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141. Resumption of anticoagulant therapy after anticoagulant-related gastrointestinal bleeding: A systematic review and meta-analysis

Resumption of anticoagulant therapy after anticoagulant-related gastrointestinal bleeding: A systematic review and meta-analysis Oral anticoagulation (OAC) is permanently discontinued in up to 50% of patients following a gastrointestinal (GI) bleed. A previous meta-analysis showed a reduced risk of thromboembolism and death, and a non-statistically significant increased risk of re-bleeding associated with resumption. We conducted an updated meta-analysis to determine the risks of recurrent GI

2019 EvidenceUpdates

142. Cardiovascular efficacy and safety of sodium-glucose co-transporter-2 inhibitors and glucagon-like peptide-1 receptor agonists: a systematic review and network meta-analysis

Cardiovascular efficacy and safety of sodium-glucose co-transporter-2 inhibitors and glucagon-like peptide-1 receptor agonists: a systematic review and network meta-analysis To compare the cardiovascular efficacy and safety of sodium-glucose co-transporter-2 (SGLT2) inhibitors and glucagon-like peptide-1 receptor agonists (GLP-1RAs) in adults with Type 2 diabetes.Electronic databases were searched from inception to 22 October 2018 for randomized controlled trials designed to assess (...) the cardiovascular efficacy of SGLT2 inhibitors or GLP-1RAs with regard to a three-point composite measure of major adverse cardiovascular events (non-fatal stroke, non-fatal myocardial infarction and cardiovascular mortality). Cardiovascular and safety data were synthesized using Bayesian network meta-analyses.Eight trials, including 60 082 participants, were deemed eligible for the network meta-analysis. Both SGLT2 inhibitors [hazard ratio 0.86 (95% credible interval 0.74, 1.01]) and GLP-1RAs [hazard ratio

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2019 EvidenceUpdates

143. Oral immunotherapy for peanut allergy (PACE): a systematic review and meta-analysis of efficacy and safety. (PubMed)

Oral immunotherapy for peanut allergy (PACE): a systematic review and meta-analysis of efficacy and safety. Oral immunotherapy is an emerging experimental treatment for peanut allergy, but its benefits and harms are unclear. We systematically reviewed the efficacy and safety of oral immunotherapy versus allergen avoidance or placebo (no oral immunotherapy) for peanut allergy.In the Peanut Allergen immunotherapy, Clarifying the Evidence (PACE) systematic review and meta-analysis, we searched

2019 Lancet

144. Drug-eluting or bare-metal stents for percutaneous coronary intervention: a systematic review and individual patient data meta-analysis of randomised clinical trials. (PubMed)

Drug-eluting or bare-metal stents for percutaneous coronary intervention: a systematic review and individual patient data meta-analysis of randomised clinical trials. New-generation drug-eluting stents (DES) have mostly been investigated in head-to-head non-inferiority trials against early-generation DES and have typically shown similar efficacy and superior safety. How the safety profile of new-generation DES compares with that of bare-metal stents (BMS) is less clear.We did an individual (...) patient data meta-analysis of randomised clinical trials to compare outcomes after implantation of new-generation DES or BMS among patients undergoing percutaneous coronary intervention. The primary outcome was the composite of cardiac death or myocardial infarction. Data were pooled in a one-stage random-effects meta-analysis and examined at maximum follow-up and a 1-year landmark. Risk estimates are reported as hazard ratios (HRs) with 95% CIs. This study is registered in PROSPERO, number

2019 Lancet

145. Effects of Promotility Agents on Gastric Emptying and Symptoms: A Systematic Review and Meta-analysis

Effects of Promotility Agents on Gastric Emptying and Symptoms: A Systematic Review and Meta-analysis Studies have reported a lack of association between improvements in gastric emptying (GE) and upper gastrointestinal (UGI) symptoms with promotility drugs. However, GE test methods were suboptimal in some studies. We assessed improvements in GE and UGI symptoms in patients given promotility agents in studies with optimal or moderate test methods (scintigraphy or breath test, solid meal, >2 (...) found no significant association between change in GE and UGI symptoms. However, when only studies with optimal GE test methods were evaluated, there was a significant positive association between improvement in GE and UGI symptoms (P = .02).In a meta-analysis of published trials, we found promotility agents to significantly accelerate GE (when optimal test methods were used) and to produce significant improvements in UGI symptoms.Copyright © 2019 AGA Institute. Published by Elsevier Inc. All rights

