scholarly journals Bevacizumab Treatment of Radiation-Induced Brain Necrosis: A Systematic Review

2021 ◽  
Vol 11 ◽  
Author(s):  
Guixiang Liao ◽  
Muhammad Khan ◽  
Zhihong Zhao ◽  
Sumbal Arooj ◽  
Maosheng Yan ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Improvement ◽  
Data Extraction ◽  
Cochrane Library ◽  
Efficacy And Safety ◽  
Gadolinium Enhancement ◽  
Brain Necrosis ◽  
Study Selection ◽  
Bevacizumab Treatment ◽  
Radiation Induced

BackgroundRadiation brain necrosis (RBN) is a serious complication in patients receiving radiotherapy for intracranial disease. Many studies have investigated the efficacy and safety of bevacizumab in patients with RBN. In the present study, we systematically reviewed the medical literature for studies reporting the efficacy and safety of bevacizumab, as well as for studies comparing bevacizumab with corticosteroids.Materials and MethodsWe searched PubMed, Cochrane library, EMBASE, and ClinicalTrials.gov from their inception through 1 March, 2020 for studies that evaluated the efficacy and safety of bevacizumab in patients with RBN. Two investigators independently performed the study selection, data extraction, and data synthesis.ResultsOverall, the present systematic review included 12 studies (eight retrospective, two prospective, and two randomized control trials [RCTs]) involving 236 patients with RBN treated who were treated with bevacizumab. The two RCTs also had control arms comprising patients with RBN who were treated with corticosteroids/placebo (n=57). Radiographic responses were recorded in 84.7% (200/236) of patients, and radiographic progression was observed in 15.3% (36/236). Clinical improvement was observed in 91% (n=127) of responding patients among seven studies (n=113). All 12 studies reported volume reduction on T1 gadolinium enhancement MRI (median: 50%, range: 26%–80%) and/or T2 FLAIR MRI images (median: 59%, range: 48%–74%). In total, 46 responding patients (34%) had recurrence. The two RCTs revealed significantly improved radiographic response in patients treated with bevacizumab (Levin et al.: p = 0.0013; Xu et al.: p < 0.001). Both also showed clinical improvement (Levin et al.: NA; Xu et al.: p = 0.039) and significant reduction in edema volume on both T1 gadolinium enhancement MRI (Levin et al.: p=0.0058; Xu et al.: p=0.027) and T2 FLAIR MRI (Levin et al.: p=0.0149; Xu et al.: p < 0.001). Neurocognitive improvement was significantly better after 2 months of treatment in patients receiving bevacizumab than in those given corticosteroids, as assessed by the MoCA scale (p = 0.028). The recurrence rate and side effects of the treatments showed no significant differences.ConclusionsPatients with RBN respond to bevacizumab, which can improve clinical outcomes and cognitive function. Bevacizumab appears to be more efficacious than corticosteroid-based treatment. The safety profile was comparable to that of the corticosteroids.

scholarly journals Prioritising recommendations following analyses of adverse events in healthcare: a systematic review

2020 ◽  
Vol 9 (4) ◽  
pp. e000843
Author(s):  
Kelly Bos ◽  
Maarten J van der Laan ◽  
Dave A Dongelmans
Keyword(s):  
Systematic Review ◽  
Adverse Events ◽  
Data Extraction ◽  
Data Sources ◽  
Cochrane Library ◽  
High Quality ◽  
Data Synthesis ◽  
Study Selection ◽  
Personal Opinion ◽  
User Friendly

PurposeThe purpose of this systematic review was to identify an appropriate method—a user-friendly and validated method—that prioritises recommendations following analyses of adverse events (AEs) based on objective features.Data sourcesThe electronic databases PubMed/MEDLINE, Embase (Ovid), Cochrane Library, PsycINFO (Ovid) and ERIC (Ovid) were searched.Study selectionStudies were considered eligible when reporting on methods to prioritise recommendations.Data extractionTwo teams of reviewers performed the data extraction which was defined prior to this phase.Results of data synthesisEleven methods were identified that are designed to prioritise recommendations. After completing the data extraction, none of the methods met all the predefined criteria. Nine methods were considered user-friendly. One study validated the developed method. Five methods prioritised recommendations based on objective features, not affected by personal opinion or knowledge and expected to be reproducible by different users.ConclusionThere are several methods available to prioritise recommendations following analyses of AEs. All these methods can be used to discuss and select recommendations for implementation. None of the methods is a user-friendly and validated method that prioritises recommendations based on objective features. Although there are possibilities to further improve their features, the ‘Typology of safety functions’ by de Dianous and Fiévez, and the ‘Hierarchy of hazard controls’ by McCaughan have the most potential to select high-quality recommendations as they have only a few clearly defined categories in a well-arranged ordinal sequence.

