scholarly journals Accuracy and clinical utility of comprehensive dysphagia screening assessments in acute stroke: A systematic review and meta‐analysis

2020 ◽  
Vol 29 (9-10) ◽  
pp. 1527-1538 ◽  
Author(s):  
Jacqueline K. Benfield ◽  
Lisa F. Everton ◽  
Philip M. Bath ◽  
Timothy J. England
Keyword(s):  
Systematic Review ◽  
Acute Stroke ◽  
Clinical Utility ◽  
Meta Analysis

scholarly journals Benefits and safety of transdermal glyceryl trinitrate in acute stroke: a systematic review and meta-analysis of randomised trials (protocol)

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e043591
Author(s):  
Beng Leong Lim ◽  
Wei Feng Lee ◽  
Wei Ming Ng ◽  
Wei Ling Tay ◽  
Wui Ling Chan
Keyword(s):  
Systematic Review ◽  
Ischaemic Stroke ◽  
Glyceryl Trinitrate ◽  
Acute Stroke ◽  
Meta Analysis ◽  
Cochrane Review ◽  
Cochrane Library ◽  
Placebo Control ◽  
Randomised Trials ◽  
Patient Subgroup

IntroductionHigh blood pressure (BP) in acute stroke has adverse outcomes. Transdermal glyceryl trinitrate (GTN) has beneficial properties in controlling BP. The 2016 meta-analysis and 2017 Cochrane review showed that transdermal GTN was beneficial in a small patient subgroup with stroke onset ≤6 hours. Larger studies focusing on this patient subgroup have since been conducted. We report the protocol for an updated systematic review and meta-analysis on the safety and benefits of transdermal GTN in acute stroke.Methods and analysisWe will search Medline, Pubmed, Embase, CINAHL and Cochrane Library from inception until June 2020 for randomised trials that report the efficacy and safety of transdermal GTN versus placebo/control therapy among adult patients with acute stroke. Primary outcomes include in-hospital mortality, BP lowering and late functional status. Secondary outcomes include early, late, resource utilisation and surrogate outcomes. Safety outcomes include reported adverse events. Reviewers will first screen titles and abstracts, and then full texts, to identify eligible studies. Independently and in duplicate, they will extract data, assess risk of bias (RoB) using a modified Cochrane RoB tool and quality of evidence using Grading of Recommendations, Assessment, Development and Evaluation. Disagreement will be resolved by discussion and consultation with an external reviewer if necessary. Using a random-effects model, we will report effect sizes using relative risks and 95% CIs. We will perform predefined subgroup analyses: intracerebral haemorrhage versus ischaemic stroke; minor (NIHSS (National Institutes of Health Stroke Scale) ≤five) versus major (NIHSS >five) ischaemic stroke; ischaemic stroke with versus without thrombolysis; prehospital versus non-prehospital settings; time from stroke to randomisation ≤6 versus >6 hours and high versus low overall RoB studies. We will also perform trial sequential analysis for the primary outcomes.Ethics and disseminationEthics board approval is unnecessary. PROSPERO registration has been obtained. The results will be disseminated through publication in a peer-reviewed journal.PROSPERO registration numberCRD42020173093.

Clinical Utility of Intravascular Ultrasound (IVUS) in Carotid Artery Interventions: A Systematic Review and Meta-analysis

2021 ◽  
pp. 152660282110648
Author(s):  
B. Mishra ◽  
A. K. Pandit ◽  
S. Miyachi ◽  
T. Ohshima ◽  
R. Kawaguchi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Carotid Artery ◽  
Intravascular Ultrasound ◽  
Clinical Utility ◽  
English Literature ◽  
Meta Analysis ◽  
Randomized Controlled Studies ◽  
Stent Type ◽  
Pooled Prevalence ◽  
Practice Parameters

Background: Carotid plaque morphology plays an important role in determining outcome of carotid artery stenting (CAS). Intravascular ultrasound (IVUS) and its extension VH (Virtual Histology)-IVUS evaluate plaque characteristics in real time and guide decision making during stenting. To date, there is no consensus about indications of IVUS and its validated methods. This systematic review and meta-analysis aims to evaluate the clinical utility of IVUS in carotid artery interventions (CAS) and develop a future consensus for research and practice parameters. Methods: A systematic review and meta-analysis was performed of the English literature articles published till February 2021. Studies reporting on IVUS parameters and findings and also its performance compared with other imaging modalities were included in review. Pooled prevalence with 95% confidence intervals (CI) was calculated. The statistical analysis was conducted in R version 3.6.2. Results: A total of 2015 patients from 29 studies were included. Proportional meta-analysis was performed on 1566 patients from 11 studies. In 9 studies, stroke/transient ischemic attack (TIA) had a pooled prevalence of 4% (95% CI 3%–5%) while asymptomatic stroke had a pooled prevalence of 46% (95% CI 31%–62%) in 4 studies following IVUS. Two studies reported that IVUS detected more plaque protrusion compared with angiography (n=33/396 vs 11/396). IVUS led to stent type or size change in 8 of 48 cases which were missed on angiography in 3 other studies. Concordance between VH-IVUS and true histology was good at 80% to 85% reported in 2 studies. Conclusions: This systematic review and meta-analysis showed, though IVUS fared better to computed tomography (CT)/magnetic resonance (MR) angiography for better stent selection during CAS, with low to moderate risk of bias in the studies included. However, large scale, preferably randomized controlled studies are needed to predict its role in determining clinical outcome.

