scholarly journals Zusanli (ST36) Acupoint Injection With Dexamethasone for Chemotherapy-Induced Myelosuppression: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 11 ◽  
Author(s):  
Jiangfeng Chen ◽  
Zhixian Lin ◽  
Jiyuan Ding

ObjectiveMyelosuppression is the most common adverse reaction of chemotherapy, which seriously affects the course of treatment. Zusanli (ST36) acupoint injection with dexamethasone has achieved good clinical efficacy in China. This study aimed to systematically evaluate the efficacy of ST36 acupoint injection with dexamethasone in the treatment of chemotherapy-induced myelosuppression (CIM).MethodsRandomized controlled trials of CIM treated with ST36 acupoint injection with dexamethasone were retrieved from eight electronic databases. We used the Cochrane Collaboration tool to assess the risk of bias. Excel 2010 was used to establish a database for information extraction, and RevMan 5.3.0 software was used to analyze the included test data. GRADE profiler 3.6 software was used to grade the quality of evidence for the outcome indicators of the study.ResultsA total of 17 studies involving 1177 patients were included in this meta-analysis. The results showed that, compared with conventional western medicine (CWM), ST36 acupoint injection with dexamethasone could significantly improve the clinical total effective rate [RR=1.95, 95% CI (1.53, 2.49), P <0.00001] and increase white blood cell (WBC) (MD=1.38, 95% CI (0.74, 2.01), P<0.0001) and hemoglobin (Hb) levels [MD=3.89, 95% CI (1.57, 6.20), P=0.001]. In addition, ST36 acupoint injection with dexamethasone can shorten recovery time of myelosuppression [MD=-3.94, 95% CI (-4.97 to -2.91), P<0.00001] and improve Karnofsky performance status [MD=10.7, 95% CI (1.36, 20.05), P=0.02<0.05]. However, there was no significant difference among ST36 acupoint injection with dexamethasone and CWM in platelet (PLT) elevation [MD=4.61, 95% CI (-10.14, 19.35), P=0.54].ConclusionThis study found that ST36 acupoint injection with dexamethasone had a positive effect on CIM. However, more studies with well-designed, large sample size, strict randomization, and clear descriptions about detection and reporting processes are needed in the future to further confirm the efficacy of ST36 acupoint injection with dexamethasone in the treatment of CIM.Systematic Review Registrationhttps://www.crd.york.ac.uk/, identifier CRD42021223979.

Polymers ◽  
2021 ◽  
Vol 13 (14) ◽  
pp. 2251
Author(s):  
Maciej Zarow ◽  
Marzena Dominiak ◽  
Katarzyna Szczeklik ◽  
Louis Hardan ◽  
Rim Bourgi ◽  
...  

Various material properties are involved in the success of endodontically treated restorations. At present, restorative composites are commonly employed as core build-up materials. This study aimed to systematically review the literature to assess the effect of using composite core materials on the in vitro fracture of endodontically treated teeth. Two different reviewers screened the literature, up to June 2021, in five distinct electronic databases: PubMed (MedLine), Scopus, Scielo, ISI Web of Science, and EMBASE. Only in vitro studies reporting the effect of the use of composite core materials on the fracture resistance of endodontically treated teeth were included. A meta-analysis was carried out using a software program (Review Manager v5.4.1; The Cochrane Collaboration, Copenhagen, Denmark). The risk of bias in each study was assessed following the parameters of another systematic review. A total of 5016 relevant papers were retrieved from all databases. After assessing the title and abstract, five publications remained for qualitative analysis. From these, only three studies remained for meta-analysis. The fracture strength of endodontically treated teeth where a core build-up composite was used was statistically significantly higher than the control (p = 0.04). Most of the analyses showed a high heterogenicity. The in vitro evidence suggests that the composite core build-up with higher filler content tended to improve the fracture resistance of the endodontically treated teeth, in comparison with conventional composite resins. This research received no external funding. Considering that this systematic review was only carried out on in vitro papers, registration was not performed. Furthermore, there were no identified clinical studies assessing core build-up materials; therefore, more well-designed research on these materials is needed.


Author(s):  
Iramar Nascimento ◽  
Guilherme Dienstmann ◽  
Matheus de Souza ◽  
Raquel Fleig ◽  
Carla Hoffmann ◽  
...  

