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Gelatin tannate for acute diarrhoea and gastroenteritis in children: a systematic review and meta-analysis / Laura Fernanda Niño Serna  

Público ISBD Título : Gelatin tannate for acute diarrhoea and gastroenteritis in children: a systematic review and meta-analysis Tipo de documento : documento electrónico Autores : Laura Fernanda Niño Serna, Fecha de publicación : 2020 Títulos uniformes : Archives of Disease in Childhood Idioma : Inglés (eng) Palabras clave : Children  diarrhoea  gastroenteritis  gelatin  meta-analysis  systematic review  tannate Resumen : Objective: To determine the effectiveness and safety of gelatin tannate (GT) for reducing the duration of the acute diarrhoea and gastroenteritis (ADG) in children. Design: Systematic review and meta-analysis. Data sources: MEDLINE, Embase, CINAHL, Cochrane Central Register of Controlled Trials, LILACS and grey literature, published from inception to October 2018. No language restrictions. Eligibility criteria for selecting studies: Randomised controlled trials in children with ADG, comparing GT with placebo. Results: Of 797 titles identified, we included three studies (276 children). We performed a random effects model meta-analysis for the main outcome (diarrhoea duration). We did not find significant differences between GT and placebo for diarrhoea duration (mean difference (MD)=−15.85 hours; 95% CI −42.24 to 14.82, I2=92%; three studies), stool frequency at day 2 (MD=0.11 stools/day; 95% CI −0.39 to 0.62: I2=26%; two studies), diarrhoea at day 3 (risk ratio [RR]=0.46; 95% CI 0.06 to 3.47: I2=73%; two studies), vomiting (RR=1.31; 95% CI 0.95 to 1.80: I2=0%; two studies) or adverse events (RR=0.86; 95% CI 0.27 to 2.66: I2=0%; two studies). Most common adverse events included abdominal pain and nausea. Conclusion: The effect of GT was no different to placebo for mean diarrhoea duration (low certainty on the evidence) and stool frequency at day 2 (high certainty) and for the presence of diarrhoea at day 3 (very low certainty) of vomiting (moderate certainty) and of adverse events (low certainty). Mención de responsabilidad : Ivan D Florez, Javier M Sierra, Laura F Niño-Serna Referencia : Arch Dis Child. 2020 Feb;105(2):141-146. DOI (Digital Object Identifier) : 10.1136/archdischild-2018-316385 PMID : 31272969 En línea : https://adc.bmj.com/content/early/2019/07/04/archdischild-2018-316385 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=4241 Gelatin tannate for acute diarrhoea and gastroenteritis in children: a systematic review and meta-analysis [documento electrónico] / Laura Fernanda Niño Serna,  . - 2020. Obra : Archives of Disease in Childhood Idioma : Inglés (eng) Palabras clave : Children  diarrhoea  gastroenteritis  gelatin  meta-analysis  systematic review  tannate Resumen : Objective: To determine the effectiveness and safety of gelatin tannate (GT) for reducing the duration of the acute diarrhoea and gastroenteritis (ADG) in children. Design: Systematic review and meta-analysis. Data sources: MEDLINE, Embase, CINAHL, Cochrane Central Register of Controlled Trials, LILACS and grey literature, published from inception to October 2018. No language restrictions. Eligibility criteria for selecting studies: Randomised controlled trials in children with ADG, comparing GT with placebo. Results: Of 797 titles identified, we included three studies (276 children). We performed a random effects model meta-analysis for the main outcome (diarrhoea duration). We did not find significant differences between GT and placebo for diarrhoea duration (mean difference (MD)=−15.85 hours; 95% CI −42.24 to 14.82, I2=92%; three studies), stool frequency at day 2 (MD=0.11 stools/day; 95% CI −0.39 to 0.62: I2=26%; two studies), diarrhoea at day 3 (risk ratio [RR]=0.46; 95% CI 0.06 to 3.47: I2=73%; two studies), vomiting (RR=1.31; 95% CI 0.95 to 1.80: I2=0%; two studies) or adverse events (RR=0.86; 95% CI 0.27 to 2.66: I2=0%; two studies). Most common adverse events included abdominal pain and nausea. Conclusion: The effect of GT was no different to placebo for mean diarrhoea duration (low certainty on the evidence) and stool frequency at day 2 (high certainty) and for the presence of diarrhoea at day 3 (very low certainty) of vomiting (moderate certainty) and of adverse events (low certainty). Mención de responsabilidad : Ivan D Florez, Javier M Sierra, Laura F Niño-Serna Referencia : Arch Dis Child. 2020 Feb;105(2):141-146. DOI (Digital Object Identifier) : 10.1136/archdischild-2018-316385 PMID : 31272969 En línea : https://adc.bmj.com/content/early/2019/07/04/archdischild-2018-316385 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=4241

