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121. Mechanical thrombectomy

therapy with antiplatelet agents (aspirin) or anticoagulants. 10. Comparative safety Five randomised trials of MT plus usual care and usual care alone were identified which met the PICO-defined inclusion criteria: ESCAPE; EXTEND-IA; MR CLEAN; REVASCAT and SWIFT PRIME. 6 Death and symptomatic intracerebral haemorrhage outcomes were consistently reported across the five trials and thus analysed in the meta-analysis by Goyal et al. 2016. In the meta- analysis of the individual patient data from the five

2017 Medical Services Advisory Committee

122. Venous Thromboembolism Prophylaxis in Major Orthopedic Surgery: Systematic Review Update

postoperative VTE, major bleeding, and other adverse events. We conducted pairwise meta-analyses, Bayesian network meta-analyses, and strength of evidence (SoE) synthesis. Results. Overall, 127 RCTs and 15 NRCSs met criteria. For THR: low molecular weight heparin (LMWH) has lower risk than unfractionated heparin (UFH) of various VTE outcomes (moderate to high SoE) and major bleeding (moderate SoE). LMWH and aspirin have similar risks of total PE, symptomatic DVT, and major bleeding (low SoE). LMWH has less (...) lower risk of various VTE outcomes (low to moderate SoE). For HFx surgery: LMWH has lower total DVT risk than FXaI (moderate SoE). Conclusions. VTE prophylaxis after major orthopedic surgery trades off lowered VTE risk with possible adverse events—in particular, for most interventions, major bleeding. In THR, LMWH has lower VTE and adverse event risks than UFH, LMWH and aspirin have similar risks of VTE and major bleeding, DTI has lower DVT risk than LMWH but higher major bleeding risk, and higher

2017 Effective Health Care Program (AHRQ)

123. Interventions Targeting Sensory Challenges in Children with Autism Spectrum Disorder - An Update

, Tornatore LA, Brancazio L, et al. Can children with autism spectrum disorders "hear" a speaking face? Child Dev. 2011 Sep-Oct;82(5):1397-403. doi: 10.1111/j.1467-8624.2011.01619.x. PMID: 21790542.X-1 682. Ishikawa T, Takahashi K, Ikeda N, et al. Transporter-Mediated Drug Interaction Strategy for 5-Aminolevulinic Acid (ALA)- Based Photodynamic Diagnosis of Malignant Brain Tumor: Molecular Design of ABCG2 Inhibitors. Pharmaceutics. 2011;3(3):615-35. doi: 10.3390/pharmaceutics3030615. PMID: 24310600.X-1 (...) -5 688. Kaluzna-Czaplinska J, Michalska M, Rynkowski J. Vitamin supplementation reduces the level of homocysteine in the urine of autistic children. Nutr Res. 2011 Apr;31(4):318-21. doi: 10.1016/j.nutres.2011.03.009. PMID: 21530806. X-3 689. Kaluzna-Czaplinska J, Socha E, Rynkowski J. B vitamin supplementation reduces excretion of urinary dicarboxylic acids in autistic children. Nutr Res. 2011 Jul;31(7):497-502. doi: 10.1016/j.nutres.2011.06.002. PMID: 21840465.X-1, X-3 690. Kamp-Becker I

2017 Effective Health Care Program (AHRQ)

124. Same-day surgery for femoral, inguinal and umbilical hernia repair in adults

with low complications. Meyer et al. (2015) Case series; prospective; consecutive patients N=50 NR 100% Same-day surgery is safe and effective and should be considered for all patients Voorbrood et al. (2015) Case series; prospective; consecutive patients N=336 ASA I or II Unilateral 97% Same-day inguinal hernia repair is safe and effective, both from an institutional and patient perspective Kulacoglu et al. (2012) Case series; retrospective; consecutive patients N=100 paraumbilical 100% Same day (...) umbilical hernia repair is safe and effective with low infection and recurrence rates Kurzer et al. (2004) Case series; prospective N=73 ASA I or II NR Open repair with mesh is suitable for umblical hernia and lends itself to same- day surgery with local anaesthetic in the majority of patients Menon & Brown (2003) Case series; retrospective N=32 Uncomplicated 100% Same-day umbilical hernia repair is safe and effective ASA: American Society of Anesthesiologists status; NR: not reported. Same-day surgery

