scholarly journals Aspirin desensitization in NSAID-exacerbated respiratory disease and its outcomes in the clinical course of asthma: A systematic review of the literature and meta-analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0247871
Author(s):  
Isabel Eraso ◽  
Saveria Sangiovanni ◽  
Eliana I. Morales ◽  
Liliana Fernández-Trujillo
Keyword(s):  
Systematic Review ◽  
Lung Function ◽  
Respiratory Disease ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Previous History ◽  
Provocation Test ◽  
Clinical Effects ◽  
Aspirin Desensitization ◽  
Asthma Exacerbations

Background Nonsteroidal anti-inflammatory drug-exacerbated respiratory disease (NERD) might benefit from aspirin desensitization (AD) as an alternative treatment to standard care. However, there is conflicting evidence regarding its role in bronchial symptoms and asthma exacerbations. Objective To analyze the clinical effects of AD in terms of lung function, systemic and inhaled steroid use, the frequency of acute asthma exacerbations, and adverse effects in patients with NERD and asthma. Methodology We identified randomized clinical trials (RCTs) from PubMed, EMBASE, SCOPUS, and EBSCO. We also searched the RCT references for additional studies. Studies comparing AD to placebo in patients with a previous history of pulmonary symptoms triggered by ASA or other NSAIDs or with a positive provocation test to ASA were included. Primary results Five studies with 210 participants with NERD were included in this review. The study duration ranged from 3 to 6 months. Overall, the risk of bias across the included RCTs was low. We identified 3 studies evaluating lung function, 2 of which reported a significant improvement in FEV1 in the AD group after 6 months, while the other reported no difference among the treatments. Due to high heterogeneity, we did not pool the results. The remaining primary outcomes were reported only in a single study each, hindering their interpretation. Secondary outcomes revealed reduced symptom and medication scores in patients with AD. Conclusions Due to the small number of studies included in this systematic review, conclusions should be made with caution. AD shows a trend towards improving lung function (FEV1) following 6 months of treatment, although no conclusions can be made regarding the use of corticosteroids or the frequency of acute exacerbations. AD appears to reduce both symptom and medication scores. Additional RCTs are needed to fully assess the efficacy of AD in reducing bronchial symptoms in patients with NERD.

scholarly journals Effects of exercise training on physical and psychosocial health in children with chronic respiratory disease: a systematic review and meta-analysis

2018 ◽  
Vol 4 (1) ◽  
pp. e000409 ◽  
Author(s):  
Barbara Joschtel ◽  
Sjaan R Gomersall ◽  
Sean Tweedy ◽  
Helen Petsky ◽  
Anne B Chang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Lung Function ◽  
Exercise Training ◽  
Respiratory Disease ◽  
Effect Size ◽  
Meta Analysis ◽  
Chronic Respiratory Disease ◽  
Cardiovascular Fitness ◽  
Standard Mean Difference ◽  
Children With Asthma

IntroductionChronic disease in children is increasing, including the prevalence of chronic respiratory diseases such as asthma, cystic fibrosis (CF), bronchiectasis and bronchopulmonary dysplasia (BPD). The aim of this systematic review and meta-analysis was to evaluate the effects of exercise training on health outcomes in children with chronic respiratory disease.MethodFive databases were searched for randomised controlled trials investigating the effects of exercise training on children with chronic respiratory disease. Following the PRISMA guidelines, eligible studies were identified and data were extracted. A meta-analysis was conducted for the outcomes cardiovascular fitness, lung function and quality of life (QoL).ResultsThe initial search returned 3688 papers. Twenty-seven (17 in children with asthma, 10 in children with CF) were included in the systematic review and 24 of these were included in the meta-analysis. No studies were identified in children with bronchiectasis or BPD. Included papers had a total of 1009 participants aged 8–20 years. In addition to cardiovascular fitness, lung function and QoL, studies also assessed pulmonary function, respiratory muscle strength, muscular strength and inflammation. Meta-analysis showed a large significant effect size in favour of exercise for cardiovascular fitness (peak VO2) (standard mean difference (SMD)=1.16, 95%  CI 0.61 to 1.70) and QoL (SMD=1.27, 95% CI 0.72 to 1.82) as well as a small, non-significant effect size for lung function (FEV1) (SMD=0.02, 95% CI -0.38 to 0.42).ConclusionExercise training significantly improves cardiovascular fitness and QoL in children with asthma and CF. Further research is needed, particularly in children with bronchiectasis and BPD.

scholarly journals Clinical Effectiveness of Bulk-Fill and Conventional Resin Composite Restorations: Systematic Review and Meta-Analysis

Polymers ◽  
2020 ◽  
Vol 12 (8) ◽  
pp. 1786 ◽  
Author(s):  
Heber Isac Arbildo-Vega ◽  
Barbara Lapinska ◽  
Saurav Panda ◽  
César Lamas-Lara ◽  
Abdul Samad Khan ◽  
...  
Keyword(s):  
Systematic Review ◽  
Randomized Clinical Trials ◽  
Resin Composite ◽  
Meta Analysis ◽  
Color Stability ◽  
Clinical Effectiveness ◽  
Clinical Effects ◽  
Composite Restorations ◽  
Restoration Technique ◽  
Bibliographic Search

