scholarly journals Pharmacologic Treatment Options for Insomnia in Patients with Schizophrenia

Medicines ◽  
2018 ◽  
Vol 5 (3) ◽  
pp. 88 ◽  
Author(s):  
Lauren Stummer ◽  
Marija Markovic ◽  
Megan Maroney
Keyword(s):  
Sleep Disturbances ◽  
Literature Search ◽  
Treatment Options ◽  
Sodium Oxybate ◽  
Controlled Trials ◽  
Evidence Based ◽  
Pharmacologic Treatment ◽  
Search Results ◽  
Randomized Controlled ◽  
Second Generation Antipsychotic

Background: Symptoms of sleep disorders, such as disturbances in sleep initiation and continuity, are commonly reported in patients with schizophrenia, especially in the acute phase of illness. Studies have shown that up to 80% of patients diagnosed with schizophrenia report symptoms of insomnia. Sleep disturbances have been shown to increase the risk of cognitive dysfunction and relapse in patients with schizophrenia. Currently, there are no medications approved specifically for the treatment of insomnia in patients with schizophrenia. Methods: A literature search was performed through OVID and PubMed to compile publications of pharmacotherapy options studied to treat insomnia in patients with schizophrenia. Articles were reviewed from 1 January 2000 through 1 March 2018 with some additional earlier articles selected if deemed by the authors to be particularly relevant. Results: Pharmacotherapies collected from the search results that were reviewed and evaluated included melatonin, eszopiclone, sodium oxybate, and antipsychotics. Conclusions: Overall, this review confirmed that there are a few evidence-based options to treat insomnia in patients with schizophrenia, including selecting a more sedating second-generation antipsychotic such as paliperidone, or adding melatonin or eszopiclone. Further randomized controlled trials are needed.

scholarly journals COVID-19 Tedavisinde Favipiravir Kullanımı

2021 ◽  
Vol 26 (1) ◽  
pp. 1-11
Author(s):  
Emre Kara ◽  
Ahmet Çağkan İnkaya ◽  
Kutay Demirkan ◽  
Serhat Ünal
Keyword(s):  
Adverse Effects ◽  
Drug Interactions ◽  
Literature Search ◽  
Case Reports ◽  
Treatment Options ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
The World

There are treatment options with partially shown efficacy against SARS-CoV-2. A drug with proven effect on survival has not yet been developed for the new coronavirus disease (COVID-19) defined in December 2019. Many chemicals that are being used or developed for different indications have been used for COVID-19 treatment, based on their effects observed in in vitro studies. Favipiravir, one of these drugs, was first used in Wuhan, the starting center of the pandemic. Since the spread of the infection to the world, it has been used in our country as well as countries such as Italy, Japan, Russia, Ukraine, Uzbekistan, Moldova and Kazakhstan, Bangladesh, Egypt, India. There are few studies conducted and published to evaluate the effectiveness of favipiravir, but many studies are ongoing. In this review, it was aimed to review and evaluate the studies and case reports reporting the efficacy of favipiravir in the treatment of COVID-19. With the literature search, 223 results were reached, 210 articles were fully accessed, and a total of 34 articles were included in the analysis. In the scope of the review, under the title of pharmacology of favipiravir, adverse effects and drug interactions in addition to pharmacokinetic and pharmacodynamic properties are mentioned. Favipiravir is one of the options for the treatment of COVID-19 patients, but randomized, controlled trials involving much more patients and longer follow-up periods need to be planned and the results of ongoing trials evaluated.

Trends in randomized controlled trials in ENT: a 30-year review

1997 ◽  
Vol 111 (7) ◽  
pp. 611-613 ◽  
Author(s):  
K. W. Ah-See ◽  
N. C. Molony ◽  
A. G. D. Maran
Keyword(s):  
Clinical Trials ◽  
Clinical Practice ◽  
Randomized Controlled Trials ◽  
Gold Standard ◽  
Controlled Trials ◽  
Evidence Based ◽  
Controlled Clinical Trials ◽  
Medline Search ◽  
Randomized Controlled Clinical Trials ◽  
Randomized Controlled

AbstractThere is a growth in the demand for clinical practice to be evidence based. Recent years have seen a rise in the number of randomized controlled clinical trials (RCTS). Such trials while acknowledged as the gold standard for evidence can be difficult to perform in surgical specialities. We have recently identified a low proportion of RCTS in the otolaryngology literature. Our aim was to identify any trend in the number of published RCTS within the ENT literature over a 30-year period and to identify which areas of our speciality lend themselves to this form of study design. A Medline search of 10 prominent journals published between 1966 and 1995 was performed. Two hundred and ninety-six RCTS were identified. Only five were published before 1980. Two hundred (71 per cent) of RCTS were in the areas of otology and rhinology. An encouraging trend is seen in RCTS within ENT literature.