2017 Publication 80

125. Treatment of Osteoarthritis of the Knee: An Update Review

) Guidelines 4 and the 2013 American Academy of Orthopaedic Surgeons (AAOS) guidelines for the treatment of OA of the knee. These guidelines are not in total agreement about the recommended treatments: For example the 2012 ACR Guidelines conditionally recommend hyaluronic acid (HA), while the AAOS guidelines recommend against its use to treat patients with symptomatic conditions. 5 Scope and Key Questions Scope of the Review Systematic reviews have been conducted on many of the interventions used to treat (...) OA of the knee, including four reviews by Agency for Healthcare Research and Quality (AHRQ) Evidence-based Practice Centers since 2007. 1, 6-8 Uncertainty continues to surround the use of all treatments intended as disease-modifying agents (including intra-articular hyaluronic acid [HA] and glucosamine and chondroitin), acupuncture, physical therapy, exercise, braces and orthotics, and arthroscopic lavage, as well as the comparative efficacy and safety of oral, topical, and intraarticular

2017 Effective Health Care Program (AHRQ)

127. Antibacterial-coated sutures versus non-antibacterial-coated sutures for the prevention of abdominal, superficial and deep, surgical site infection (SSI)

- NRSI A Cochrane Risk Of Bias Assessment Tool: for Non-Randomized Studies of Interventions AE Adverse event AGENAS L’Agenzia Nazionale per i Servizi Sanitari Regionali AMSTAR A Measurement Tool to Assess Systematic Reviews ASA American Society of Anesthesiology ASC/AST Active Surveillance Culture/Testing BMI Body mass index BSI British Standards Institution CA Collaborative Assessment CABG Coronary artery bypass graft CADTH Canadian Agency for Drugs and Technologies in Health CBGB Coronary artery (...) to the skin sutures were statistically significantly higher in the comparator group using polyglactin 910 Vicryl (7/91 vs 16/93, p T Basic SSI risk index Sum of scores Abbreviations: W1= Clean; W2 = Clean-contaminated; W3 = Contaminated; W4 = Dirty or infected; UNK = Unknown. The Physical status classification is developed by the American Society of Anesthesiology (ASA) [88]. ASA physical status classification: ASA score Description A1 A1 Normally healthy patient A2 A2 Patient with mild systemic disease

2017 EUnetHTA

128. Interventions to Prevent Age-Related Cognitive Decline, Mild Cognitive Impairment, and Clinical Alzheimer's-Type Dementia

no benefit in cognitive performance included: vitamin E in women; B 12 plus folic acid for executive/attention/processing speed; and angiotensin-converting enzyme plus thiazide versus placebo and angiotensin receptor blockers versus placebo on brief cognitive screening tests. We found low-strength evidence that the selective estrogen receptor modulator raloxifene reduced risk of probable MCI, but also that estrogen replacement with or without progesterone therapy increased risk of MCI and CATD. Physical (...) activity interventions show no consistent benefit in preventing cognitive decline, but the percent of results showing benefit was unlikely to be explained solely by chance, providing a signal of a possible relationship. A few other interventions (vitamin B 12 plus folic acid; nutraceuticals; one multimodal intervention using diet, physical activity, and cognitive training; antihypertensives; and NSAIDs) showed at least one positive finding for a specific outcome, some reaching low strength of evidence