The objective of this systematic review and meta-analysis was to determine the clinical effectiveness of bulk-fill and conventional resin in composite restorations. A bibliographic search was carried out until May 2020, in the biomedical databases Pubmed/MEDLINE, EMBASE, Scopus, CENTRAL and Web of Science. The study selection criteria were: randomized clinical trials, in English, with no time limit, with a follow-up greater than or equal to 6 months and that reported the clinical effects (absence of fractures, absence of discoloration or marginal staining, adequate adaptation marginal, absence of post-operative sensitivity, absence of secondary caries, adequate color stability and translucency, proper surface texture, proper anatomical form, adequate tooth integrity without wear, adequate restoration integrity, proper occlusion, absence of inflammation and adequate point of contact) of restorations made with conventional and bulk resins. The risk of bias of the study was analyzed using the Cochrane Manual of Systematic Reviews of Interventions. Sixteen articles were eligible and included in the study. The results indicated that there is no difference between restorations with conventional and bulk resins for the type of restoration, type of tooth restored and restoration technique used. However, further properly designed clinical studies are required in order to reach a better conclusion.

Benefits and harms of aspirin desensitization for aspirin‐exacerbated respiratory disease: a systematic review and meta‐analysis

2019 ◽  
Vol 9 (12) ◽  
pp. 1409-1419 ◽  
Author(s):  
Derek K. Chu ◽  
Daniel J. Lee ◽  
Keith M. Lee ◽  
Holger J. Schünemann ◽  
Wojciech Szczeklik ◽  
...  
Keyword(s):  
Systematic Review ◽  
Respiratory Disease ◽  
Meta Analysis ◽  
Aspirin Desensitization ◽  
Aspirin Exacerbated Respiratory Disease

Meta-analysis Exploring Sinopulmonary Outcomes of Aspirin Desensitization in Aspirin-Exacerbated Respiratory Disease

2020 ◽  
pp. 019459982093213
Author(s):  
Mohamad R. Chaaban ◽  
David Moffatt ◽  
Alex E. Wright ◽  
James A. Cowthran ◽  
En Shuo Hsu ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Respiratory Disease ◽  
Meta Analysis ◽  
Forced Expiratory Volume ◽  
Life Assessment ◽  
Steroid Use ◽  
Aspirin Desensitization ◽  
Aspirin Exacerbated Respiratory Disease

Objective The objective of this study is to explore the sinopulmonary outcomes of aspirin desensitization through a systematic review and meta-analysis. Data Sources Embase and OVID Medline databases. Review Methods A systematic review of published articles on outcomes following aspirin desensitization in any language for relevant articles was performed in February 2019. Outcomes included sinonasal quality-of-life assessment, sense-of-smell scores, FEV-1 (forced expiratory volume in 1 second), and medication/steroid use. Results Thirteen studies met the inclusion criteria out of 6055 articles screened. Aspirin desensitization resulted in significant improvement in FEV-1 and reduction in asthma medication/steroid use ( P < .05). There was no significant improvement in the sinonasal quality of life of patients who underwent aspirin desensitization ( P = .098). Conclusion Aspirin desensitization appears to be effective in improving pulmonary outcomes and should be considered in the treatment of patients with aspirin-exacerbated respiratory disease. However, good-quality studies are still needed to determine the ideal protocol tailored to individual patients.

Maternal and Neonatal Effect of Fentanyl as a Premedication before Induction of General Anesthesia in Cesarean Surgery: A Systematic Review and Meta-analysis of Randomized Clinical Trials

2019 ◽  
Vol 15 (4) ◽  
pp. 232-237
Author(s):  
Mir Hadi Musavi ◽  
Behzad Jodeiri ◽  
Keyvan Mirnia ◽  
Morteza Ghojazadeh ◽  
Zeinab Nikniaz
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Cesarean Section ◽  
General Anesthesia ◽  
Apgar Score ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Intravenous Fentanyl ◽  
Neonatal Effect ◽  
Fentanyl Group

Background: Although, some clinical trials investigated the maternal and neonatal effect of fentanyl as a premedication before induction of general anesthesia in cesarean section, to the best of our knowledge, there is no systematic review to summarize these results. Objectives: The present systematic review and meta-analysis evaluated the maternal and neonatal effect of intravenous fentanyl as a premedication before induction of general anesthesia in cesarean section. Methods: The databases of Pubmed, Embase, Scopus and Cochrane library were searched till July 2017 to identify randomized clinical trials which evaluated the effects of intravenous fentanyl as a premedication before induction of general anesthesia compared with placebo on neonate first and fifth minute Apgar score and maternal heart rate and mean arterial pressure (MAP) in cesarean section. Standard Mean difference (SMD) was calculated and I-square statistic test was used for heterogeneity analysis. Results: The present systematic review and meta-analysis consisted of three clinical trials including 180 women in labor. Considering the results of meta-analysis, there is no significant differences between fentanyl and placebo in the case of Apgar score at 1 minute; however, the Apgar score of 5 minutes was significantly lower in fentanyl group compared with placebo (SMD -0.68, 95%CI: - 0.98, -0.38, p<0.001). In the term of maternal hemodynamics, the heart rate (SMD -0.43, 95%CI: - 0.72, -0.13, p=0.004) and MAP (SMD -0.78, 95% CI: -1.09, -0.48, p<0.001) in fentanyl group were significantly lower compared with placebo group. Conclusion: The present meta-analysis showed that using intravenous fentanyl as a premedication before induction of general anesthesia had adverse effects on neonate Apgar score. However, it had positive effects on preventing adverse consequences of intubation on maternal hemodynamics.

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