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Systematic review of the literature on reproducibility of the interpretation of renal biopsy in lupus nephritis / Mauricio Restrepo Escobar ; Paula Andrea Granda Carvajal ; Fabián Alberto Jaimes Barragán  

Público ISBD Título : Systematic review of the literature on reproducibility of the interpretation of renal biopsy in lupus nephritis Tipo de documento : documento electrónico Autores : Mauricio Restrepo Escobar, ; Paula Andrea Granda Carvajal, ; Fabián Alberto Jaimes Barragán, Fecha de publicación : 2017 Títulos uniformes : Lupus Idioma : Inglés (eng) Palabras clave : Biopsy  nephritis  reliability  renal lupus  reproducibility of results  systematic review Resumen : Objective: Before using a test, it should be determined whether the results are reliable. The reliability of the interpretation of renal biopsy in patients with lupus nephritis has not been clearly elucidated. Our objective was to estimate inter and intraobserver reliability of the histological classification, as well as activity and chronicity indices in renal biopsy of patients with lupus nephritis. Methods: We conducted a systematic search of the literature, which included articles in any language, using PubMed, Embase, Cochrane and Lilacs databases. Search terms included were: reproducibility, reliability, agreement, systemic lupus erythematosus and lupus nephritis. Comparative studies with any design were included, regardless of the year or the language of publication. Two investigators, independently, screened the literature published in accordance with pre-established inclusion and exclusion criteria. Results: We found 13 relevant studies. Inter-observer reproducibility of most measurements was moderate or low, despite the fact that, in most cases, the readings were made by expert nephropathologists. There was great diversity among designs, participants, including samples and outcomes evaluated in different studies. Although there are too many reports on the clinical use, studies evaluating the reliability of classifications on renal biopsy in lupus nephritis are rare. The quality of the methodological design and reporting was fair. Conclusion: The interpretation of renal biopsy in lupus nephritis is poorly reproducible, causing serious doubts about its validity and its clinical application. As it can lead to serious diagnosis, treatment and prognosis errors, it is necessary to intensify research in this field. Mención de responsabilidad : M Restrepo-Escobar, P A Granda-Carvajal, F Jaimes Referencia : Lupus. 2017 Dec;26(14):1502-1512. DOI (Digital Object Identifier) : 10.1177/0961203317706556 PMID : 28441914 En línea : https://journals.sagepub.com/doi/abs/10.1177/0961203317706556 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=4048 Systematic review of the literature on reproducibility of the interpretation of renal biopsy in lupus nephritis [documento electrónico] / Mauricio Restrepo Escobar, ; Paula Andrea Granda Carvajal, ; Fabián Alberto Jaimes Barragán,  . - 2017. Obra : Lupus Idioma : Inglés (eng) Palabras clave : Biopsy  nephritis  reliability  renal lupus  reproducibility of results  systematic review Resumen : Objective: Before using a test, it should be determined whether the results are reliable. The reliability of the interpretation of renal biopsy in patients with lupus nephritis has not been clearly elucidated. Our objective was to estimate inter and intraobserver reliability of the histological classification, as well as activity and chronicity indices in renal biopsy of patients with lupus nephritis. Methods: We conducted a systematic search of the literature, which included articles in any language, using PubMed, Embase, Cochrane and Lilacs databases. Search terms included were: reproducibility, reliability, agreement, systemic lupus erythematosus and lupus nephritis. Comparative studies with any design were included, regardless of the year or the language of publication. Two investigators, independently, screened the literature published in accordance with pre-established inclusion and exclusion