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.


2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
A. Chiesa ◽  
A. Serretti ◽  
R. Calati ◽  
D. de Ronchi

Objective:Sexual dysfunction is an important under-estimated side effect of antidepressant drugs. Patients, in fact, if not directly questioned, tend to scarcely report them. Thus, the aim of the present meta-analysis is to quantify sexual dysfunction caused by antidepressants on the basis of studies where sexual functioning was purposely investigated through direct inquiry and specific questionnaires.Methods:A literature search was conducted using Medline, Isi web of Knowledge and references of selected articles. Selected studies performed on patients without previous sexual dysfunction were entered in the Cochrane Collaboration Review Manager Software (RevMan version 4.2). Our primary outcome measure was the rate of total treatment emergent sexual dysfunction. Our secondary outcome measures were the rates of treatment emergent desire, arousal and orgasm dysfunction.Results:Our analyses indicated significantly higher rates of treatment emergent sexual dysfunction as well as specific phases dysfunction compared to placebo for the following drugs: citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine, sertraline, duloxetine, venlafaxine, clomipramine, imipramine and phenelzine, whereas no significant difference with placebo was found for the following antidepressants: amineptine, bupropion, moclobemide, mirtazapine and nefazodone. Nonetheless sufficient evidences (>100 subjects) are available only for bupropion, citalopram, fluoxetine, paroxetine, sertraline and venlafaxine.Discussion:Present evidence on treatment emergent sexual dysfunction caused by antidepressant is sufficiently studied only for few drugs. Furthermore some statistical limiting assumptions, as the inclusion of open label or small studies and the presence of an evident publication bias, could reduce the significativity of our findings. Thus, treatment emergent sexual dysfunction should be more deeply investigated.


2019 ◽  
Vol 2019 ◽  
pp. 1-9
Author(s):  
Shuangdi Chen ◽  
Wenli Zhao ◽  
Binjie Zhang ◽  
Yijun Jia ◽  
Shihua Wu ◽  
...  

Objective. To comprehensively compare the effects of conventional therapy combined with intravenous vitamin C and conventional therapy on viral myocarditis in children through a meta-analysis. Methods. Relevant articles including clinical trials of normal treatment combined with intravenous vitamin C and conventional therapy for viral myocarditis in children that were published between January 2000 and February 2018 were selected from PubMed, Cochrane Library, China National Knowledge Infrastructure, China Science and Technology Journal Database, and WANFANG database. The quality of the included studies was assessed using the Cochrane systematic review method (version 5.1.0); data quality was evaluated by two independent researchers. The total effective rate; LDH, CK, and CK-MB levels; and other indicators were analyzed using Rev Man 5.3 software. Results. Eight studies were eligible for this meta-analysis, which included a total of 426 patients in the treatment group and 363 patients in the control group. The meta-analysis results of six studies showed that the total effective rate of intravenous vitamin C combined with conventional therapy was higher than that of conventional therapy alone [Z = 5.46, 95% confidence interval (CI): 1.21 (1.13 to 1.30), P < 0.00001]; that of five studies showed that LDH levels were lower in children receiving intravenous vitamin C combined with conventional therapy than in those receiving conventional therapy alone [Z = 3.70, 95% CI: −1.88 (−2.88 to −0.88), P = 0.0002]; that of three studies showed that CK levels were lower in children receiving intravenous vitamin C combined with conventional therapy than in those receiving conventional therapy alone [Z = 4.21, 95% CI: −0.55 (−0.81 to −0.30), P < 0.0001]; that of four studies showed that CK-MB levels were lower in children receiving intravenous vitamin C combined with conventional therapy than in those receiving conventional therapy alone [Z = 13.64, 95% CI: −1.44 (−1.65 to −1.24), P < 0.00001]; that of two studies showed that CD3 levels were higher in children receiving intravenous vitamin C combined with conventional therapy than in those receiving conventional therapy alone [Z = 2.45, 95% CI: 0.41 (0.08–0.73), P = 0.01]; that of two studies showed no significant difference in changes in CD4 levels between children receiving intravenous vitamin C combined with conventional therapy and those receiving conventional therapy alone [Z = 0.28, 95% CI: −0.21 (−1.69 to 1.28), P = 0.78]; and that of two studies showed no significant difference in changes in CD4/CD8 between children receiving intravenous vitamin C combined with conventional therapy and those receiving conventional therapy alone [Z = 0.07, 95% CI: −0.03 (−0.73 to 0.67), P = 0.94]. Conclusion. The meta-analysis results showed that intravenous vitamin C combined with conventional therapy is better than the simple, conventional therapy for the treatment of viral myocarditis in children in terms of the total effective rate and LDH, CK, and CK-MB levels.


