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[Effectiveness of anti-emetics for the prophylaxis of cisplatin-induced delayed emesis: a systematic review]

We performed a systematic review of the effectiveness of anti-emetics for prophylaxis of cisplatin-induced delayed emesis using meta-analysis. We selected 12 reports of randomized controlled trials from MEDLINE (1966-2003. 4) and The Cochrane Library Issue 1, 2003. Nine of these reports were evaluated as high quality and the others as low quality according to the evaluation criteria of Jadad et al., and only the high-quality reports were subjected to meta-analysis. The statistical results obtained from all 12 reports were also compared with those obtained from the 9 reports of high quality. Corticosteroids significantly reduced the occurrence of delayed emesis. Metoclopramide tended to reduce the occurrence of delayed emesis, although not to a significant extent. In contrast, 5-HT3 receptor antagonists did not show a significant prophylactic effect on delayed emesis. Combination treatments using corticosteroids with metoclopramide or 5-HT3 receptor antagonists did not show significant additional benefits over corticosteroids alone. In conclusion, treatment with corticosteroids without additional metoclopramide or 5-HT3 receptor antagonists appears to be preferable for the prevention of delayed emesis induced by cisplatin.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2004

Review article: prophylactic metoclopramide for patients receiving intravenous morphine in the emergency setting; a systematic review and meta-analysis of randomized controlled trials

The objective of the present study was to conduct a systematic review and meta-analysis of randomized controlled trials, comparing metoclopramide with placebo, for preventing vomiting in patients who have received i.v. morphine for acute pain in the emergency setting, and to determine the level of evidence supporting the use of prophylactic metoclopramide in this population. Comprehensive systematic electronic searches were conducted of MEDLINE, EMBASE and the Cochrane Library for randomized controlled trials addressing the clinical question. Reference lists of identified articles were hand-searched. Methodologically appropriate clinical trials identified in the search process were included in a meta-analysis to provide a pooled estimate of effect. Three randomized controlled trials fulfilled the search criteria. All three studies were included in the final meta-analysis that demonstrated an overall result of no difference between metoclopramide and placebo for the primary outcome of vomiting (odds ratios 0.72; 95% confidence intervals 0.11-4.58). There was little evidence that routine prophylactic administration of metoclopramide following the administration of i.v. morphine for acute pain management in the emergency setting is clinically beneficial. Routine metoclopramide administration might expose patients to a risk of harm which is not justifiable given a lack of evidence of benefit.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2011

Metoclopramide for nausea and vomiting prophylaxis during and after caesarean delivery: a systematic review and meta-analysis

Nausea and vomiting occur commonly during and after Caesarean delivery (CD) performed under neuraxial anaesthesia. Metoclopramide is a prokinetic agent reported to be safe in parturients. This meta-analysis assesses the efficacy of metoclopramide for prophylaxis against intra- and postoperative nausea and vomiting (IONV and PONV) in parturients undergoing CD under neuraxial anaesthesia. We performed a literature search of MEDLINE (1966-2011), Cochrane Central Register of Controlled Trials, EMBASE (1947-2011), Google scholar, and CINAHL for randomized controlled trials which compared metoclopramide with placebo in women having CD under neuraxial anaesthesia. Eleven studies with 702 patients were included in the analysis. Administration of metoclopramide (10 mg) resulted in a significant reduction in the incidence of ION and IOV when given before block placement [relative risk (RR) (95% confidence interval, 95% CI)=0.27 (0.16, 0.45) and 0.14 (0.03, 0.56), respectively] or after delivery [RR (95% CI)=0.38 (0.20, 0.75) and 0.34 (0.18, 0.66), respectively]. The incidence of early (0-3 or 0-4 h) PON and POV [RR (95% CI)=0.47 (0.26, 0.87) and 0.45 (0.21, 0.93), respectively] and overall (0-24 or 3-24 h) PON (RR 0.69; 95% CI 0.52, 0.92) were also reduced with metoclopramide. Extra-pyramidal side-effects were not reported in any patient. In conclusion, this review suggests that metoclopramide is effective and safe for IONV and PONV prophylaxis in this patient population. Given the quality of the studies and the infrequent use of neuraxial opioids, these results should be interpreted with caution in current practice and further studies are needed to confirm those findings.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2012

