane Collaboration ◽  
Medical Abortion ◽  
Cochrane Library ◽  
Published Data ◽  
Study Results ◽  
Randomised Controlled ◽  
Meta Analyses

BackgroundMedical abortion with mifepristone and misoprostol usually involves an interval of 36–48 hours between administering these drugs; however, it is possible that the clinical efficacy at early gestations may be maintained when the drugs are taken simultaneously. The objective of this systematic review was to determine the safety and effectiveness of simultaneous compared with interval administration of mifepristone and misoprostol for abortion up to 10+0 weeks’ gestation.MethodsWe searched Embase Classic, Embase; Ovid MEDLINE(R) including Daily, and Epub Ahead-of-Print, In-Process & Other Non-Indexed Citations; and Cochrane Library on 11 December 2019. We included randomised controlled trials (RCTs), published in English from 1985, comparing simultaneous to interval administration of mifepristone and misoprostol for early abortion. Risk of bias was assessed using the Cochrane Collaboration checklist for RCTs. Meta-analysis of risk ratios (RRs) using the Mantel-Haenszel method were performed. The quality of the evidence was assessed using GRADE.ResultsMeta-analyses of three RCTs (n=1280) showed no differences in ‘ongoing pregnancy’ (RR 1.78, 95% CI 0.38 to 8.36), ‘haemorrhage requiring transfusion or ≥500 mL blood loss’ (RR 0.11, 95% CI 0.01 to 2.03) and ‘incomplete abortion with the need for surgical intervention’ (RR 1.30, 95% CI 0.76 to 2.25) between the interventions. Individual study results showed no difference in patient satisfaction, or ‘need for repeat misoprostol’, although ‘time to onset of bleeding or cramping’ was longer after simultaneous than interval administration. The quality of evidence was very low to moderate.ConclusionThe published data support the use of simultaneous mifepristone and misoprostol for medical abortion up to 9+0 weeks in women who prefer this method of administration.

How to Write a Systematic Review of the Literature

2017 ◽  
Vol 11 (1) ◽  
pp. 15-30 ◽  
Author(s):  
Debajyoti Pati ◽  
Lesa N. Lorusso
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Research Question ◽  
Cochrane Collaboration ◽  
Quality Level ◽  
Methodological Rigor ◽  
Prisma Statement ◽  
Level Of Understanding ◽  
Meta Analyses ◽  
The Cochrane Collaboration

This article provides a step-by-step approach to conducting and reporting systematic literature reviews (SLRs) in the domain of healthcare design and discusses some of the key quality issues associated with SLRs. SLR, as the name implies, is a systematic way of collecting, critically evaluating, integrating, and presenting findings from across multiple research studies on a research question or topic of interest. SLR provides a way to assess the quality level and magnitude of existing evidence on a question or topic of interest. It offers a broader and more accurate level of understanding than a traditional literature review. A systematic review adheres to standardized methodologies/guidelines in systematic searching, filtering, reviewing, critiquing, interpreting, synthesizing, and reporting of findings from multiple publications on a topic/domain of interest. The Cochrane Collaboration is the most well-known and widely respected global organization producing SLRs within the healthcare field and a standard to follow for any researcher seeking to write a transparent and methodologically sound SLR. Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA), like the Cochrane Collaboration, was created by an international network of health-based collaborators and provides the framework for SLR to ensure methodological rigor and quality. The PRISMA statement is an evidence-based guide consisting of a checklist and flowchart intended to be used as tools for authors seeking to write SLR and meta-analyses.

Bone Density and Clinical Periodontal Attachment in Postmenopausal Women: A Systematic Review and Meta-Analysis

2017 ◽  
Vol 96 (3) ◽  
pp. 261-269 ◽  
Author(s):  
D.C. Penoni ◽  
T.K.S. Fidalgo ◽  
S.R. Torres ◽  
V.M. Varela ◽  
D. Masterson ◽  
...  
Keyword(s):  
Systematic Review ◽  
Postmenopausal Women ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Qualitative Synthesis ◽  
Mineral Density ◽  
Clinical Attachment Loss ◽  
Attachment Loss ◽  
Meta Analyses ◽  
Periodontal Attachment

