scholarly journals Bivalirudin Versus Heparin During Intervention in Acute Coronary Syndrome: A Systematic Review of Randomized Trials

2020 ◽  
Vol 20 (1) ◽  
pp. 3-15
Author(s):  
Sukhdee Bhogal ◽  
Debabrata Mukherjee ◽  
Jayant Bagai ◽  
Huu T. Truong ◽  
Hemang B. Panchal ◽  
...  
Keyword(s):  
Systematic Review ◽  
Stent Thrombosis ◽  
Systematic Reviews ◽  
Bleeding Complications ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Coronary Syndrome ◽  
Ischemic Complications ◽  
Meta Analyses ◽  
Acute Stent Thrombosis

Introduction: Bivalirudin and heparin are the two most commonly used anticoagulants used during Percutaneous Coronary Intervention (PCI). The results of Randomized Controlled Trials (RCTs) comparing bivalirudin versus heparin monotherapy in the era of radial access are controversial, questioning the positive impact of bivalirudin on bleeding. The purpose of this systematic review is to summarize the results of RCTs comparing the efficacy and safety of bivalirudin versus heparin with or without Glycoprotein IIb/IIIa Inhibitors (GPI). Methods: This systematic review was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses PRISMA statements for reporting systematic reviews. We searched the National Library of Medicine PubMed, Clinicaltrial.gov and the Cochrane Central Register of Controlled Trials to include clinical studies comparing bivalirudin with heparin in patients undergoing PCI. Sixteen studies met inclusion criteria and were reviewed for the summary. Findings: Several RCTs and meta-analyses have demonstrated the superiority of bivalirudin over heparin plus routine GPI use in terms of preventing bleeding complications but at the expense of increased risk of ischemic complications such as stent thrombosis. The hypothesis of post- PCI bivalirudin infusion to mitigate the risk of acute stent thrombosis has been tested in various RCTs with conflicting results. In comparison, heparin offers the advantage of having a reversible agent, of lower cost and reduced incidence of ischemic complications. Conclusion: Bivalirudin demonstrates its superiority over heparin plus GPI with better clinical outcomes in terms of less bleeding complications, thus making it as anticoagulation of choice particularly in patients at high risk of bleeding. Further studies are warranted for head to head comparison of bivalirudin to heparin monotherapy to establish an optimal heparin dosing regimen and post-PCI bivalirudin infusion to affirm its beneficial effect in reducing acute stent thrombosis.

scholarly journals Buteyko method for people with asthma: a protocol for a systematic review and meta-analysis

BMJ Open ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. e049213
Author(s):  
Karla Morganna Pereira Pinto de Mendonça ◽  
Sean Collins ◽  
Tácito ZM Santos ◽  
Gabriela Chaves ◽  
Sarah Leite ◽  
...  
Keyword(s):  
Systematic Review ◽  
Systematic Reviews ◽  
Meta Analysis ◽  
Secondary Data ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Plain Language ◽  
Randomised Controlled ◽  
Meta Analyses

IntroductionButeyko method is recommended as a non-pharmacological treatment for people with asthma. Although the worldwide interest in the Buteyko method, there is a paucity of studies gathering evidence to support its use. Therefore, we aim to conduct a systematic review and meta-analysis to assess the effects of the Buteyko method in children and adults with asthma.Methods and analysisWe will search on Cochrane Central Register of Controlled Trials, MEDLINE, Embase, US National Institutes of Health Ongoing Trials Register ClinicalTrials.gov and WHO International Clinical Trials Registry Platform for studies focusing on the Buteyko method for children and adults with asthma. The searches will be carried out in September 2021 from database’s inception to the present. We will include randomised controlled trials comparing Buteyko method alone with asthma education or inactive control intervention. There will be no restriction on language. Primary outcomes include quality of life, asthma symptoms and adverse events/side effects. Two review authors will independently screen the studies for inclusion and extract data. We will assess the quality of the included studies using the ‘Risk of Bias’ tool. The certainty of the evidence will be assessed using the GRADE approach. Data synthesis will be conducted using Review Manager software. Reporting of the review will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidance and the Cochrane Handbook for Systematic Reviews of Interventions.Ethics and disseminationThis study will assess and provide evidence for the use of the Buteyko method in people with asthma. We will analyse secondary data and this does not require ethics approval. The findings will be published in peer-reviewed journals, at relevant conferences and will be shared in plain language in social media. Moreover, the findings of this review could guide the direction of healthcare practice and research.PROSPERO registration numberCRD42020193132.