Metoclopramide for the treatment of gastroesophageal reflux disease in infants: a systematic review

This review assessed the efficacy, effectiveness and toxicity of metoclopramide for the treatment of gastroesophageal reflux disease (GERD) in infants. Given the small number of studies found, the lack of similarity between the included studies in terms of population, metoclopramide doses and outcomes, and the small sample sizes and lack of consistency in the literature, the authors' conclusion that there is insufficient evidence to support or oppose the use of metoclopramide for GERD in infants seems appropriate.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2006

The relative efficacy of phenothiazines for the treatment of acute migraine: a meta-analysis

The authors concluded that phenothiazines were more effective than placebo for the treatment of migraine headache and had higher rates of clinical success than other agents. These conclusions are supported by the results of the review and are likely to be reliable.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2009

Meta-analysis of the effects of prokinetic agents in patients with functional dyspepsia

This review, which assessed the effectiveness of prokinetic agents in patients with functional dyspepsia, concluded that prokinetic agents are effective as a short-term treatment. The review appears to have been conducted appropriately, but the reliability and generalisability of the results is potentially hindered by a number of limitations identified with the included studies.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2007

Prokinetics in acute upper GI bleeding: a meta-analysis

This review investigated the effect of prokinetics on the effectiveness of gastroscopy in patients with acute upper gastrointestinal bleeding. The authors concluded that either erythromycin or metoclopramide effectively decreased the need for repeat endoscopy. Although the review was methodologically sound, the limited evidence and poor-quality included studies mean the authors’ conclusions should be treated with caution.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2010

Systematic review of the treatment of cancer-associated anorexia and weight loss

The review authors concluded that there was evidence supporting the use of progestins and corticosteroids and strong evidence against hydrazine sulphate; further research is required. The evidence presented appears to support the authors' conclusions, but poor reporting of review methods and the lack of an adequate quality assessment make it difficult to confirm the robustness of the conclusions.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2005

Dementia: A NICE-SCIE Guideline on Supporting People With Dementia and Their Carers in Health and Social Care

This guideline has been developed to advise on supporting people with dementia and their carers in health and social care. The guideline recommendations have been developed by a multidisciplinary team of health and social care professionals, a person with dementia, carers and guideline methodologists after careful consideration of the best available evidence. It is intended that the guideline will be useful to practitioners and service commissioners in providing and planning high-quality care for those with dementia while also emphasising the importance of the experience of care for people with dementia and carers.

NICE Clinical Guidelines - National Collaborating Centre for Mental Health (UK).

Version: 2007
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Antidysrhythmic drug therapy for the termination of stable, monomorphic ventricular tachycardia: a systematic review

OBJECTIVE: We performed a systematic review of the literature to compare the efficacy of different drug therapies for the termination of stable, monomorphic ventricular tachycardia (VT).

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2013

The use of antiarrhythmic drugs for adult cardiac arrest: a systematic review

There was no conclusive evidence that anti-arrhythmic drugs improved survival in adults with cardiac arrest. Given the limited quality of available studies, few suitably controlled trials and the absence of statistical data, the authors' cautious conclusions are appropriate. However, the strength of evidence in the review does not support the recommendations for practice.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2011

Treatment of new-onset atrial fibrillation in noncardiac intensive care unit patients: a systematic review of randomized controlled trials

The authors found insufficient evidence to make recommendations about standard treatment of noncardiac critically ill patients with new-onset atrial fibrillation. Despite some concerns about the risk of language and publication bias, this was generally a well-conducted review and the authors’ conclusions were likely to be reliable.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2008

Systematic review and meta-analysis of the efficacy of cardioversion by vernakalant and comparators in patients with atrial fibrillation

This review concluded that results suggested vernakalant intravenous, propafenone intravenous and flecainide appeared to be effective in achieving rapid cardioversion in patients with short duration atrial fibrillation compared to other agents. Given the limitations of the review, and limited data available for some of the the interventions, the reliability of the conclusions is uncertain.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2012

Pharmacologic strategies for prevention of atrial fibrillation after open heart surgery

This review found that treatments for preventing atrial fibrillation after heart surgery were effective, but no single drug was shown to be consistently superior. The main recommendations were the use of beta-blockers, unless contraindicated, and the treatment of electrolyte deficiencies. Those at higher risk should also receive amiodarone or sotalol. There were some problems with the methodology used in the review.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2005

Dietary Supplements in Adults Taking Cardiovascular Drugs [Internet]

A substantial proportion of patients with cardiovascular diseases use dietary supplements in anticipation of benefit. This also poses risks of adverse events from supplement-drug interactions and nonadherence associated with polypharmacy.

