scholarly journals A meta‐analysis of toxicities related to hydroxycarbamide dosing strategies

eJHaem ◽  
2020 ◽  
Vol 1 (1) ◽  
pp. 235-238
Author(s):  
Joacy G. Mathias ◽  
Vikki G. Nolan ◽  
Meghan Meadows‐Taylor ◽  
L. Ashley Robinson ◽  
Kristen E. Howell ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Dosing Strategies

scholarly journals Clinical Outcomes with Alternative Dosing Strategies for Piperacillin/Tazobactam: A Systematic Review and Meta-Analysis

PLoS ONE ◽  
2015 ◽  
Vol 10 (1) ◽  
pp. e0116769 ◽  
Author(s):  
Hui Yang ◽  
Chao Zhang ◽  
Quanyu Zhou ◽  
Yike Wang ◽  
Lujia Chen
Keyword(s):  
Systematic Review ◽  
Clinical Outcomes ◽  
Meta Analysis ◽  
Dosing Strategies

scholarly journals Evaluation Outcomes Associated with Alternative Dosing Strategies for Piperacillin/Tazobactam: A Systematic Review and Meta-Analysis

2016 ◽  
Vol 19 (2) ◽  
pp. 274 ◽  
Author(s):  
Hui Yang ◽  
Xiangli Cui ◽  
Zhuo Ma ◽  
Lihong Liu
Keyword(s):  
Systematic Review ◽  
Continuous Infusion ◽  
Clinical Cure ◽  
Observational Studies ◽  
Clinical Cure Rate ◽  
Meta Analysis ◽  
Intermittent Infusion ◽  
Cure Rate ◽  
Randomized Controlled ◽  
Dosing Strategies

A better dosing strategy can improve clinical outcomes for patients. We systematically reviewed the literatures to determine whether any clinical benefits exist for piperacillin/tazobactam by extended or continuous infusion. Methods - A search of PubMed, Web of Science, ProQuest, ScienceDirect, Cochrane, Embase and related ICAAC and ACCP conferences were conducted up to September 5, 2015. Randomized controlled and observational studies that compared extended or continuous infusion with conventional intermittent infusion of piperacillin/tazobactam were identified from the databases above and analyzed. Two reviewers independently evaluated the methodology and extracted data from primary studies. A meta-analysis was performed using Revman 5.2 software. The quality of each study was assessed. Sensitivity analysis and publication bias were evaluated. Results - Three randomized controlled trials and twelve observational studies were included in this study. All included studies had high quality and no publication bias was found. Compared to the conventional intermittent infusion approach, the extended or continuous infusion group had a significant cost effectiveness (OR -0.89.02, CI (-114.69,-63.35), P<0.00001). No statistical difference was observed for clinical cure rate (OR 1.64, 95% CI (0.88, 3.30), P=0.12) between the two dosing regimens. The sensitivity analysis showed the results were stable. Conclusions - Our systematic review and meta-analysis found that the outcomes associated with alternative dosing strategies of piperacillin/tazobactam have changed compared with conclusions before for several literatures with large samples published. Further data on the outcomes should be generated for a better understanding of the extended or continuous infusion strategy. On the whole, our meta-analysis suggested that the extended or continuous infusion should be recommended for clinical use only considering its economic advantage, but there was no significantly higher clinical cure rate and lower mortality rate compared with the conventional intermittent infusion. This article is open to POST-PUBLICATION REVIEW. Registered readers (see “For Readers”) may comment by clicking on ABSTRACT on the issue’s contents page.

Intrapleural Tissue Plasminogen Activator for Traumatic Retained Hemothorax

2019 ◽  
Vol 53 (10) ◽  
pp. 1060-1066
Author(s):  
Maya R. Holsen ◽  
Ashley M. Tameron ◽  
David C. Evans ◽  
Molly Thompson
Keyword(s):  
Plasminogen Activator ◽  
Tissue Plasminogen Activator ◽  
Case Reports ◽  
Data Extraction ◽  
Meta Analysis ◽  
Search Terms ◽  
Study Selection ◽  
Tissue Plasminogen ◽  
Dosing Strategies ◽  
Retained Hemothorax

Objective: To describe the efficacy, safety, dosing regimen, and administration technique of intrapleural alteplase for the treatment of retained hemothorax. Data Sources: A PubMed, EMBASE, and Google Scholar search (January 2000 to February 2019) was conducted with the search terms intrapleural, fibrinolytic, fibrinolysis, alteplase, tissue plasminogen activator, and hemothorax. Study Selection and Data Extraction: Articles were included if they described the use of intrapleural alteplase in adult patients with a retained hemothorax; single patient case reports and abstracts were excluded. Data Synthesis: A total of 6 retrospective reviews and 1 meta-analysis were identified for inclusion. A variety of dosing strategies have been defined for the administration of intrapleural alteplase ranging from 6 to 100 mg, volume of fluid from 50 to 120 mL of normal saline, and the number of total doses has ranged from 1 to 8 over the treatment course. A majority of studies showed a greater than 80% success rate and less than 7% bleeding rate. Relevance to Patient Care and Clinical Practice: Because of the paucity of data for use of alteplase in retained hemothorax and administration of a high-risk medication, this review provides dosing and administration recommendations based on reported safety and efficacy. Conclusion: Administration of intrapleural alteplase should be considered in patients with retained hemothorax as an alternative to surgical intervention. In contrast to intrapleural alteplase administration for other indications such as empyema, higher doses and volumes of alteplase are recommended for retained hemothorax.

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