scholarly journals eHealth interventions for reducing cardiovascular disease risk in men: a systematic review and meta-analysis

2021 ◽  
Vol 20 (Supplement_1) ◽  
Author(s):  
J Mcmahon ◽  
DR Thompson ◽  
MC Pascoe ◽  
K Brazil ◽  
CF Ski
Keyword(s):  
Systematic Review ◽  
Cardiovascular Disease ◽  
Behavior Change ◽  
Systematic Reviews ◽  
Meta Analysis ◽  
Database Search ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Cvd Risk ◽  
Meta Analyses

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Department for the Economy (DfE) studentships Background. Men remain at a higher risk of developing cardiovascular disease (CVD) than women and behavioral risk factor modification is an important preventive measure. However, engaging men in behavior change interventions is challenging. eHealth interventions have the potential to address this gap, though their effectiveness for reducing CVD risk in men is unclear. Purpose. To conduct a systematic review and meta-analysis to evaluate the effectiveness of eHealth interventions for reducing CVD risk in men. Methods. This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and principles laid out by the Cochrane Handbook for Systematic Reviews of Interventions. A search of published randomised controlled trials (RCTs) with no date restrictions up to July 2020 was conducted across five electronic databases: Cochrane Central register of Controlled Trials (CENTRAL), Medline, CINAHL Plus, PsycINFO and SCOPUS. Reference lists of relevant systematic reviews and meta-analyses were manually searched for additional trials not identified during the database search. Eligible studies were RCTs that focused on the use of eHealth to improve a minimum of two major CVD related risk factors in males aged 18 years or older. Results. A total of 3168 records were retrieved from the online database search, with nine trials meeting the inclusion criteria following screening and full-text assessment. Study quality ranged from low to unclear, with one trial at a high risk of bias. Compared to those in a control group or receiving printed materials, participants randomised to an eHealth intervention had statistically significant improvements in BMI (Z=-2.75, p = 0.01), body weight (Z=-3.25, p = 0.01), waist circumference (Z=-2.30, p = 0.02) and systolic (Z=-3.57, p = 0.01) and diastolic (Z=-3.56, p = 0.01) blood pressure. Though less evident, there were also improvements in physical activity and diet in favour of the intervention group. Conclusion. This was the first systematic review and meta-analysis conducted on the effectiveness of eHealth interventions for reducing CVD risk in men. This review suggests that eHealth interventions can reduce CVD risk in adult men through behavior change. However, we were unable to determine the association between intervention characteristics and outcomes. Also, overall, participant adherence to the intervention was poor. Both of these issues should be considered in future studies.

scholarly journals Comparison of effects of different dietary interventions on cognitive function in Alzheimer’s disease: protocol for systematic review and network meta-analysis

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e042997
Author(s):  
Lili Chen ◽  
Xinhua Xu ◽  
Huizhen Cao ◽  
Hong Li
Keyword(s):  
Systematic Review ◽  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Function ◽  
Risk Of Bias ◽  
Evaluation Framework ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Dietary Interventions ◽  
Meta Analyses

IntroductionAlzheimer’s disease (AD) is the most common neurodegenerative disease and is characterised by cognitive impairment. Non-pharmacological treatments such as diet therapy have been widely investigated in studies on AD. Given the synergistic effects of nutrients present in foods, considering overall dietary composition rather than focusing on a single nutrient may be more useful for evaluating the relationship between diet and AD cognition. The present study aimed to assess the efficacy of different dietary interventions (eg, ketogenic and Mediterranean diets) on cognitive function in patients with AD in a systematic review and pairwise and network meta-analyses of randomised controlled trials or clinical trials.Methods and analysisTwo reviewers will independently conduct searches of PubMed, Cochrane Central Register of Controlled Trials, Embase, CINAHL, PsycINFO and China National Knowledge Infrastructure databases. Data will be extracted from selected studies and risk of bias will be assessed using the revised Cochrane risk-of-bias tool, and evidence quality will be assessed according to the Grading of Recommendations, Assessment, Development and Evaluation framework. The primary outcome of interest is cognitive function in patients with AD; secondary outcomes include biochemical biomarkers of AD and oxidative stress and/or inflammatory biomarkers in cerebrospinal fluid or plasma. For each outcome, random-effects pairwise and network meta-analyses will be carried out to determine the pooled relative effect of each intervention relative to every other intervention.Ethics and disseminationAs this study is based solely on published literature, no ethics approval is required. The research will be published in a peer-reviewed journal.