scholarly journals Endovascular Management of Acute Stroke in the Elderly: A Systematic Review and Meta-Analysis

2018 ◽  
Vol 39 (5) ◽  
pp. 887-891 ◽  
Author(s):  
C.A. Hilditch ◽  
P. Nicholson ◽  
M.H. Murad ◽  
A. Rabinstein ◽  
J. Schaafsma ◽  
...  
Keyword(s):  
Systematic Review ◽  
Acute Stroke ◽  
Meta Analysis ◽  
The Elderly ◽  
Endovascular Management

scholarly journals Telestroke strategies to enhance acute stroke management in rural settings: A systematic review and meta‐analysis

2020 ◽  
Vol 10 (10) ◽  
Author(s):  
Gilbert Lazarus ◽  
Affan Priyambodo Permana ◽  
Setyo Widi Nugroho ◽  
Jessica Audrey ◽  
Davin Nathan Wijaya ◽  
...  
Keyword(s):  
Systematic Review ◽  
Acute Stroke ◽  
Meta Analysis ◽  
Stroke Management ◽  
Rural Settings

A prognostic role for Low tri-iodothyronine syndrome in acute stroke patients: A systematic review and meta-analysis

2018 ◽  
Vol 169 ◽  
pp. 55-63 ◽  
Author(s):  
Nayan Lamba ◽  
Chunming Liu ◽  
Hasan Zaidi ◽  
M.L.D. Broekman ◽  
Thomas Simjian ◽  
...  
Keyword(s):  
Systematic Review ◽  
Acute Stroke ◽  
Meta Analysis ◽  
Prognostic Role ◽  
Stroke Patients

scholarly journals Lowering blood pressure after acute intracerebral haemorrhage: protocol for a systematic review and meta-analysis using individual patient data from randomised controlled trials participating in the Blood Pressure in Acute Stroke Collaboration (BASC)

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e030121 ◽  
Author(s):  
Tom J Moullaali ◽  
Xia Wang ◽  
Lisa J Woodhouse ◽  
Zhe Kang Law ◽  
Candice Delcourt ◽  
...  
Keyword(s):  
Systematic Review ◽  
Blood Pressure ◽  
Acute Stroke ◽  
Intracerebral Haemorrhage ◽  
Randomised Controlled Trials ◽  
Meta Analysis ◽  
Patient Data ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Randomised Controlled

IntroductionConflicting results from multiple randomised trials indicate that the methods and effects of blood pressure (BP) reduction after acute intracerebral haemorrhage (ICH) are complex. The Blood pressure in Acute Stroke Collaboration is an international collaboration, which aims to determine the optimal management of BP after acute stroke including ICH.Methods and analysisA systematic review will be undertaken according to the Preferred Reporting Items for Systematic review and Meta-Analysis of Individual Participant Data (IPD) guideline. A search of Cochrane Central Register of Controlled Trials, EMBASE and MEDLINE from inception will be conducted to identify randomised controlled trials of BP management in adults with acute spontaneous (non-traumatic) ICH enrolled within the first 7 days of symptom onset. Authors of studies that meet the inclusion criteria will be invited to share their IPD. The primary outcome will be functional outcome according to the modified Rankin Scale. Safety outcomes will be early neurological deterioration, symptomatic hypotension and serious adverse events. Secondary outcomes will include death and neuroradiological and haemodynamic variables. Meta-analyses of pooled IPD using the intention-to-treat dataset of included trials, including subgroup analyses to assess modification of the effects of BP lowering by time to treatment, treatment strategy and patient’s demographic, clinical and prestroke neuroradiological characteristics.Ethics and disseminationNo new patient data will be collected nor is there any deviation from the original purposes of each study where ethical approvals were granted; therefore, further ethical approval is not required. Results will be reported in international peer-reviewed journals.PROSPERO registration numberCRD42019141136.

Sign in / Sign up

Export Citation Format

Share Document