scholarly journals A Systematic Review of Efficacy and Safety of Ofatumumab Therapy in Children With Difficult-to-treat Nephrotic Syndrome

2020 ◽  
Vol 8 (4) ◽  
pp. 223-228
Author(s):  
Yalda Ravanshad ◽  
◽  
Mohadeseh Golsorkhi ◽  
Sahar Ravanshad ◽  
Mohammad Esmaeeli ◽  
...  
Keyword(s):  
Systematic Review ◽  
Nephrotic Syndrome ◽  
Remission Rate ◽  
Data Extraction ◽  
Effective Drug ◽  
Efficacy And Safety ◽  
Long Term Effects ◽  
Study Selection ◽  
Refractory Nephrotic Syndrome ◽  
Key Terms

Context: Different studies have been done so far on drug safety and efficacy in children with refractory nephrotic syndrome (NS). Ofatumumab might be an effective drug for this syndrome; however, the long-term effects and cost-effectiveness of ofatumumab treatment have not been comprehensively assessed.  Objectives: This study aims to perform a systematic review of the efficacy and safety of ofatumumab in children with difficult-to-treat NS. Study Selection: An electronic literature search was conducted to identify appropriate studies. The search key terms were as follows: (“nephrotic syndrome” OR “minimal change disease” OR “focal segmental glomerulosclerosis” OR “membranous”) AND (“Ofatumumab” or “CD20” or “Arzerra” or “HuMax-CD20”).  Data Extraction: Data were extracted from the articles according to the selection criteria by two independent reviewers. Results: A total of 83 potentially relevant articles were identified. Thirty-two articles were removed due to duplication. Then 26 more articles were excluded because they were book sections and review papers and therefore not relevant. Another 14 items were removed after reviewing the full text of selected papers because the topics did not fit our study subject. Finally, 11 studies were selected in our systematic review. The benchmark considered to assess the efficacy of ofatumumab in children with nephrotic syndrome in most of the studies was a complete remission rate. Conclusions: In conclusion, our systematic review showed that ofatumumab may be an effective drug in refractory NS treatment in children and could bring down the use of steroids and immunosuppressants. However, further large randomized trials are suggested.

scholarly journals Can dorzolamide/timolol-fixed combination effectively treat primary open-angle glaucoma? A protocol for systematic review and meta-analysis

2020 ◽  
Author(s):  
Yan-Xiu Qi ◽  
Hong-wei Liu ◽  
Xing-jie Su ◽  
Lin Han
Keyword(s):  
Systematic Review ◽  
Primary Open Angle Glaucoma ◽  
Fixed Combination ◽  
Open Angle Glaucoma ◽  
Data Extraction ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Open Angle ◽  
Efficacy And Safety ◽  
China National Knowledge Infrastructure

Abstract Background: Primary open-angle glaucoma (POAG) is a very common disorder, and it is the second leading reason that leads to blindness worldwide after cataracts. Previous studies have reported that dorzolamide/timolol-fixed combination (DTFC) can be used to treat patients with POAG. However, there are still inconsistent results. Thus, this study will systematically investigate the efficacy and safety of DTFC for the treatment of patients with POAG.Methods: A comprehensive search will be carried out in the electronic databases of Cochrane Library, MEDLINE, EMBASE, CINAHI, ACMD, China National Knowledge Infrastructure, and Wanfang Data from origin to the March 1, 2020. There are no limitations related to the language and publication status. Only randomized controlled trials that assessed the efficacy and safety of DTFC for the treatment of POAG will be included. Two researchers will independently undertake record selection, data extraction, and methodological quality assessment. Any divisions will be solved by discussion with a third researcher. We will perform statistical analysis using RevMan 5.3 softwareDiscussion: This study will summarize present evidence to identify the efficacy and safety of DTFC for the treatment of POAG through mean intraocular pressure, best corrected visual acuity, contrast sensitivity, bioelectric activity of the retina, rate of progression of glaucoma, quality of life, and adverse events. The results of this study will help to determine whether DTFC is effective and safety for the treatment of POAG.Systematic review registration: INPLASY202040120.

scholarly journals The efficacy and safety of COVID-19 vaccine: A protocol of systematic review and meta-analysis