2019 EvidenceUpdates

146. The neutrophil-lymphocyte count ratio as a diagnostic marker for bacteraemia: A systematic review and meta-analysis

The neutrophil-lymphocyte count ratio as a diagnostic marker for bacteraemia: A systematic review and meta-analysis Bacteraemia is a common cause of increased morbidity and mortality in critically ill patients, but its early diagnosis and identification are complicated. The neutrophil-lymphocyte count ratio (NLCR) has been suggested as a useful indicator for the diagnosis of bacteraemia. We performed this meta-analysis to investigate the diagnostic accuracy of the NLCR for bacteraemia.We (...) searched the PubMed, Embase, Web of Science, and Cochrane Library databases for this meta-analysis. We calculated individual and pooled sensitivities and specificities. I2 statistics and Cochran's Q test were used to evaluate heterogeneity, and the cause of heterogeneity was explored with sensitivity analyses.In total, 8 of 1086 eligible articles were included in the present meta-analysis. The pooled analyses revealed that the diagnostic accuracy of the NLCR in terms of its bacteraemia sensitivity

2019 EvidenceUpdates

147. Oral anticoagulation in patients with chronic kidney disease: A systematic review and meta-analysis

Oral anticoagulation in patients with chronic kidney disease: A systematic review and meta-analysis Data regarding the efficacy and safety of warfarin and non-vitamin K antagonist oral anticoagulant (NOAC) among patients with chronic kidney disease (CKD) remain scarce.Systematic review and meta-analysis of studies involving patients with CKD treated with oral anticoagulants were conducted to evaluate the following outcomes: ischemic stroke, intracerebral hemorrhage (ICH), combined ischemic

2019 EvidenceUpdates

148. Lidocaine lubricants for intubation-related complications: a systematic review and meta-analysis

Lidocaine lubricants for intubation-related complications: a systematic review and meta-analysis Postoperative sore throat (POST) is a relatively common morbidity. Topical lidocaine lubricants have been proposed to prevent POST; however, their effectiveness remains uncertain. This meta-analysis aimed to evaluate the prophylactic effect of lidocaine lubrications against POST, cough, and hoarseness in adult patients after surgery.Randomized-controlled trials from PubMed, Embase, the Cochrane

2019 EvidenceUpdates

149. The effectiveness of trunk training on trunk control, sitting and standing balance and mobility post-stroke: a systematic review and meta-analysis

The effectiveness of trunk training on trunk control, sitting and standing balance and mobility post-stroke: a systematic review and meta-analysis To investigate the effectiveness of trunk training on trunk control, sitting and standing balance and mobility.PubMed/MEDLINE, Web of Science, Physiotherapy Evidence Database (PEDro), Cochrane Library, Rehab+ and ScienceDirect were searched until January 2019.Randomized controlled trials were included if they investigated the effect of trunk (...) exercises on balance and gait after stroke. Four reviewers independently screened and performed data extraction and risk of bias assessment with the PEDro scale. Disagreements were resolved by a fifth independent reviewer. A meta-analysis was performed to quantitatively describe the results.After screening of 1881 studies, 22 studies and 394 participants met the inclusion criteria. Trunk training was executed as core stability, reaching, weight-shift or proprioceptive neuromuscular facilitation

2019 EvidenceUpdates

150. Low-Level Laser Therapy for Fibromyalgia: A Systematic Review and Meta-Analysis

Low-Level Laser Therapy for Fibromyalgia: A Systematic Review and Meta-Analysis Fibromyalgia is a chronic disorder characterized by widespread pain and tenderness. Low-level laser therapy (LLLT), an emerging nonpharmacological treatment, has been used for relieving musculoskeletal or neuropathic pain.The objective of this review and meta-analysis was to determine the efficacy of LLLT on patients with fibromyalgia.This study involved systematic review and quantitative meta-analysis of published (...) randomized controlled trials (RCTs).This study examined all RCTs evaluating the effect of LLLT on fibromyalgia.We performed a systematic review and meta-analysis of RCTs evaluating the effect of LLLT on patients with fibromyalgia. PubMed, EMBASE, and the Cochrane Library were searched for articles published before August 2018. RCTs meeting our selection criteria were included. The methodological quality of the RCTs was evaluated according to the Cochrane risk-for-bias method. Review Manager version 5.3

2019 EvidenceUpdates

151. A systematic review and meta-analysis of the long-term outcomes of endovascular versus open repair of abdominal aortic aneurysm