Developing, Implementing, and Applying Novel Techniques During Systematic Reviews of Primary Space Medicine Data

2021 ◽  
Vol 92 (8) ◽  
pp. 681-688
Author(s):  
Andrew Winnard ◽  
Nick Caplan ◽  
Claire Bruce-Martin ◽  
Patrick Swain ◽  
Rochelle Velho ◽  
...  
Keyword(s):  
Systematic Review ◽  
Systematic Reviews ◽  
Quantitative Methods ◽  
Primary Data ◽  
Controlled Trials ◽  
Synthesis Methods ◽  
Space Medicine ◽  
Systematic Review Methods ◽  
Meta Analyses ◽  
Primary Space

BACKGROUND: The Aerospace Medicine Systematic Review Group was set up in 2016 to facilitate high quality and transparent synthesis of primary data to enable evidence-based practice. The group identified many research methods specific to space medicine that need consideration for systematic review methods. The group has developed space medicine specific methods to address this and trialed usage of these methods across seven published systematic reviews. This paper outlines evolution of space medicine synthesis methods and discussion of their initial application.METHODS: Space medicine systematic review guidance has been developed for protocol planning, quantitative and qualitative synthesis, sourcing gray data, and assessing quality and transferability of space medicine human spaceflight simulation study environments.RESULTS: Decision algorithms for guidance and tool usage were created based on usage. Six reviews used quantitative methods in which no meta-analyses were possible due to lack of controlled trials or reporting issues. All reviews scored the quality and transferability of space simulation environments. One review was qualitative. Several research gaps were identified.CONCLUSION: Successful use of the developed methods demonstrates usability and initial validity. The current space medicine evidence base resulting in no meta-analyses being possible shows the need for standardized guidance on how to synthesize data in this field. It also provides evidence to call for increasing use of controlled trials, standardizing outcome measures, and improving minimum reporting standards. Space medicine is a unique field of medical research that requires specific systematic review methods.Winnard A, Caplan N, Bruce-Martin C, Swain P, Velho R, Meroni R, Wotring V, Damann V, Weber T, Evetts S, Laws J. Developing, implementing, and applying novel techniques during systematic reviews of primary space medicine data. Aerosp Med Hum Perform. 2021; 92(8):681688.

scholarly journals Tai Chi and other mind–body interventions for cancer-related fatigue: an updated systematic review and network meta-analyses protocol

BMJ Open ◽  
2022 ◽  
Vol 12 (1) ◽  
pp. e052137
Author(s):  
Hong-Juan Fu ◽  
Hao Zhou ◽  
Yong Tang ◽  
Jie Li ◽  
Da Zhang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Evaluation System ◽  
Tai Chi ◽  
Evidence Base ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
China National Knowledge Infrastructure ◽  
Cancer Related Fatigue ◽  
Meta Analyses

IntroductionFatigue is one of the most common symptoms in patients with cancer and is responsible for a reduced quality of life. There is a strong evidence base for mind–body interventions (MBIs) to manage cancer-related fatigue (CRF). However, the efficacy of Tai Chi and other MBIs in the treatment of CRF remains controversial.Methods and analysisWe will perform a systematic review and network meta-analyses (NMAs) that aim to assess the effects of Tai Chi and other MBIs in patients with CRF. The following databases will be searched from their inception to 1 August 2021: PubMed, EMBASE, Scopus, OVID, Web of Science, Cochrane Central Register of Controlled Trials, the China National Knowledge Infrastructure, China Science and Technology Journal Database, Chinese Biomedical Database and Wan Fang Digital Journals. We will include randomised controlled trials that compare MBIs with no treatment, placebo and usual care in the treatment of CRF. The primary outcome will be changes in the fatigue state as evaluated by validated scales. We will perform a Bayesian NMA to analyse all the evidence for each outcome. The surface under the cumulative ranking curve and the mean ranks will be used to rank the various treatments. We will assess the quality of evidence contributing to network estimates of outcomes using the Grading of Recommendations Assessment, Development and Evaluation system framework.Ethics and disseminationThis NMAs will be disseminated through publication in a peer-reviewed journal. Since no individual patient data will be involved in the review, ethics approval and concerns about privacy are not needed.PROSPERO registration numberCRD42021244999.

scholarly journals TaiChi and Qigong for Depressive Symptoms in Patients with Chronic Heart Failure: A Systematic Review with Meta-Analysis