2021 ◽  
Author(s):  
XiaLi XUE ◽  
Zhongyi Deng ◽  
Ning Li ◽  
Ling Zhou ◽  
Nan Wang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Vaccine Development ◽  
Data Extraction ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Symptomatic Therapy ◽  
Efficacy And Safety ◽  
China National Knowledge Infrastructure ◽  
Report Quality ◽  
Study Results

Abstract Background: The coronavirus disease 2019 (COVID-19) is one of the most wide-spread and threatening infectious diseases in human history. Experts in the field of medicine and biology are working to develop methods to treat and prevent COVID-19. Currently, COVID-19 is predominantly treated with symptomatic therapy and there is still a lack of effective antiviral therapy. Therefore, the prevention and control of novel coronavirus is primarily focused on vaccine development. Several vaccines have been developed, but their relative efficacy and safety have not been proven. Therefore, the aim of this study is to investigate the efficacy and safety of COVID-19 vaccines.Methods and analysis: The electronic databases we will use to retrieve information include PubMed, The Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang Database and Weipu Electronics. The retrieval period is from the establishment of the database to March 2021. All randomized controlled trials in humans vaccinated with COVID-19 were collected, and data were independently selected and extracted according to predesigned inclusion/exclusion criteria. Full-text screening, data extraction and quality assessment were conducted independently by two reviewers. Two additional investigators will conduct report quality, risk of bias, sensitivity analysis and subgroup analysis to ensure the reliability of our study results. The software RevMan 5.3 was used for statistical analysis. Systematic review and meta-analyses will be conducted to evaluate the pooled evidence of efficacy and safety of the COVID-19 vaccines.Result: This study will evaluate the efficacy and safety of the COVID-19 vaccines.Conclusion: The conclusions of this study will provide an evidence-based analysis of the safety and efficacy of COVID-19 vaccines.Systematic review registration: PROSPERO CRD42021242581

scholarly journals Dorzolamide/Timolol-Fixed Combination For Primary Open-Angle Glaucoma: A Protocol For Systematic Review

2020 ◽  
Author(s):  
Yan-Xiu Qi ◽  
Hong-wei Liu ◽  
Quan Sun ◽  
Xing-jie Su ◽  
Lin Han
Keyword(s):  
Systematic Review ◽  
Primary Open Angle Glaucoma ◽  
Fixed Combination ◽  
Open Angle Glaucoma ◽  
Data Extraction ◽  
Cochrane Library ◽  
Open Angle ◽  
Efficacy And Safety ◽  
China National Knowledge Infrastructure ◽  
Record Selection

Abstract Background: Primary open-angle glaucoma (POAG) is a very common disorder, and it is the second leading cause that results in blindness worldwide after cataracts. Previous studies have reported that dorzolamide/timolol-fixed combination (DTFC) can be used in treating POAG. However, there are still inconsistent results. Thus, this study will systematically investigate the efficacy and safety of DTFC on POAG. Methods: A comprehensive search will be carried out in Cochrane Library, MEDLINE, EMBASE, CINAHI, ACMD, China National Knowledge Infrastructure, and WANGFANG database from origin to the present. There are no limitations related to the language and publication status. Only randomized controlled trials that assessed the efficacy and safety of DTFC for the treatment of POAG will be included. Two researchers will independently undertake record selection, data extraction, and study quality assessment. Any divisions will be solved by discussion with a third researcher. We will perform statistical analysis using RevMan 5.3 software Discussion: This study will summarize the present evidence to identify the efficacy and safety of DTFC in treating POAG through mean intraocular pressure, best corrected visual acuity, contrast sensitivity, bioelectric activity of the retina, rate of progression of glaucoma, quality of life, and adverse events. The results of this study will help to determine whether DTFC is effective and safety for the treatment of POAG.Systematic review registration: PROSPERO CRD42020170531.

scholarly journals Efficacy and safety of Chinese herbal footbaths for the treatment of dysmenorrhea: Protocol for a systematic review and meta-analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (5) ◽  
pp. e0250685
Author(s):  
Min Xiao ◽  
Lizhou Liu ◽  
Steve Tumilty ◽  
Dan Liu ◽  
Yanyan You ◽  
...  
Keyword(s):  
Systematic Review ◽  
Evaluation System ◽  
Rating Scale ◽  
Data Extraction ◽  
Meta Analysis ◽  
Biomedical Literature ◽  
Current Evidence ◽  
Cochrane Library ◽  
Efficacy And Safety ◽  
Chinese Herbal