Osteoporosis is a systemic skeletal disease characterized by low bone mineral density (BMD) and has been considered a risk factor for periodontal disease. The aim of this systematic review and meta-analysis was to verify the scientific evidence for the association of periodontal attachment loss with low BMD in postmenopausal women. A systematic search of the literature was performed in databases until August 2016, in accordance with Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Eligibility criteria included studies that compared clinical attachment loss (CAL) between postmenopausal women with low and normal BMD. Studies using similar methodology, with lower and higher risk of bias, were pooled into 3 different meta-analyses to compare CAL among women with normal BMD, osteoporosis, and osteopenia. In the first meta-analysis, mean CAL was compared among groups. In the other 2 meta-analyses, the mean percentages of sites with CAL ≥4 mm and ≥6 mm were respectively compared among groups. From 792 unique citations, 26 articles were selected for the qualitative synthesis. Eleven of the studies were appraised as presenting low risk of bias, and the association between low BMD and CAL was observed in 10 of these studies. Thirteen cross-sectional articles were included in the meta-analysis for osteoporosis and 9 in the osteopenia analysis. Women with low BMD presented greater mean CAL than those with normal BMD (osteoporosis = 0.34 mm [95% confidence interval (CI), 0.20–0.49], P < 0.001; osteopenia = 0.07 mm [95% CI, 0.01–0.13], P = 0.02). Only studies with lower risk of bias were available for the analysis of CAL severity. Women with low BMD presented more severe attachment loss, represented as mean percentage of sites with CAL ≥4 mm (osteoporosis = 3.04 [95% CI, 1.23–4.85], P = 0.001; osteopenia = 1.74 [95% CI, 0.36–3.12], P = 0.01) and CAL ≥6 mm (osteoporosis = 5.07 [95% CI, 2.74–7.40], P < 0.001). This systematic review and meta-analysis indicates that postmenopausal women with osteoporosis or osteopenia may exhibit greater CAL compared with women with normal BMD.

scholarly journals Effect of periodontal therapy on the systemic inflammation and metabolic  markers in patients undergoing hemodialysis or/and peritoneal dialysis: a systematic review and meta-analysis

2019 ◽  
Author(s):  
Hui Yue ◽  
Xinxin Xu ◽  
Qin Liu ◽  
Xiaozhi Li ◽  
Yiting Xiao ◽  
...  
Keyword(s):  
Systematic Review ◽  
Peritoneal Dialysis ◽  
Assessment Tool ◽  
Meta Analysis ◽  
Cochrane Collaboration ◽  
Periodontal Treatment ◽  
Sufficient Evidence ◽  
Metabolic Markers ◽  
Significant Difference ◽  
Meta Analyses

Abstract Background: This systematic review aimed to investigate whether periodontal treatment can reduce the systemic inflammatory levels and improve the metabolic levels in patients undergoing hemodialysis (HD) or/and peritoneal dialysis (PD). Methods: Electronic databases (PubMed, EMBASE, CENTRAL, NCKI, and WFPD) were searched up to July 2019. The risk of bias within studies was assessed through the Cochrane Collaboration' s risk assessment tool. The systemic inflammatory and metabolic measures were the highly sensitive C-reactive protein (hs-CRP), interleukin 6 (IL-6), tumor necrosis factor-α (TNF-a), the albumin (Alb), and lipid metabolic levels. Meta-analyses (MAs) were performed to calculate the overall effect size where appropriate. Results: Five studies were eligible for this systematic review. The result of four studies revealed a significant difference in the CRP level after periodontal treatment in patients receiving HD or/and PD. Two studies reported the IL-6 and the Alb level after periodontal treatment but revealed no significant difference. No MAs could be performed on the TNF- a level and the lipid metabolic markers. Conclusions: Periodontal treatment may moderately reduce the serum of CRP levels in HD or/and PD patients. For the TNF-a, IL-6, Alb levels and lipid metabolic markers, no sufficient evidence supports the difference after periodontal treatment. Therefore, larger scales and high-quality randomized-controlled trials (RCTs) are required to assess the effect of periodontal treatment on systemic inflammatory and metabolic parameters in HD or/and PD patients.

scholarly journals Enteric pathogens associated with gastroenteritis among children under 5 years in sub-Saharan Africa: a systematic review and meta-analysis

2020 ◽  
Vol 148 ◽  
Author(s):  
T. B. Oppong ◽  
H. Yang ◽  
C. Amponsem-Boateng ◽  
E. K. D Kyere ◽  
T. Abdulai ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Acute Diarrhoea ◽  
Cochrane Collaboration ◽  
Original Data ◽  
Health Condition ◽  
Sub Saharan Africa ◽  
Sub Saharan ◽  
Meta Analyses ◽  
Children Under 5

Abstract Gastroenteritis remains a serious health condition among children under 5 years especially in Africa. We conducted a systematic review and meta-analysis to investigate the aetiologic pathogens of gastroenteritis in the region. We did a systematic search for articles with original data on the aetiology of gastroenteritis and acute diarrhoea among children younger than 5 years. Pooled results were extracted and analysed in STATA version 12.0 using random-effects for statistical test for homogeneity following the guidelines provided in the Cochrane Collaboration and Preferred reporting items for systematic reviews and meta-analyses. Overall, viruses accounted for 50.2% of the cases followed by bacteria with 31.6% of the cases. Parasites accounted for 12.1% of the case. Rotavirus was the most common cause of acute diarrhoea in all regions resulting in 29.2% of the cases followed by E. coli (15.6%) of diarrhoeal cases and Adenovirus (10.8%). The most prevalent parasite detected was Giardia lamblia (7.3%). Acute diarrhoea remains rampant with Rotavirus still being the major pathogen responsible for the disease in children less than 5 years old despite the introduction of vaccine. It is recommended that the vaccine should be promoted much more widely in the region.