scholarly journals PubMed is Slightly More Sensitive but More Time Intensive to Search than Ovid MEDLINE

2011 ◽  
Vol 6 (2) ◽  
pp. 51
Author(s):  
Cari Merkley
Keyword(s):  
Rheumatoid Arthritis ◽  
Systematic Review ◽  
Randomized Controlled Trials ◽  
Controlled Trials ◽  
Medline Search ◽  
Search Results ◽  
Randomized Controlled ◽  
Ovid Medline ◽  
Mesh Terms ◽  
The University

Objective — To compare the results of searching the MEDLINE database through Ovid and the free online version of PubMed administered by the National Library of Medicine for randomized controlled trials on the subject of the drug methotrexate (MTX) for patients suffering from rheumatoid arthritis. Design — Comparative analysis of search results. Setting — Searches conducted by researchers affiliated with Mahidol University in Bangkok, Thailand, and the University of Toronto and the University Health Network in Toronto, Ontario. Subjects — A total of 3966 search results obtained from Ovid MEDLINE and PubMed. Methods — This study employs an Ovid MEDLINE search strategy originally created for a published systematic review that identified randomized controlled trials on MTX and rheumatoid arthritis (Katchamart, Trudeau, Phumethum, & Bombardier, 2009). Two of the authors of the original systematic review (Katchamart and Bombardier) are among the authors of this current study. Appropriate medical subject heading (MeSH) terms and their synonyms were identified for the three main concepts (rheumatoid arthritis, MTX, and randomized controlled trials). The search was performed in Ovid MEDLINE, seeking articles in any language that met the search criteria, from the earliest date covered by MEDLINE to January 2009. Each MeSH or keyword term within a concept was searched separately, and then combined with other like terms using the Boolean operator OR. The searches for the three concepts were finally combined using AND. The Ovid MEDLINE search was then translated for use in PubMed by an information professional. The formatting and terminology used in some of the original Ovid MEDLINE search statements had to be changed so they would work in the new database environment, but the researchers tried to ensure that the two searches were as similar as possible. The translated search was then executed in PubMed. The final results, as well as the number of articles retrieved for each key search concept (rheumatoid arthritis, MTX, and randomized controlled trials), were then compared. The final results were further analyzed for measures of sensitivity, precision, and number needed to read. Sensitivity is calculated by the number of eligible studies found in a database divided by the “total number of eligible studies in the review” multiplied by 100 (Katchamart, Faulkner, Feldman, Tomlinson, & Bombardier, p. 806). Eligible studies were identified using the inclusion/exclusion criteria developed by Katchamart et al. The figure for “total number of eligible studies in the review” is taken from that same study, which forms the “gold standard” for this analysis (Katchamart et al., p. 806). Precision is calculated by dividing the total number of eligible citations from a database by the total number of citations returned by the database for the search multiplied by 100 (Katchamart et al., p. 806). The number needed to read (NNR) formula used by the authors is 1/precision, taken from a study by Bachman, Coray, Estermann, and Ter Riet (2002). Main Results — The PubMed search found more results than Ovid MEDLINE for each of the three key concepts – rheumatoid arthritis, MTX and randomized controlled trials. Once the three concepts were combined, PubMed found 106 more articles than Ovid MEDLINE (2036 vs. 1930). Once the review eligibility criteria were applied to the search results from PubMed, 18 eligible articles were identified, one more article than in Ovid MEDLINE. The authors indicated that the additional article located in PubMed was from a journal that was not yet indexed by MEDLINE at the time the relevant article was published. To determine database sensitivity, these numbers were then divided by 20, the total number of eligible studies located in the Katachamart et al. 2009 review, which employed tools like EMBASE and strategies like hand searching in addition to MEDLINE in order to identify relevant studies. Because of the additional study it located, the sensitivity of PubMed was determined to be slightly higher than Ovid MEDLINE (90% vs. 85%). There was little difference between the two databases in terms of precision and NNR. Precision for Ovid MEDLINE was calculated at 0.881% and at 0.884% for PubMed. The NNR was 114 for Ovid MEDLINE and 113 for PubMed. Conclusion — The authors state that while PubMed had a higher calculated sensitivity than Ovid MEDLINE in the context of this particular search because it contained content not indexed by Ovid MEDLINE that proved to be relevant for this topic, its precision and NNR were almost equal to MEDLINE’s. Some technical limitations of the PubMed interface were experienced by researchers during the study, such as periodic instability and the inability to save and modify searches and their results line by line. These same issues did not arise while using Ovid MEDLINE. The need for a skilled translation of Ovid MEDLINE searches for use in the PubMed interface was also emphasized by the authors, as differences in syntax and formatting that are not properly addressed could impact PubMed’s sensitivity and precision.