criteria. Results: We found 13 relevant studies. Inter-observer reproducibility of most measurements was moderate or low, despite the fact that, in most cases, the readings were made by expert nephropathologists. There was great diversity among designs, participants, including samples and outcomes evaluated in different studies. Although there are too many reports on the clinical use, studies evaluating the reliability of classifications on renal biopsy in lupus nephritis are rare. The quality of the methodological design and reporting was fair. Conclusion: The interpretation of renal biopsy in lupus nephritis is poorly reproducible, causing serious doubts about its validity and its clinical application. As it can lead to serious diagnosis, treatment and prognosis errors, it is necessary to intensify research in this field. Mención de responsabilidad : M Restrepo-Escobar, P A Granda-Carvajal, F Jaimes Referencia : Lupus. 2017 Dec;26(14):1502-1512. DOI (Digital Object Identifier) : 10.1177/0961203317706556 PMID : 28441914 En línea : https://journals.sagepub.com/doi/abs/10.1177/0961203317706556 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=4048

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Opioids compared with placebo or other treatments for chronic low back pain: an update of the Cochrane Review / Luis Enrique Chaparro Gómez  

Público ISBD Título : Opioids compared with placebo or other treatments for chronic low back pain: an update of the Cochrane Review Tipo de documento : documento electrónico Autores : Luis Enrique Chaparro Gómez, Fecha de publicación : 2014 Títulos uniformes : Spine Idioma : Inglés (eng) Palabras clave : Analgesics  opioid/adverse effects  opioid/therapeutic use  buprenorphine/therapeutic use  Cochrane Review  hydromorphone/therapeutic use  low back pain/drug therapy  metaanalysis  morphine/therapeutic use  oxycodone/therapeutic use  oxymorphone/therapeutic use  sciatica/drug therapy  systematic review  tramadol/therapeutic use Resumen : Study Design: Systematic review and meta-analysis. Objective:To assess the efficacy of opioids in adults with chronic low back pain (CLBP). Summary of Background Data. Opioids for CLBP has increased dramatically. However, the benefits and risks remain unclear. Methods: We updated a 2007 Cochrane Review through October 2012 of randomized controlled trials from multiple databases. Use of noninjectable opioids in CLBP for at least 4 weeks was compared with placebo or other treatments; comparisons with different opioids were excluded. Outcomes included pain and function using standardized mean difference (SMD) or risk ratios with 95% confidence intervals (CIs), and absolute risk difference with 95% CI for adverse effects. Study quality was evaluated using Grading of Recommendations Assessment, Development, and Evaluation criteria. Results: Fifteen trials (5540 participants), including twelve new, met the criteria. Tramadol was better than placebo for pain (SMD, −0.55; 95% CI, −0.66 to −0.44) and function (SMD, −0.18; 95% CI, −0.29 to −0.07). Compared with placebo, transdermal buprenorphine decreased pain (SMD, −2.47; 95% CI, −2.69 to −2.25), but not function (SMD, −0.14; 95% CI, −0.53 to 0.25). Strong opioids (morphine, hydromorphone, oxycodone, oxymorphone, and tapentadol), were better than placebo for pain (SMD, −0.43; 95% CI, −0.52 to −0.33) and function (SMD, −0.26; 95% CI, −0.37 to −0.15). One trial demonstrated little difference with tramadol compared with celecoxib for pain relief. Two trials (272 participants) found no difference between opioids and antidepressants for pain or function. Reviewed trials had low to moderate quality, high drop-out rates, short duration, and limited interpretability of functional improvement. No serious adverse effects, risks (addiction or overdose), or complications (sleep apnea, opioid-induced hyperalgesia, hypogonadism) were reported. Conclusion. There is evidence of short-term efficacy (moderate for pain and small for function) of opioids to treat CLBP compared with placebo. The effectiveness and safety of long- term opioid therapy for treatment of CLBP remains unproven. Level of Evidence: 1 Mención de responsabilidad : Luis Enrique Chaparro, Andrea D Furlan, Amol Deshpande, Angela Mailis-Gagnon, Steven Atlas, Dennis C Turk Referencia : Spine (Phila Pa 1976). 