Postgraduate medicine
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Postgraduate medicine · Jan 2017
Review Meta Analysis Comparative StudyIncreased plasma/serum levels of prolactin in systemic lupus erythematosus: a systematic review and meta-analysis.
Prolactin (PRL), a polypeptide hormone produced by the pituitary gland, is involved in the regulation of humoral and cell mediated immune responses. PRL levels have been investigated in several autoimmune diseases including systemic lupus erythematosus (SLE), however, yielded different and inconsistent results. This study aims to derive a more precise evaluation on plasma/serum PRL levels in SLE patients, as well as the potential influential factors. ⋯ Overall, our study suggests that SLE patients have higher plasma/serum PRL level, but with a regional difference.
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Postgraduate medicine · Aug 2016
Review Meta AnalysisPositive penicillin allergy testing results: a systematic review and meta-analysis of papers published from 2010 through 2015.
β-lactam antibiotics are the most widely used group of antibiotics, given their effectiveness for the most common bacterial pathogens and their relatively low price. Adverse reactions, mainly cutaneous, are often reported to be associated with their use and hence, less effective and usually more costly alternative antibiotics are prescribed. However, it is not clear what is the risk of immediate immune-mediated (i.e. developing within one hour of administration) and potentially life-threatening reactions among those using β-lactam antibiotic. ⋯ The I(2) value ranged between 87.2% and 97.0%. Our results indicate that the prevalence of immediate reactions is higher in adults than in children. However, wide confidence intervals and a large study heterogeneity preclude conclusive estimates.
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Postgraduate medicine · Jan 2016
Review Meta AnalysisEfficacy of methylnaltrexone for the treatment of opiod-induced constipation: a meta-analysis and systematic review.
Constipation is a common adverse effect in patients requiring long-term opioid therapy for pain control. Methylnaltrexone, a quaternary peripheral mu-opioid receptor antagonist, is an effective treatment of opioid induced constipation (OIC) without affecting centrally mediated analgesia. Our objective was to conduct a review and meta-analysis to evaluate the efficacy of methylnaltrexone for treatment of OIC, as well as to provide a clinical discussion regarding newly developed alternatives and provide the current treatment algorithm utilized at our institution. ⋯ Results support the use of methylnaltrexone. Furthermore, the use of methylnaltrexone to induce laxation may decrease use of health care resources, increase work productivity, and improve cost utilization. New treatments have been made available; however, controlled clinical studies are needed to demonstrate long-term efficacy, safety and cost-effectiveness. Possible limitations of this study include the relatively small number of randomized, placebo-controlled trials investigating the efficacy of methylnaltrexone versus placebo. There is also the possibility of publication bias, which may lead to overestimating the efficacy of methylnaltrexone in treating OIC.
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Postgraduate medicine · Aug 2015
Review Meta AnalysisPhysical urticaria: Review on classification, triggers and management with special focus on prevalence including a meta-analysis.
Physical urticaria (PU) is a subset of chronic urticaria (CU) induced by physical stimuli. To date, there is no consensus in the literature on the prevalence of PU among patients with CU. ⋯ Our results must be viewed with circumspection because of the small number of eligible articles and heterogeneity among studies. Even so, the results suggest that PU is an important subset of CU and that physicians should be aware of this important condition in order to manage patients appropriately.
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Postgraduate medicine · Jun 2015
Meta AnalysisEfficacy and safety of the dipeptidyl peptidase-4 inhibitor linagliptin in black/African American patients with type 2 diabetes: Pooled analysis from eight Phase III trials.
The prevalence of type 2 diabetes in black/African Americans from North and South America is high; yet data evaluating antidiabetic agents in this population is scarce. To address this gap, we pooled data from the clinical development program for linagliptin. ⋯ Linagliptin provided clinically significant improvements in glycemic control without increased risk of hypoglycemia and without weight gain, representing a useful type 2 diabetes therapy option for the black/African American population.