scholarly journals TRADE-OFFS BETWEEN EPISTEMIC AND MORAL VALUES IN EVIDENCE-BASED POLICY

2018 ◽  
Vol 35 (1) ◽  
pp. 49-78 ◽  
Author(s):  
Donal Khosrowi
Keyword(s):  
Controlled Trials ◽  
Evidence Based ◽  
Epistemic Values ◽  
High Quality ◽  
Political Values ◽  
Randomized Controlled ◽  
High Quality Evidence ◽  
Evidence Based Policy ◽  
Trade Offs ◽  
Quality Evidence

Abstract:Proponents of evidence-based policy (EBP) call for public policy to be informed by high-quality evidence from randomized controlled trials. This methodological preference aims to promote several epistemic values, e.g. rigour, unbiasedness, precision, and the ability to obtain causal conclusions. I argue that there is a trade-off between these epistemic values and several non-epistemic, moral and political values. This is because the evidence afforded by standard EBP methods is differentially useful for pursuing different moral and political values. I expand on how this challenges ideals of value-freedom and -neutrality in EBP, and offer suggestions for how EBP methodology might be revised.

scholarly journals COVID-19 and Vitamin D (Co-VIVID Study): a systematic review and meta-analysis of randomized controlled trials

2021 ◽  
Author(s):  
Seshadri Reddy Varikasuvu ◽  
Balachandar Thangappazham ◽  
Hemanth Raj
Keyword(s):  
Vitamin D ◽  
Randomized Controlled Trials ◽  
Literature Search ◽  
Meta Analysis ◽  
Statistical Significance ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Individual Outcomes ◽  
Vitamin D Levels

Background: Vitamin D levels have been reported to be associated with COVID-19 susceptibility, severity and mortality events.. We performed a meta-analysis of randomized controlled trials (RCTs) to evaluate the use of vitamin D intervention on COVID-19 outcomes. Methods: Literature search was conducted using PubMed, Cochrane library, and ClinicalTrials.gov databases (latest search on August 5, 2021). We included RCTs reporting the use of vitamin D intervention to control/placebo group in COVID-19. Two independent researchers did literature search, abstracted data, and the risk of bias assessment. Results: A total of 6 RCTs with 551 COVID-19 patients were included. The overall collective evidence pooling all the outcomes across all RCTs indicated the beneficial use of vitamin D intervention in COVID-19 (relative risk, RR = 0.60, 95% CI 0.40 to 0.92, Z=2.33, p=0.02, I2 = 48%). However, no statistical significance was observed for individual outcomes of ICU care (RR = 0.11, 95% CI 0.15 to 1.30, Z=1.48, p=0.14, I2 = 66%) and mortality (RR = 0.78, 95% CI 0.25 to 2.40, Z=0.66, p=0.02, I2 = 33%), though decreased rates were noted. The rates of RT-CR positivity was significantly decreased in the intervention group as compared to the non-vitamin D groups (RR = 0.46, 95% CI 0.24 to 0.89, Z=2.31, p=0.02, I2 = 0%). Conclusion: COVID-19 patients supplemented with vitamin D are more likely to demonstrate fewer rates of ICU admission, mortality events and RT-PCR positivity. However, no statistical significance has been achieved for individual outcomes of ICU and deaths. More RCTs and completion of ongoing trials largely needed to precisely establish the association between vitamin D use and COVID-19.

scholarly journals Breast Cancer Research to Support Evidence-Based Medicine in Nigeria: A Review of the Literature

2021 ◽  
pp. 384-390
Author(s):  
Omolara A. Fatiregun ◽  
Temiloluwa Oluokun ◽  
Nwamaka N. Lasebikan ◽  
Emmanuella Nwachukwu ◽  
Abiola A. Ibraheem ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Research ◽  
Randomized Controlled Trials ◽  
Evidence Based Medicine ◽  
Treatment Guidelines ◽  
Breast Cancer Research ◽  
Controlled Trials ◽  
Evidence Based ◽  
Randomized Controlled ◽  
Based Medicine