2014 Apr 1;39(7):556-63. DOI (Digital Object Identifier) : 10.1097/BRS.0000000000000249 PMID : 24480962 En línea : https://insights.ovid.com/crossref?an=00007632-201404010-00010 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=3786 Opioids compared with placebo or other treatments for chronic low back pain: an update of the Cochrane Review [documento electrónico] / Luis Enrique Chaparro Gómez,  . - 2014. Obra : Spine Idioma : Inglés (eng) Palabras clave : Analgesics  opioid/adverse effects  opioid/therapeutic use  buprenorphine/therapeutic use  Cochrane Review  hydromorphone/therapeutic use  low back pain/drug therapy  metaanalysis  morphine/therapeutic use  oxycodone/therapeutic use  oxymorphone/therapeutic use  sciatica/drug therapy  systematic review  tramadol/therapeutic use Resumen : Study Design: Systematic review and meta-analysis. Objective:To assess the efficacy of opioids in adults with chronic low back pain (CLBP). Summary of Background Data. Opioids for CLBP has increased dramatically. However, the benefits and risks remain unclear. Methods: We updated a 2007 Cochrane Review through October 2012 of randomized controlled trials from multiple databases. Use of noninjectable opioids in CLBP for at least 4 weeks was compared with placebo or other treatments; comparisons with different opioids were excluded. Outcomes included pain and function using standardized mean difference (SMD) or risk ratios with 95% confidence intervals (CIs), and absolute risk difference with 95% CI for adverse effects. Study quality was evaluated using Grading of Recommendations Assessment, Development, and Evaluation criteria. Results: Fifteen trials (5540 participants), including twelve new, met the criteria. Tramadol was better than placebo for pain (SMD, −0.55; 95% CI, −0.66 to −0.44) and function (SMD, −0.18; 95% CI, −0.29 to −0.07). Compared with placebo, transdermal buprenorphine decreased pain (SMD, −2.47; 95% CI, −2.69 to −2.25), but not function (SMD, −0.14; 95% CI, −0.53 to 0.25). Strong opioids (morphine, hydromorphone, oxycodone, oxymorphone, and tapentadol), were better than placebo for pain (SMD, −0.43; 95% CI, −0.52 to −0.33) and function (SMD, −0.26; 95% CI, −0.37 to −0.15). One trial demonstrated little difference with tramadol compared with celecoxib for pain relief. Two trials (272 participants) found no difference between opioids and antidepressants for pain or function. Reviewed trials had low to moderate quality, high drop-out rates, short duration, and limited interpretability of functional improvement. No serious adverse effects, risks (addiction or overdose), or complications (sleep apnea, opioid-induced hyperalgesia, hypogonadism) were reported. Conclusion. There is evidence of short-term efficacy (moderate for pain and small for function) of opioids to treat CLBP compared with placebo. The effectiveness and safety of long- term opioid therapy for treatment of CLBP remains unproven. Level of Evidence: 1 Mención de responsabilidad : Luis Enrique Chaparro, Andrea D Furlan, Amol Deshpande, Angela Mailis-Gagnon, Steven Atlas, Dennis C Turk Referencia : Spine (Phila Pa 1976). 2014 Apr 1;39(7):556-63. DOI (Digital Object Identifier) : 10.1097/BRS.0000000000000249 PMID : 24480962 En línea : https://insights.ovid.com/crossref?an=00007632-201404010-00010 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=3786

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Neuromonitoring in thyroidectomy: a meta-analysis of effectiveness from randomized controlled trials / Álvaro Enrique Sanabria Quiroga  

Público ISBD Título : Neuromonitoring in thyroidectomy: a meta-analysis of effectiveness from randomized controlled trials Tipo de documento : documento electrónico Autores : Álvaro Enrique Sanabria Quiroga, Fecha de publicación : 2013 Títulos uniformes : European Archives of Oto-rhino-laryngology Idioma : Inglés (eng) Palabras clave : Thyroidectomy  laryngeal nerve injuries  neuromonitoring  meta-analysis  systematic review Resumen : Neuromonitoring in thyroid surgery has been employed to make nerve identification easier and decrease the rates of laryngeal nerve injuries. Several individual randomized controlled trials (RCTs) have been published, which did not identify statistical differences in the rates of recurrent laryngeal nerve (RLN) or external branch of the superior laryngeal nerve (EBSLN) injuries. The objective of this report is to perform meta-analysis of the combined results of individual studies to measure