Author(s):  
Fabian Duttenhoefer ◽  
Marc Anton Fuessinger ◽  
Yasmin Beckmann ◽  
Rainer Schmelzeisen ◽  
Knut A. Groetz ◽  
...  

Abstract Objective Impaired health conditions and related lack of adequate host healing are among the most important conditions that account for dental implant failure. Today clinicians face an increasing number of immunocompromised patients requesting implant-based rehabilitation. To provide clinical evidence for prospective decision-making, the aim of this systematic review and meta-analysis was to analyse the influence of immunodeficiency on dental implant survival. Methods The study was conducted according to the PRISMA Statement and the principles of the Cochrane Collaboration. MEDLINE and Web of Science were searched. Results were calculated by the pooled incidence of implant loss. Reported odds ratios (OR) from fully adjusted models were preferred. Distinct risk estimates were synthesised with 95% confidence intervals. Results A total of 62 publications including 1751 endosseous implants placed in immunocompromised patients were included. For the follow-up of 24 months and longer, the mean survival rate of implants in patients with HIV was 93.1%, chemotherapy was 98.8%, autoimmune disease was 88.75%, after organ transplantation was 100%. Crohn’s disease showed a significant effect on early implant failure and resulted in increased, however not significant, implant loss. Conclusion No significant effect of immunocompromised conditions on implant survival was detectable. Implant-based therapy in immunocompromised patients should not aggravate the general morbidity and must not interfere in life-saving therapies. A careful risk stratification prior implant therapy is fundamental. To further decipher the role of immunosuppression on dental implantology, more data from controlled and randomised studies are needed.


2017 ◽  
Vol 11 (1) ◽  
pp. 15-30 ◽  
Author(s):  
Debajyoti Pati ◽  
Lesa N. Lorusso

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.


2018 ◽  
Vol 2018 ◽  
pp. 1-10 ◽  
Author(s):  
Jia-Rui Wu ◽  
Shu-Yu Liu ◽  
Jia-Lian Zhu ◽  
Dan Zhang ◽  
Kai-Huan Wang

Objective. This meta-analysis sought to assess the efficacy and safety of Brucea javanica oil emulsion injection (BJOEI) combined with chemotherapy for treating gastric cancer (GC). Method. Randomized controlled trials (RCTs) regarding BJOEI to treat GC were searched in PubMed, the Cochrane Library, Embase, the China National Knowledge Infrastructure Database (CNKI), the Wan-Fang Database, China Science and Technology Journal Database (VIP), and the Chinese Biomedical Literature Database (SinoMed) up to January 9, 2017. The clinical total effective rate, performance status, adverse drug reactions (ADRs), and other outcomes were analyzed with Review Manager 5.3 and Stata12.0 software. Results. 13 RCTs involving 912 patients were included in the present meta-analysis. The results demonstrated that, compared with receiving chemotherapy alone, BJOEI combined with chemotherapy was more effective in improving clinical total effective rate (RR = 1.38, 95% CI: 1.22~1.56, P<0.00001), performance status (RR = 1.63, 95% CI: 1.30~2.04, P<0.00001), and relieving ADRs such as myelosuppression, neutropenia, thrombopenia, and liver damage. Statistically significant difference was observed between the experimental group and control group. Conclusion. The pooled analysis showed that using BJOEI on the basis of the chemotherapy had a remarkable therapeutic effect for patients with GC, whereas more evidence-based medical researches were required to further support our study.


2019 ◽  
Author(s):  
Hui Yue ◽  
Xinxin Xu ◽  
Qin Liu ◽  
Xiaozhi Li ◽  
Yiting Xiao ◽  
...  

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.


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