2017 Effective Health Care Program (AHRQ)

130. Interventions to Prevent Age-Related Cognitive Decline, Mild Cognitive Impairment, and Clinical Alzheimer's-Type Dementia

no benefit in cognitive performance included: vitamin E in women; B 12 plus folic acid for executive/attention/processing speed; and angiotensin-converting enzyme plus thiazide versus placebo and angiotensin receptor blockers versus placebo on brief cognitive screening tests. We found low-strength evidence that the selective estrogen receptor modulator raloxifene reduced risk of probable MCI, but also that estrogen replacement with or without progesterone therapy increased risk of MCI and CATD. Physical (...) activity interventions show no consistent benefit in preventing cognitive decline, but the percent of results showing benefit was unlikely to be explained solely by chance, providing a signal of a possible relationship. A few other interventions (vitamin B 12 plus folic acid; nutraceuticals; one multimodal intervention using diet, physical activity, and cognitive training; antihypertensives; and NSAIDs) showed at least one positive finding for a specific outcome, some reaching low strength of evidence

2017 Effective Health Care Program (AHRQ)

131. Translating Improvements with Ixekizumab in Clinical Trial Outcomes into Clinical Practice: ASAS40, Pain, Fatigue, and Sleep in Ankylosing Spondylitis. Full Text available with Trip Pro

practice. The goals of this study were (a) to measure improvement in ixekizumab-treated patients in the four ASAS treatment response domains and in other patient-reported outcomes, and (b) to determine how the ASAS response was associated with changes in spinal pain at night, fatigue, sleep, and the Short Form 36-Item Physical Component Summary (SF-36 PCS).The COAST-V and COAST-W trials were randomized, double-blind, controlled trials examining ixekizumab efficacy in patients with AS who were biologic (...) disease-modifying antirheumatic drug (bDMARD)-naïve and tumor necrosis factor inhibitor (TNFi)-experienced, respectively. Data for the ASAS treatment response domains and other outcomes were collected through 16 weeks. Comparisons between treatment groups were made using a mixed-effects model for repeated measures. To determine how the ASAS response was associated with the changes in spinal pain at night, fatigue, sleep, and SF-36 PCS, comparisons were made between patient groups according

2019 Rheumatology and therapy Controlled trial quality: predicted high

132. Association between mortality and implantable cardioverter-defibrillators by aetiology of heart failure: a propensity-matched analysis of the WARCEF trial. Full Text available with Trip Pro

Association between mortality and implantable cardioverter-defibrillators by aetiology of heart failure: a propensity-matched analysis of the WARCEF trial. There is debate on whether the beneficial effect of implantable cardioverter-defibrillators (ICDs) is attenuated in patients with non-ischaemic cardiomyopathy (NICM). We assess whether any ICD benefit differs between patients with NICM and those with ischaemic cardiomyopathy (ICM), using data from the Warfarin versus Aspirin in Reduced

2019 ESC heart failure Controlled trial quality: uncertain

133. Ropivacaine versus placebo on postoperative analgesia and chronic pain following third molar extraction: A Prospective Randomized Controlled Study. (Abstract)

Ropivacaine versus placebo on postoperative analgesia and chronic pain following third molar extraction: A Prospective Randomized Controlled Study. The present study aimed at assessing the efficiency of ropivacaine on post-operative pain for extraction of third molars.In a single centre, prospective, parallel, double blind randomised trial, patients scheduled for removal of all four third molars, ASA I-III patients<65 year-old patients were included. After intubation under general anesthesia

2019 Journal of stomatology, oral and maxillofacial surgery Controlled trial quality: predicted high

134. Antiplatelet therapy in the primary prevention of cardiovascular disease in patients with chronic obstructive pulmonary disease: a randomised controlled proof-of-concept trial. Full Text available with Trip Pro

therapy will produce the predefined cut-off of platelet inhibition measured using the Multiplate test in COPD patients. Eligible patients were randomised to aspirin plus placebo, ticagrelor plus placebo, aspirin plus ticagrelor or placebo only for 6 months. The primary outcome comprises inhibition (binary response) of arachidonic acid- (ASPI test, cut-off <40) and adenosine diphosphate- (ADP test, cut-off <46) induced platelet aggregation at 6 months. 543 patients were screened and 120 patients were (...) recruited with mean age of 67.5 years; 47.5% patients were male. The per-protocol ASPI test response rate to aspirin was 68.3% (95% CI 52.3-80.9%). The per-protocol ADP test response rate to ticagrelaor was 68.8% (95% CI 50.4-82.6%). Platelet response to antiplatelet therapy with aspirin and ticagrelor was not observed in nearly one-third of COPD patients without prior history of cardiovascular disease. These findings support the high pro-thrombotic milieu and the need for further research to determine

