Current medical research and opinion
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Review Meta Analysis
Efficacy and safety of local anesthetics bupivacaine, ropivacaine and levobupivacaine in combination with sufentanil in epidural anesthesia for labor and delivery: a meta-analysis.
In epidural analgesia, synthetic opioids increase the potency of amide local anesthetics by modifying their analgesic properties. The purpose of this systematic review and meta-analysis is to compare the efficacy and safety of bupivacaine with ropivacaine and levobupivacaine in combination with sufentanil (BUPI-, ROPI-, and LBUPI-SUF respectively) in epidural analgesia for labor. ⋯ Whereas significantly longer labor analgesia can be achieved with ROPI-SUF and LBUPI-SUF and ropivacaine is associated with comparatively less motor blockade, labor duration after epidural analgesia has been found to be shorter in BUPI-SUF and there is a low incidence of instrumental delivery.
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Review Meta Analysis
The effect of a dual combination of noninsulin antidiabetic drugs on lipids: a systematic review and network meta-analysis.
As an ever widening array of anti-hyperglycemic agents are now available, the effect of these drugs on lipids is increasingly complex and controversial. The present meta-analysis was designed to clarify the effect of a dual combination of noninsulin anti-hyperglycemic agents on lipids in type 2 diabetes. ⋯ The effect of a dual combination of noninsulin anti-hyperglycemic agents on lipids is moderate to small, with metformin + DPP-4 inhibitor and metformin + GLP-1 agonist showing consistent beneficial effects on LDL cholesterol, HDL cholesterol, triglycerides and total cholesterol. Future trials are needed to confirm these findings.
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Effects of canagliflozin, a sodium glucose co-transporter 2 inhibitor, on serum electrolytes were evaluated using pooled data from studies of patients with type 2 diabetes mellitus (T2DM). ⋯ In patients with T2DM, canagliflozin was generally associated with small mean percent changes in serum electrolytes. Infrequent episodes of potassium elevation occurred with canagliflozin 300 mg, but occurred more often in patients with reduced eGFR.
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Review Meta Analysis Comparative Study
Systematic review of long-acting injectables versus oral atypical antipsychotics on hospitalization in schizophrenia.
To assess the impact of long-acting injectables (LAIs) versus oral antipsychotics (OAs) on hospitalizations among patients with schizophrenia by conducting a systematic literature review of studies with different study designs and performing a meta-analysis. ⋯ The primary results of this meta-analysis, including studies with both interventional and non-interventional designs and using meta-regressions, suggest that LAIs are associated with higher reductions in hospitalization rates for schizophrenia patients compared to OAs.
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Review Meta Analysis Comparative Study
Indirect comparison of bazedoxifene vs oral bisphosphonates for the prevention of vertebral fractures in postmenopausal osteoporotic women.
Compare the efficacy of bazedoxifene with oral bisphosphonates for reduction of vertebral fracture risk in postmenopausal osteoporotic (PMO) women and in higher-risk patients based on evidence from randomized controlled trials (RCTs). ⋯ The analyses only considered vertebral fractures for oral bisphosphonates versus bazedoxifene, and IPD was available only for bazedoxifene. In light of this, bazedoxifene is comparable to bisphosphonates in the overall PMO population and at least as effective as bisphosphonates for preventing vertebral fractures among higher-risk PMO patients. The findings suggest bazedoxifene performs better in higher-risk PMO than in the overall PMO.