PURPOSE Breast cancer is the most common malignancy in women worldwide. In Nigeria, it accounts for 22.7% of all new cancer cases among women. Evidence-based medicine (EBM) entails using the results from healthcare research to enhance the clinical decision-making process and develop evidence-based treatment guidelines. Level 1 and 2 studies, such as randomized controlled trials, meta-analyses, and systematic reviews of randomized controlled trials, yield more robust types of evidence. This study reviewed the levels of evidence of breast cancer publications in Nigeria. METHODS We conducted an electronic literature search of all studies published on breast cancer in Nigeria from January 1961 to August 2019. We reviewed all the articles found under the search term “Breast Cancer in Nigeria” on medical databases. RESULTS Our search identified 2,242 publications. One thousand two hundred fifty duplicates were removed, and 520 were excluded. A total of 472 articles were considered eligible for this review. Most of these articles were case series or reports (30.7%), qualitative studies (15.7%), followed by cross-sectional studies (13.3%), laboratory studies (12.9%), case-control studies (6.1%), case reports (7%), and cohort (5.7%). CONCLUSION Breast cancer research in Nigeria is yet to produce much evidence of the types considered to best support EBM. The scarcity of data hampers the implementation of EBM in Nigeria. Currently, most treatment guidelines are adapted from those developed in other countries, despite genetic differences among populations and different environmental influencing factors.

scholarly journals Treatment Options for Vestibular Migraine

US Neurology ◽  
2016 ◽  
Vol 12 (01) ◽  
pp. 39 ◽  
Author(s):  
Steffen Naegel ◽  
◽  
Manjit Matharu ◽  
Mark Obermann ◽  
◽  
...  
Keyword(s):  
Prophylactic Treatment ◽  
International Headache Society ◽  
Controlled Trial ◽  
Treatment Options ◽  
Evidence Base ◽  
Vestibular Migraine ◽  
Controlled Trials ◽  
Common Cause ◽  
Randomized Controlled ◽  
Trial Testing

Although vestibular migraine is a common cause of vertigo, affecting approximately 1% of the Western world’s population, it remains widely under-recognized and is under-diagnosed. Diagnostic criteria for vestibular migraine were recently published in collaboration with the International Headache Society and the Bárány-Society. Trials investigating the treatment of vestibular migraine are sparse but some are now underway. This review focuses on the treatments options available for vestibular migraine, based on the existing evidence base where available. Regarding acute treatments, there are two randomized controlled trials that provide evidence for the use of triptans (zolmitriptan and rizatriptan) for the management of vestibular migraine attacks. For prophylactic treatment, the evidence base is largely non-existent, since the only multicenter randomized placebo-controlled trial testing metoprolol versus placebo is still underway. Consequently, the treatment recommendations for the prophylactic treatment of vestibular migraine are mainly based on expert opinion and the treatments guidelines for migraine with and without aura.

scholarly journals Clinical Importance of Evidence Based Therapy for Diabetes Type 2

2012 ◽  
Vol 2 (2) ◽  
pp. 21-24
Author(s):  
Mohammad A. Bajubair
Keyword(s):  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Randomized Controlled Trials ◽  
Oral Treatment ◽  
Ischemic Heart ◽  
Controlled Trials ◽  
Evidence Based ◽  
Randomized Controlled ◽  
Evidence Based Therapy

Objectives: Not all practice guidelines on oral treatment of Type 2 diabetes were consistent with available evidences. Our aim was to explore the necessity of following the new clinical evidences in treatment of diabetes mellitus Type 2 in clinical practice and the availability of randomized controlled trials in literature used. Methods: Cross-sectional interview survey of 20 physicians in the Internal Medicine Departments in Althawra Teaching Hospital, University of Sana'a, Yemen, to understand the drug used in T2DM in regards to the clinically evidenced trials. The three commonly used literatures were studied for the availability of randomized controlled trials s and the systematic reviews. Results: Examples of drugs to be considered in special correlation and contradiction were metformin and thiazolidinediones (rosi-, pioglitazone). Fear of lactic acidosis was seen in 45% of physicians. Ischemic Heart disease and failure represent the commonest cause of glitazones avoidance, especially for rosiglitazone (100% vs. 50% for pioglitazone). Example of drugs used were with no agreements of their benefit are gabapentin (35%) and neurobion (30%) for neuropathy prevention. In the side effect consideration, metformin was still considered dangerous, and B-blockers hesitation in ischemic heart disease prevention. The main source of information used by physicians was Davidson's Medicine, British national formulary and pharmaceutical marketing leaflets. Conclusions: Inconsistency between the tested physicians may be improved by better access and implementation of evidence-based therapy and guidelines in T2DM.

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