2019 ERJ open research Controlled trial quality: predicted high

135. P2Y12 Inhibitor Switching in Response to Routine Notification of CYP2C19 Clopidogrel Metabolizer Status Following Acute Coronary Syndromes. (Abstract)

, in the Randomized Trial to Compare the Safety of Rivaroxaban vs Aspirin in Addition to Either Clopidogrel or Ticagrelor in Acute Coronary Syndrome (GEMINI-ACS-1) clinical trial.The GEMINI-ACS-1 trial compared rivaroxaban, 2.5 mg twice daily, with aspirin, 100 mg daily, plus open-label clopidogrel or ticagrelor (provided), in patients with recent acute coronary syndromes (ACS). The trial included 371 clinical centers in 21 countries and 3037 patients with ACS. Data were analyzed between May 2017 and February

2019 JAMA cardiology Controlled trial quality: uncertain

136. Antiplatelet versus anticoagulation treatment for patients with heart failure in sinus rhythm. Full Text available with Trip Pro

Antiplatelet versus anticoagulation treatment for patients with heart failure in sinus rhythm. Morbidity in patients with chronic heart failure is high, and this predisposes them to thrombotic complications, including stroke and thromboembolism, which in turn contribute to high mortality. Oral anticoagulants (e.g. warfarin) and antiplatelet agents (e.g. aspirin) are the principle oral antithrombotic agents. Many heart failure patients with sinus rhythm take aspirin because coronary artery (...) Organization (WHO) International Clinical Trials Registry Platform (ICTRP) Search Portal apps.who.int/trialsearch/) (searched in July 2016).We included randomised controlled trials comparing antiplatelet therapy versus oral anticoagulation in adults with chronic heart failure in sinus rhythm. Treatment had to last at least one month. We compared orally administered antiplatelet agents (aspirin, ticlopidine, clopidogrel, prasugrel, ticagrelor, dipyridamole) versus anticoagulant agents (coumarins, warfarin

2016 Cochrane

137. Oral 5-aminosalicylic acid for maintenance of medically-induced remission in Crohn's disease. Full Text available with Trip Pro

Oral 5-aminosalicylic acid for maintenance of medically-induced remission in Crohn's disease. The prevention of relapse is a major issue in the management of Crohn's disease. Corticosteroids, the mainstay of treatment of acute exacerbations, are not effective for maintenance of remission and its chronic use is limited by numerous adverse events. Randomised controlled trials assessing the efficacy of oral 5-aminosalicylic acid (5-ASA) agents for maintenance of medically-induced remission (...) in Crohn's disease have produced conflicting results.To conduct a systematic review to evaluate the efficacy and safety of oral 5-ASA agents for the maintenance of medically-induced remission in Crohn's disease.We searched MEDLINE, EMBASE, CENTRAL and the IBD Group Specialized Register from inception to 8 June 2016. We also searched reference lists and conference proceedings.We included randomised controlled trials that compared oral 5-ASA agents to either placebo or sulphasalazine in patients

2016 Cochrane

138. Adverse events associated with single dose oral analgesics for acute postoperative pain in adults - an overview of Cochrane reviews. Full Text available with Trip Pro

(NSAIDs), paracetamol, and combinations not containing opioids, there were few examples where participants experienced significantly more or fewer adverse events than with placebo. For aspirin 1000 mg and diflunisal 1000 mg, opioids, or fixed-dose combination drugs containing opioids, participants typically experienced significantly more adverse events than with placebo. Studies of combinations of ibuprofen and paracetamol reported significantly fewer adverse events.Serious adverse events were rare

2015 Cochrane

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