Background Chinese herbal footbaths are an external therapy of traditional Chinese medicine that has been widely used to treat dysmenorrhea. This review aims to systematically evaluate its efficacy and safety for the treatment of dysmenorrhea. Methods Databases of PubMed, EMBASE, Cochrane Library, CIHAHL, Web of Science, Chinese National Knowledge Infrastructure(CNKI), Chinese Scientific Journals Database (VIP), Wanfang Database, China Biomedical Literature Database(CBM), and Chinese Biomedical Literature Service System (SinoMed) will be searched from the inception to September 30, 2020. The eligible randomized controlled trials (RCTs) will be identified and included. The primary outcomes include pain intensity measured by validated scales of visual analog scale, numeric rating scale, and response rate of symptom reduction. The secondary outcomes are scores on validated pain questionnaires, quality of life measured by SF-36 or other validated scales, and adverse events. Study selection, data extraction, and assessment of bias risk will be conducted by two reviewers independently. RevMan software (V.5.3.5) will be utilized to perform data synthesis. Subgroup and sensitivity analysis will be performed when necessary. The strength of the evidence will be evaluated with the Grading of Recommendations Assessment, Development and Evaluation System. Results A high-quality synthesis of current evidence of Chinese herbal footbaths for patients with dysmenorrhea will be provided in this study. Conclusion This systematic review will provide evidence of whether Chinese herbal footbaths are an effective and safe intervention for the treatment of dysmenorrhea. Systematic review registration PROSPERO CRD42020188256.

scholarly journals Laparoscopic appendectomy versus antibiotic treatment for acute appendicitis—a systematic review

2021 ◽  
Author(s):  
Franziska Köhler ◽  
Anne Hendricks ◽  
Carolin Kastner ◽  
Sophie Müller ◽  
Kevin Boerner ◽  
...  
Keyword(s):  
Systematic Review ◽  
Antibiotic Therapy ◽  
Antibiotic Treatment ◽  
Laparoscopic Appendectomy ◽  
Data Extraction ◽  
Open Appendectomy ◽  
Cochrane Library ◽  
Pubmed Database ◽  
Uncomplicated Appendicitis ◽  
Absence From Work

Abstract Background Over the last years, laparoscopic appendectomy has progressively replaced open appendectomy and become the current gold standard treatment for suspected, uncomplicated appendicitis. At the same time, though, it is an ongoing discussion that antibiotic therapy can be an equivalent treatment for patients with uncomplicated appendicitis. The aim of this systematic review was to determine the safety and efficacy of antibiotic therapy and compare it to the laparoscopic appendectomy for acute, uncomplicated appendicitis. Methods The PubMed database, Embase database, and Cochrane library were scanned for studies comparing laparoscopic appendectomy with antibiotic treatment. Two independent reviewers performed the study selection and data extraction. The primary endpoint was defined as successful treatment of appendicitis. Secondary endpoints were pain intensity, duration of hospitalization, absence from work, and incidence of complications. Results No studies were found that exclusively compared laparoscopic appendectomy with antibiotic treatment for acute, uncomplicated appendicitis. Conclusions To date, there are no studies comparing antibiotic treatment to laparoscopic appendectomy for patients with acute uncomplicated appendicitis, thus emphasizing the lack of evidence and need for further investigation.

scholarly journals Prevalence of retinopathy in prediabetes: protocol for a systematic review and meta-analysis

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e040997
Author(s):  
Varo Kirthi ◽  
Paul Nderitu ◽  
Uazman Alam ◽  
Jennifer Evans ◽  
Sarah Nevitt ◽  
...  
Keyword(s):  
Systematic Review ◽  
Diabetic Retinopathy ◽  
Data Extraction ◽  
Meta Analysis ◽  
International Diabetes Federation ◽  
Current Data ◽  
Risk Of Bias ◽  
Fundus Photography ◽  
Primary Data ◽  
Cochrane Library

IntroductionThere is growing evidence of a higher than expected prevalence of retinopathy in prediabetes. This paper presents the protocol of a systematic review and meta-analysis of retinopathy in prediabetes. The aim of the review is to estimate the prevalence of retinopathy in prediabetes and to summarise the current data.Methods and analysisThis protocol is developed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) guidelines. A comprehensive electronic bibliographic search will be conducted in MEDLINE, EMBASE, Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Google Scholar and the Cochrane Library. Eligible studies will report prevalence data for retinopathy on fundus photography in adults with prediabetes. No time restrictions will be placed on the date of publication. Screening for eligible studies and data extraction will be conducted by two reviewers independently, using predefined inclusion criteria and prepiloted data extraction forms. Disagreements between the reviewers will be resolved by discussion, and if required, a third (senior) reviewer will arbitrate.The primary outcome is the prevalence of any standard features of diabetic retinopathy (DR) on fundus photography, as per International Clinical Diabetic Retinopathy Severity Scale (ICDRSS) classification. Secondary outcomes are the prevalence of (1) any retinal microvascular abnormalities on fundus photography that are not standard features of DR as per ICDRSS classification and (2) any macular microvascular abnormalities on fundus photography, including but not limited to the presence of macular exudates, microaneurysms and haemorrhages. Risk of bias for included studies will be assessed using a validated risk of bias tool for prevalence studies. Pooled estimates for the prespecified outcomes of interest will be calculated using random effects meta-analytic techniques. Heterogeneity will be assessed using the I2 statistic.Ethics and disseminationEthical approval is not required as this is a protocol for a systematic review and no primary data are to be collected. Findings will be disseminated through peer-reviewed publications and presentations at national and international meetings including Diabetes UK, European Association for the Study of Diabetes, American Diabetes Association and International Diabetes Federation conferences.PROSPERO registration numberCRD42020184820.