the frequency of RLN and EBSLN injuries in patients who underwent thyroidectomy with routine neuromonitoring in comparison with common practice of search and identification. RCTs comparing routine neuromonitoring versus no use in patients who underwent elective partial or total thyroidectomy were evaluated. Outcomes measured were temporary and definitive palsy of the RLN and EBSLN. A systematic review and meta-analysis was done using random effects model. GRADE was used to classify quality of evidence. Six studies with 1,602 patients and 3,064 nerves at risk were identified. Methodological quality assessment showed high risk of bias in most items. Funnel plot did not reveal publication bias. The risk difference for temporary RLN palsy, definitive RLN palsy, temporary EBSLN palsy, and definitive EBSLN palsy were −2 % (95 % confidence interval −5.1 to 1); 0 % (−1 to 1); −9 % (−15 to −2) and −1 % (−4 to 2), respectively. Quality was rated low or very low in most outcomes due to methodological flaws. Meta-analysis did not demonstrate a statistically significant decrease in the risk of temporary or definitive RLN injury and definitive EBSLN injury with the use of neuromonitoring. The neuromonitoring group had a statistically significant decrease in the risk of temporary EBSLN injury. Mención de responsabilidad : Alvaro Sanabria, Adonis Ramirez, Luiz P Kowalski, Carl E Silver, Ashok R Shaha, Randall P Owen, Carlos Suárez, Avi Khafif, Alessandra Rinaldo, Alfio Ferlito Referencia : Eur Arch Otorhinolaryngol. 2013 Aug;270(8):2175-89. DOI (Digital Object Identifier) : 10.1007/s00405-013-2557-2 PMID : 23681545 En línea : https://link.springer.com/article/10.1007%2Fs00405-013-2557-2 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=3714 Neuromonitoring in thyroidectomy: a meta-analysis of effectiveness from randomized controlled trials [documento electrónico] / Álvaro Enrique Sanabria Quiroga,  . - 2013. Obra : European Archives of Oto-rhino-laryngology Idioma : Inglés (eng) Palabras clave : Thyroidectomy  laryngeal nerve injuries  neuromonitoring  meta-analysis  systematic review Resumen : Neuromonitoring in thyroid surgery has been employed to make nerve identification easier and decrease the rates of laryngeal nerve injuries. Several individual randomized controlled trials (RCTs) have been published, which did not identify statistical differences in the rates of recurrent laryngeal nerve (RLN) or external branch of the superior laryngeal nerve (EBSLN) injuries. The objective of this report is to perform meta-analysis of the combined results of individual studies to measure the frequency of RLN and EBSLN injuries in patients who underwent thyroidectomy with routine neuromonitoring in comparison with common practice of search and identification. RCTs comparing routine neuromonitoring versus no use in patients who underwent elective partial or total thyroidectomy were evaluated. Outcomes measured were temporary and definitive palsy of the RLN and EBSLN. A systematic review and meta-analysis was done using random effects model. GRADE was used to classify quality of evidence. Six studies with 1,602 patients and 3,064 nerves at risk were identified. Methodological quality assessment showed high risk of bias in most items. Funnel plot did not reveal publication bias. The risk difference for temporary RLN palsy, definitive RLN palsy, temporary EBSLN palsy, and definitive EBSLN palsy were −2 % (95 % confidence interval −5.1 to 1); 0 % (−1 to 1); −9 % (−15 to −2) and −1 % (−4 to 2), respectively. Quality was rated low or very low in most outcomes due to methodological flaws. Meta-analysis did not demonstrate a statistically significant decrease in the risk of temporary or definitive RLN injury and definitive EBSLN injury with the use of neuromonitoring. The neuromonitoring group had a statistically significant decrease in the risk of temporary EBSLN injury. Mención de responsabilidad : Alvaro Sanabria, Adonis Ramirez, Luiz P Kowalski, Carl E Silver, Ashok R Shaha, Randall P Owen, Carlos Suárez, Avi Khafif, Alessandra Rinaldo, Alfio Ferlito Referencia : Eur Arch Otorhinolaryngol. 2013 Aug;270(8):2175-89. DOI (Digital Object Identifier) : 10.1007/s00405-013-2557-2 PMID : 23681545 En línea : https://link.springer.com/article/10.1007%2Fs00405-013-2557-2 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=3714

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