2021 ◽  
Vol 2021 ◽  
pp. 1-12
Author(s):  
Wei Jiang ◽  
Shaojun Liao ◽  
Xiankun Chen ◽  
Cecilia Stålsby Lundborg ◽  
Gaetano Marrone ◽  
...  
Keyword(s):  
Heart Failure ◽  
Systematic Review ◽  
Depressive Symptoms ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Therapeutic Effects ◽  
Cochrane Central Register ◽  
China National Knowledge Infrastructure ◽  
Beneficial Effects ◽  
Meta Analyses

Background. Depression is a debilitating comorbidity of heart failure (HF) that needs assessment and management. Along with mind-body exercise to deal with HF with depression, the use of TaiChi and/or Qigong practices (TQPs) has increased. Therefore, this systematic review assesses the effects of TQPs on depression among patients with HF. Methods. Randomized controlled trials (RCTs) that examined the effect of TQPs on depression in patients with HF were searched by five databases (PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE, CINAHL, and China National Knowledge Infrastructure (CNKI)). With standardized mean difference (SMD) and 95% confidence intervals (95% CI), random-effects meta-analyses of the effect of TQPs on depressive symptoms were performed. Results. Of eight included RCTs, seven (481 patients) provided data for the meta-analysis. The pooling revealed that TQPs contribute to depression remission in HF (SMD −0.66; 95% CI −0.98 to −0.33, P < 0.0001 ; I2 = 64%). Its antidepressive effect was not influenced by intervention duration or exercise setting, but rather by ejection fraction subtype, depressive severity, and depression instruments. The beneficial effects were preserved when the study with the largest effect was removed. Conclusion. This study suggests that TQPs might be a good strategy for alleviating depressive symptoms in patients with HF. And rigorous-design RCTs, which focus on the identified research gaps, are needed to further establish the therapeutic effects of TQPs for depression in HF.

The Effectiveness of Telemedicine Solutions for the Management of Type 2 Diabetes: A Systematic Review, Meta-Analysis, and Meta-Regression

2021 ◽  
pp. 193229682110646
Author(s):  
Stine Hangaard ◽  
Sisse H. Laursen ◽  
Jonas D. Andersen ◽  
Thomas Kronborg ◽  
Peter Vestergaard ◽  
...  
Keyword(s):  
Systematic Review ◽  
Type 2 Diabetes ◽  
Systematic Reviews ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Sufficient Information ◽  
Meta Regression ◽  
Meta Analyses

Background: Previous systematic reviews have aimed to clarify the effect of telemedicine on diabetes. However, such reviews often have a narrow focus, which calls for a more comprehensive systematic review within the field. Hence, the objective of the present systematic review, meta-analysis, and meta-regression is to evaluate the effectiveness of telemedicine solutions versus any comparator without the use of telemedicine on diabetes-related outcomes among adult patients with type 2 diabetes (T2D). Methods: This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We considered telemedicine randomized controlled trials (RCT) including adults (≥18 years) diagnosed with T2D. Change in glycated hemoglobin (HbA1c, %) was the primary outcome. PubMed, EMBASE, and the Cochrane Library Central Register of Controlled Trials (CENTRAL) were searched on October 14, 2020. An overall treatment effect was estimated using a meta-analysis performed on the pool of included studies based on the mean difference (MD). The revised Cochrane risk-of-bias tool was applied and the certainty of evidence was graded using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach. Results: The final sample of papers included a total of 246, of which 168 had sufficient information to calculate the effect of HbA1c%. The results favored telemedicine, with an MD of −0.415% (95% confidence interval [CI] = −0.482% to −0.348%). The heterogeneity was great (I2 = 93.05%). A monitoring component gave rise to the higher effects of telemedicine. Conclusions: In conclusion, telemedicine may serve as a valuable supplement to usual care for patients with T2D. The inclusion of a telemonitoring component seems to increase the effect of telemedicine.

scholarly journals “Restauraciones de lesiones cervicales no cariosas: un protocolo de revisión sistemática para la práctica clínica”.