scholarly journals Effectiveness of Antalgic Therapies in Patients with Vertebral Bone Metastasis: A Protocol for a Systematic Review and Meta-Analysis

2021 ◽  
Vol 18 (8) ◽  
pp. 3991
Author(s):  
Antonio Jose Martin-Perez ◽  
María Fernández-González ◽  
Paula Postigo-Martin ◽  
Marc Sampedro Pilegaard ◽  
Carolina Fernández-Lao ◽  
...  
Keyword(s):  
Systematic Review ◽  
Bone Metastasis ◽  
Data Extraction ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Cochrane Library ◽  
Pharmacological Intervention ◽  
Vertebral Metastasis ◽  
Randomized Controlled Clinical Trials

There is no systematic review that has identified existing studies evaluating the pharmacological and non-pharmacological intervention for pain management in patients with bone metastasis. To fill this gap in the literature, this systematic review with meta-analysis aims to evaluate the effectiveness of different antalgic therapies (pharmacological and non-pharmacological) in the improvement of pain of these patients. To this end, this protocol has been written according to the Preferred Reporting Items for Systematic review and Meta-Analysis Protocols (PRISMA-P) and registered in PROSPERO (CRD42020135762). A systematic search will be carried out in four international databases: Medline (Via PubMed), Web of Science, Cochrane Library and SCOPUS, to select the randomized controlled clinical trials. The Risk of Bias Tool developed by Cochrane will be used to assess the risk of bias and the quality of the identified studies. A narrative synthesis will be used to describe and compare the studies, and after the data extraction, random effects model and a subgroup analyses will be performed according to the type of intervention, if possible. This protocol aims to generate a systematic review that compiles and synthesizes the best and most recent evidence on the treatment of pain derived from vertebral metastasis.

scholarly journals Natural history and treatment options of radiation-induced brain cavernomas: a systematic review

2021 ◽  
Author(s):  
Gildas Patet ◽  
Andrea Bartoli ◽  
Torstein R. Meling
Keyword(s):  
Systematic Review ◽  
Natural History ◽  
Radiation Treatment ◽  
Neurological Deficits ◽  
Cochrane Library ◽  
Average Dose ◽  
Cavernous Malformations ◽  
Radiation Induced ◽  
The Mean

AbstractRadiation-induced cavernous malformations (RICMs) are delayed complications of brain irradiation during childhood. Its natural history is largely unknown and its incidence may be underestimated as RCIMS tend to develop several years following radiation. No clear consensus exists regarding the long-term follow-up or treatment. A systematic review of Embase, Cochrane Library, PubMed, Google Scholar, and Web of Science databases, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, was performed. Based on our inclusion/exclusion criteria, 12 articles were included, totaling 113 children with RICMs, 86 were treated conservatively, and 27 with microsurgery. We were unable to precisely define the incidence and natural history from this data. The mean age at radiation treatment was 7.3 years, with a slight male predominance (54%) and an average dose of 50.0 Gy. The mean time to detection of RICM was 9.2 years after radiation. RICM often developed at distance from the primary lesion, more specifically frontal (35%) and temporal lobe (34%). On average, 2.6 RICMs were discovered per child. Sixty-seven percent were asymptomatic. Twenty-one percent presented signs of hemorrhage. Clinical outcome was favorable in all children except in 2. Follow-up data were lacking in most of the studies. RICM is most often asymptomatic but probably an underestimated complication of cerebral irradiation in the pediatric population. Based on the radiological development of RICMs, many authors suggest a follow-up of at least 15 years. Studies suggest observation for asymptomatic lesions, while surgery is reserved for symptomatic growth, hemorrhage, or focal neurological deficits.

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