A systematic review and meta-analysis of the long-term outcomes of endovascular versus open repair of abdominal aortic aneurysm This study synthesized the literature comparing the long-term (5-9 years) and very long-term (≥10 years) all-cause mortality, reintervention, and secondary rupture rates between endovascular aneurysm repair (EVAR) and open surgical repair (OSR) of abdominal aortic aneurysm (AAA).MEDLINE, Embase, and CENTRAL databases were searched from inception to May 2018 for studies

2019 EvidenceUpdates

152. Outcomes following surgical versus endovascular treatment of spinal dural arteriovenous fistula: a systematic review and meta-analysis

Outcomes following surgical versus endovascular treatment of spinal dural arteriovenous fistula: a systematic review and meta-analysis Although surgical resection is associated with a complete cure in most cases of spinal dural arteriovenous fistulas (SDAVF), there has been an increasing trend towards embolisation. We performed a systematic review and meta-analysis comparing surgical resection with endovascular treatment in terms of success of treatment, rate of recurrence and complications (...) . A literature search was conducted using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Strength of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation Working Group system. Surgical outcomes such as initial treatment failure, late recurrence, neurological improvement and complications were compared between the two approaches. We included 57 studies with 2029 patients, of which 32 studies with 1341 patients directly compared

2019 EvidenceUpdates

153. A systematic review and meta-analysis of the management of visceral artery aneurysms

A systematic review and meta-analysis of the management of visceral artery aneurysms The evidence supporting management decisions of visceral artery aneurysms (VAAs) is sparse. Practice guidelines are needed to help patients and surgeons choose between endovascular and open surgery approaches.We searched MEDLINE, EMBASE, Cochrane databases, and Scopus for studies of patients with VAAs. Studies were selected and appraised by pairs of independent reviewers. Meta-analysis was performed when (...) more often by surgeons. The endovascular approach was associated with shorter hospital stay and lower rates of cardiovascular complications but higher rates of reintervention. Postembolization syndrome rates ranged from 9% (renal) to 38% (splenic). Coil migration ranged from 8% (splenic) to 29% (renal). Otherwise, access site complication were low (<5%). Pseudoaneurysms tended to have higher mortality and reintervention rates.This systematic review provides event rates for outcomes important

2019 EvidenceUpdates

154. Association Between Adjuvant Chemotherapy Duration and Survival Among Patients With Stage II and III Colon Cancer: A Systematic Review and Meta-analysis

Association Between Adjuvant Chemotherapy Duration and Survival Among Patients With Stage II and III Colon Cancer: A Systematic Review and Meta-analysis The results from the recent International Duration Evaluation of Adjuvant Therapy (IDEA) collaboration have led some clinicians to adopt shorter durations of adjuvant chemotherapy for patients with stage III colon cancer. The extent to which these findings are supported by other data is unknown.To conduct a systematic review and meta-analysis (...) was assessed by 2 authors using the Cochrane and Risk of Bias in Nonrandomized Studies of Interventions (ROBINS-I) tools. The results were synthesized using a random-effects model.The primary and secondary outcomes were overall survival and disease-free survival, respectively. It was hypothesized a priori that 3 months of chemotherapy would be as effective as 6 months of chemotherapy.Twenty-two studies were included in the meta-analysis, representing 43 671 patients. The inclusion of patients with stage II

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2019 EvidenceUpdates

155. Risk of venous and arterial thrombosis in non-surgical patients receiving systemic tranexamic acid: A systematic review and meta-analysis

Risk of venous and arterial thrombosis in non-surgical patients receiving systemic tranexamic acid: A systematic review and meta-analysis Antifibrinolytic agents such as tranexamic acid (TXA) are commonly used as adjunctive therapies to prevent and treat excessive bleeding. In non-surgical settings, TXA is known to reduce bleeding related mortality. However, impact of TXA use on thrombosis is uncertain.We systematically searched the MEDLINE, EMBASE, and CENTRAL databases from January 1985 (...) had a significantly lower risk of death from any cause (RR = 0.92; 95% CI = 0.87-0.98; I2 = 0%). There was no significant increase in the risk of stroke (RR = 1.10; 95% CI = 0.68-1.78; I2 = 31%), myocardial infarction (RR = 0.88; 95% CI = 0.43-1.84; I2 = 46%), pulmonary embolism (RR = 0.97; 95% CI = 0.75-1.26; I2 = 0%), or deep vein thrombosis (RR = 0.99; 95% CI = 0.70-1.41; I2 = 0%) from use of TXA. The results were similar when restricted to studies at low risk of bias.In our systematic review

2019 EvidenceUpdates

156. New WHO prevalence estimates of mental disorders in conflict settings: a systematic review and meta-analysis. (PubMed)