Effect of evening primrose oil supplementation on lipid profile: A systematic review and meta‐analysis of randomized clinical trials

2020 ◽  
Vol 34 (10) ◽  
pp. 2628-2638
Author(s):  
Masoud Khorshidi ◽  
Meysam Zarezadeh ◽  
Omid Moradi Moghaddam ◽  
Mohammad Reza Emami ◽  
Hamed Kord‐Varkaneh ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Lipid Profile ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Evening Primrose Oil ◽  
Evening Primrose

scholarly journals Associations of occupational standing with musculoskeletal symptoms: a systematic review with meta-analysis

2016 ◽  
Vol 52 (3) ◽  
pp. 176-183 ◽  
Author(s):  
Pieter Coenen ◽  
Lisa Willenberg ◽  
Sharon Parry ◽  
Joyce W Shi ◽  
Lorena Romero ◽  
...  
Keyword(s):  
Systematic Review ◽  
Lower Extremity ◽  
Upper Extremity ◽  
Meta Analysis ◽  
Musculoskeletal Symptoms ◽  
Low Back ◽  
Potential Health ◽  
High Exposure ◽  
Meta Analyses ◽  
Upper Extremity Symptoms

ObjectiveGiven the high exposure to occupational standing in specific occupations, and recent initiatives to encourage intermittent standing among white-collar workers, a better understanding of the potential health consequences of occupational standing is required. We aimed to review and quantify the epidemiological evidence on associations of occupational standing with musculoskeletal symptoms.DesignA systematic review was performed. Data from included articles were extracted and described, and meta-analyses conducted when data were sufficiently homogeneous.Data sourcesElectronic databases were systematically searched.Eligibility criteriaPeer-reviewed articles on occupational standing and musculoskeletal symptoms from epidemiological studies were identified.ResultsOf the 11 750 articles screened, 50 articles reporting 49 studies were included (45 cross-sectional and 5 longitudinal; n=88 158 participants) describing the associations of occupational standing with musculoskeletal symptoms, including low-back (39 articles), lower extremity (14 articles) and upper extremity (18 articles) symptoms. In the meta-analysis, ‘substantial’ (>4 hours/workday) occupational standing was associated with the occurrence of low-back symptoms (pooled OR (95% CI) 1.31 (1.10 to 1.56)). Evidence on lower and upper extremity symptoms was too heterogeneous for meta-analyses. The majority of included studies reported statistically significant detrimental associations of occupational standing with lower extremity, but not with upper extremity symptoms.ConclusionsThe evidence suggests that substantial occupational standing is associated with the occurrence of low-back and (inconclusively) lower extremity symptoms, but there may not be such an association with upper extremity symptoms. However, these conclusions are tentative as only limited evidence was found from high-quality, longitudinal studies with fully adjusted models using objective measures of standing.

scholarly journals Red and Processed Meat Consumption and Risk of Depression: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 17 (18) ◽  
pp. 6686 ◽  
Author(s):  
Daniele Nucci ◽  
Cristina Fatigoni ◽  
Andrea Amerio ◽  
Anna Odone ◽  
Vincenza Gianfredi
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Cochrane Collaboration ◽  
P Value ◽  
Processed Meat ◽  
Meat Intake ◽  
Policy Makers ◽  
Meta Analyses ◽  
The Cochrane Collaboration ◽  
Red And Processed Meat

Depression is one of the leading causes of disability worldwide, with more than 264 million people affected. On average, depression first appears during the late teens to mid-20s as result of a complex interaction of social, psychological and biological factors. The aim of this systematic review with meta-analysis is to assess the association between red and processed meat intake and depression (both incident and prevalent). This systematic review was conducted according to the methods recommended by the Cochrane Collaboration and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Relevant papers published through March 2020 were identified by searching the electronic databases MEDLINE, Embase and Scopus. All analyses were conducted using ProMeta3 software. A critical appraisal was conducted. Finally, 17 studies met the inclusion criteria. The overall effect size (ES) of depression for red and processed meat intake was 1.08 [(95% CI = 1.04; 1.12), p-value < 0.001], based on 241,738 participants. The results from our meta-analysis showed a significant association between red and processed meat intake and risk of depression. The presented synthesis will be useful for health professionals and policy makers to better consider the effect of diet on mental health status.

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