Comparative Effectiveness Reviews - Agency for Healthcare Research and Quality (US).

Version: April 2012
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Cardiopulmonary Syndromes (PDQ®): Health Professional Version

Expert-reviewed information summary about common conditions that produce chest symptoms. The cardiopulmonary syndromes addressed in this summary are cancer-related dyspnea, malignant pleural effusion, pericardial effusion, and superior vena cava syndrome.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: October 21, 2014

Drug Class Review: Beta Adrenergic Blockers: Final Report Update 4 [Internet]

Beta blockers inhibit the chronotropic, inotropic, and vasoconstrictor responses to the catecholamines, epinephrine, and norepinephrine. Beta blockers differ in their duration of effect (3 hours to 22 hours), the types of beta receptors they block (β1-selective or β1/β2-nonselective), whether they are simultaneously capable of exerting low level heart rate increases (intrinsic sympathomimetic activity [ISA]), and in whether they provide additional blood vessel dilation effects by also blocking alpha-1 receptors. All beta blockers are approved for the treatment of hypertension. Other US Food and Drug Administration-approved uses are specific to each beta blocker and include stable and unstable angina, atrial arrhythmias, bleeding esophageal varices, coronary artery disease, asymptomatic and symptomatic heart failure, migraine, and secondary prevention of post-myocardial infarction. The objective of this review was to evaluate the comparative effectiveness and harms of beta blockers in adult patients with hypertension, angina, coronary artery bypass graft, recent myocardial infarction, heart failure, atrial arrhythmia, migraine or bleeding esophageal varices.

Drug Class Reviews - Oregon Health & Science University.

Version: July 2009
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Drug treatment for myotonia (delayed muscle relaxation after contraction) in muscle diseases such as myotonic dystrophy and myotonia congenita

Myotonia is an abnormal delay in the relaxation of muscles after contraction. It is a key symptom in a number of muscle diseases called myotonic disorders. It can be mild or severe, interfering with daily activities such as walking, climbing stairs or opening and closing the eyelids. It can be worse after periods of rest or triggered by cold or fatigue. People with mild myotonia can manage their disease without medication but in severe cases treatment is usually necessary. Drugs that have been used to treat myotonia include sodium channel blockers such as procainamide, phenytoin and mexiletine, tricyclic antidepressant drugs such as clomipramine or imipramine, benzodiazepines, calcium antagonists, taurine and prednisone. This review describes ten randomised controlled trials which tested the effectiveness of twelve different drug treatments. The review was updated in July 2009 and no new trials were found. The ten trials included a total of 143 participants of which 113 had myotonic dystrophy and 30 had myotonia congenita. The trials were generally small and of poor quality. Meta‐analysis was not possible due to a lack of appropriate trials and data. Two small studies suggested that clomipramine and imipramine might have a short‐term beneficial effect on the myotonia in myotonic dystrophy and one small study suggested that taurine might have a long‐term beneficial effect in myotonic dystrophy. Minor side effects such as dry mouth and dizziness were reported with clomipramine and imipramine, but not with taurine. It was not possible to determine whether drug treatment is safe and effective for myotonia in people with a myotonic disorder based on the evidence from the ten trials included in this review. Larger, well‐designed randomised controlled trials are needed.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Rhythm vs rate control of atrial fibrillation meta-analysed by number needed to treat

This review looked at rate control versus rhythm control for atrial fibrillation. The authors found that rate control was associated with a lower incidence of hospitalisation, but there were little other differences in outcomes. They concluded that rate control was preferable. There were a number of problems with the review and the conclusion may not, therefore, be reliable.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2005

Rate-control vs. rhythm-control in patients with atrial fibrillation: a meta-analysis

This review looked at two strategies for treating atrial fibrillation: rate control by means of drugs compared with rhythm control by cardioversion followed by prophylactic drugs. The authors found that rate control was associated with a lower risk of death or thromboembolic stroke. Although information on some aspects of the review process was missing, the conclusions are likely to be reliable.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2005

Systematic Reviews in PubMed

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