New WHO prevalence estimates of mental disorders in conflict settings: a systematic review and meta-analysis. Existing WHO estimates of the prevalence of mental disorders in emergency settings are more than a decade old and do not reflect modern methods to gather existing data and derive estimates. We sought to update WHO estimates for the prevalence of mental disorders in conflict-affected settings and calculate the burden per 1000 population.In this systematic review and meta-analysis, we (...) updated a previous systematic review by searching MEDLINE (PubMed), PsycINFO, and Embase for studies published between Jan 1, 2000, and Aug 9, 2017, on the prevalence of depression, anxiety disorder, post-traumatic stress disorder, bipolar disorder, and schizophrenia. We also searched the grey literature, such as government reports, conference proceedings, and dissertations, to source additional data, and we searched datasets from existing literature reviews of the global prevalence of depression

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2019 Lancet

157. Prevalence and main outcomes of placenta accreta spectrum: a systematic review and metaanalysis. (PubMed)

Prevalence and main outcomes of placenta accreta spectrum: a systematic review and metaanalysis. The objective of this study was to evaluate the prevalence of placenta accreta spectrum in general population studies and the main maternal outcomes at delivery.Data sources: We searched PubMed, Google Scholar, clinicalTrials.gov and MEDLINE between 1982 and 2018.Articles providing data on the number of cases of placenta accreta spectrum per pregnancies, births or deliveries in a defined (...) of the diagnosis and differential diagnosis between adherent and invasive accreta placentation.This meta-analysis indicates wide variation between studies for the prevalence rate of placenta accreta spectrum and for the different grades of accreta placentation, highlighting the need for consistency in definitions used to describe placenta accreta spectrum at birth and in reporting on this increasing common obstetric complication.Copyright © 2019. Published by Elsevier Inc.

2019 American Journal of Obstetrics and Gynecology

158. Pregnancy outcomes in women with kidney transplant: Metaanalysis and systematic review. (PubMed)

Pregnancy outcomes in women with kidney transplant: Metaanalysis and systematic review. Reproductive function in women with end stage renal disease generally improves after kidney transplant. However, pregnancy remains challenging due to the risk of adverse clinical outcomes.We searched PubMed/MEDLINE, Elsevier EMBASE, Scopus, BIOSIS Previews, ISI Science Citation Index Expanded, and the Cochrane Central Register of Controlled Trials from date of inception through August 2017 for studies

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2019 BMC Nephrology

159. Venous Thrombotic Risk in Transgender Women Undergoing Estrogen Therapy: A Systematic Review and Metaanalysis. (PubMed)

Venous Thrombotic Risk in Transgender Women Undergoing Estrogen Therapy: A Systematic Review and Metaanalysis. Transgender women are female individuals who were recorded men at birth based on natal sex. Supporting a person's gender identity improves their psychological health, and gender-affirming hormones reduce gender dysphoria and benefit mental health. For transgender women, estrogen administration has clinically significant benefits. Previous reviews have reported conflicting literature (...) on the thrombotic risk of estrogen therapy in transgender women and have highlighted the need for more high-quality research.To help address the gap in understanding thrombotic risk in transgender women receiving estrogen therapy, we performed a systematic literature review and metaanalysis. Two evaluators independently assessed quality using the Ottawa Scale for Cohort Studies. The Poisson normal model was used to estimate the study-specific incidence rates and the pooled incidence rate. Heterogeneity

2019 Clinical Chemistry

160. Systematic review with meta analysis: Erythropoietin corrects anaemia and reduces the risk of blood transfusion in people with chronic kidney disease, but has uncertain effects on other patient-level outcomes

Systematic review with meta analysis: Erythropoietin corrects anaemia and reduces the risk of blood transfusion in people with chronic kidney disease, but has uncertain effects on other patient-level outcomes Erythropoietin corrects anaemia and reduces the risk of blood transfusion in people with chronic kidney disease, but has uncertain effects on other patient-level outcomes | BMJ Evidence-Based Medicine We use cookies to improve our service and to tailor our content and advertising to you (...) Erythropoietin corrects anaemia and reduces the risk of blood transfusion in people with chronic kidney disease, but has uncertain effects on other patient-level outcomes Article Text Therapeutics/Prevention Systematic review with meta analysis Erythropoietin corrects anaemia and reduces the risk of blood transfusion in people with chronic kidney disease, but has uncertain effects on other patient-level outcomes David W Johnson Statistics from Altmetric.com Commentary on: Cody JD , Hodson EM . Recombinant

2016 Evidence-Based Medicine (Requires free registration)

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