2018 ◽  
Vol 43 (2) ◽  
pp. 33-41
Author(s):  
Duniel Ricardo Ortuño Borroto ◽  
Beatriz Mellado ◽  
Sebastián Prado ◽  
Juan Pablo Vargas ◽  
Gabriel Rada
Keyword(s):  
Systematic Reviews ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Central Register ◽  
Revisión Sistemática ◽  
Meta Analyses

Introducción: Las lesiones cervicales no cariosas son condiciones patológicas no bacterianas localizadas en el límite amelocementario de los dientes. Los principales biomateriales descritos para el tratamiento restaurador de estas lesiones son: vidrios ionómeros, vidrios ionómeros modificados con resinas, compómeros y resinas compuestas. El objetivo de este protocolo, consiste en establecer los elementos metodológicos de una revisión sistemática que evaluará el comportamiento clínico de restauraciones cervicales realizadas con estos biomateriales. Métodos: El protocolo fue diseñado, y será reportado, en línea con Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P 2015). Se realizará una búsqueda sensible en MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials y ClinicalTrials.gov, sin restricción por lenguaje o publicación, para identificar ensayos controlados aleatorizados que comparen dos o más tratamientos restauradores en lesiones cervicales no cariosas. Los desenlaces a evaluar serán la retención de las restauraciones y caries secundaria, según criterios RYGE/USPHS. Al menos dos investigadores realizarán de manera independiente la selección de los ensayos y la extracción de los datos. El riesgo de sesgo será evaluado utilizando la herramienta recomendada por la colaboración Cochrane. Si es posible, se realizará un metanálisis y los datos serán presentados en tablas de resúmenes de resultados mediante el método Grading of Recommendations Assesment, Development and Evaluation (GRADE). Fortalezas y debilidades: Esta revisión sistemática entregará evidencia actualizada sobre el comportamiento de cuatro biomateriales en el tratamiento de lesiones cervicales no cariosas. La principal limitación proviene de la baja cantidad o deficiencias metodológicas de los estudios primarios. Número de registro (PROSPERO): CRD42017071114.

scholarly journals Preemptive local analgesia at vaginal hysterectomy: a systematic review

2021 ◽  
Author(s):  
Nadja Taumberger ◽  
Anna-Maria Schütz ◽  
Klaus Jeitler ◽  
Andrea Siebenhofer ◽  
Holger Simonis ◽  
...  
Keyword(s):  
Systematic Review ◽  
Postoperative Pain ◽  
Systematic Reviews ◽  
Vaginal Hysterectomy ◽  
Preemptive Analgesia ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Local Analgesia ◽  
Cochrane Database ◽  
Full Text Review

Abstract Introduction and hypothesis We conducted a systematic review of the effectiveness of local preemptive analgesia for postoperative pain control in women undergoing vaginal hysterectomy. Methods MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials and the Cochrane Database of Systematic Reviews were searched systematically to identify eligible studies published through September 25, 2019. Only randomized controlled trials and systematic reviews addressing local preemptive analgesia compared to placebo at vaginal hysterectomy were considered. Data were extracted by two independent reviewers. Results were compared, and disagreement was resolved by discussion. Forty-seven studies met inclusion criteria for full-text review. Four RCTs, including a total of 197 patients, and two SRs were included in the review. Results Preemptive local analgesia reduced postoperative pain scores up to 6 h and postoperative opioid requirements in the first 24 h after surgery. Conclusion Preemptive local analgesia at vaginal hysterectomy results in less postoperative pain and less postoperative opioid consumption.

scholarly journals Current management of shoulder adhesive capsulitis: a randomized, triple-blind placebo-controlled trial

2018 ◽  
Vol 5 (9) ◽  
pp. 3678
Author(s):  
Riyadh A. Almashni ◽  
Abdullah W. Calacattawi ◽  
Meshal A. Almeshal ◽  
Elaf J. Alsharif ◽  
Mohamad W. Hijazi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Systematic Reviews ◽  
Controlled Trial ◽  
Adhesive Capsulitis ◽  
Frozen Shoulder ◽  
Cochrane Central Register ◽  
Current Management ◽  
Improved Function ◽  
Meta Analyses ◽  
Stretching Exercises

This review is aiming to discuss both operative and non-operative current management of this adhesive capsulitis. The present review was conducted in accordance with the preferred reporting items for systematic reviews and meta-analyses (PRISMA) declaration standards for systematic reviews. A systematic search for the terms adhesive capsulitis, frozen shoulder, glucocorticoid, non-operative operative, current management, and management of systematic review in different databases, including MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials (CENTRAL), were searched up to March 2018 for published and unpublished studies and without language restrictions. The majority of the trials show level 2 [mid-level] evidence, positive results were found for intra-articular corticosteroid injections combined with shoulder mobility and stretching exercises are more effective in providing short-term (4-6 weeks) pain relief and improved function compared to shoulder mobility and stretching exercises alone. On the basis of current clinical evidence, this systematic review suggests that there is no strong evidence to support or refute the current practice in term of adhesive capsulitis management. As there is a need of further research in this issue and to have clear uniformed prospective about the adhesive capsulitis.

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