Scientific reports
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Meta Analysis Comparative Study
Mechanical versus manual chest compressions for out-of-hospital cardiac arrest: a meta-analysis of randomized controlled trials.
Recent evidence regarding mechanical chest compressions in out-of-hospital cardiac arrest (OHCA) is conflicting. The objective of this study was to perform a meta-analysis of randomized controlled trials (RCTs) to compare the effect of mechanical versus manual chest compressions on resuscitation outcomes in OHCA. PubMed, Embase, the Cochrane Central Register of Controlled Trials, and the ClinicalTrials.gov registry were searched. ⋯ Compared with manual chest compressions, mechanical chest compressions did not significantly improve survival with good neurological outcome to hospital discharge (relative risks (RR) 0.80, 95% CI 0.61-1.04, P = 0.10; I(2) = 65%), return of spontaneous circulation (RR 1.02, 95% CI 0.95-1.09, P = 0.59; I(2) = 0%), or long-term (≥6 months) survival (RR 0.96, 95% CI 0.79-1.16, P = 0.65; I(2) = 16%). In addition, mechanical chest compressions were associated with worse survival to hospital admission (RR 0.94, 95% CI 0.89-1.00, P = 0.04; I(2) = 0%) and to hospital discharge (RR 0.88, 95% CI 0.78-0.99, P = 0.03; I(2) = 0%). Based on the current evidence, widespread use of mechanical devices for chest compressions in OHCA cannot be recommended.
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Although the FDA revoked metastatic breast cancer (MBC) from bevacizumab (BEV) indication in 2011, BEV combined with paclitaxel has been written in the breast cancer NCCN guidelines. This systematic assessment was performed to evaluate the efficacy and safety of BEV + chemotherapy (CHE) for managing MBC. PubMed and EMBASE were searched for original articles written in English and published before July, 2015. ⋯ Significantly more grade 3 febrile neutropenia, hypertension, proteinuria, and cardiac events were observed in the CHE + BEV arm, which are controllable and reversible. Severe bleeding occurred more in the BEV + taxane arms and in patients with brain metastases. Therefore, CHE + BEV significantly increases progression-free survival in patients with MBC, it should be considered as a treatment option for these patients under the premise of reasonable selection of target population and combined CHE drugs.
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Both chemotherapy and epidermal growth factor receptor tyrosine kinase inhibitors (EGFR TKIs) are widely applied for the treatment of non-small cell lung cancer (NSCLC), but the efficacy of these two treatments in combination is not yet clear. Thus, we sought to evaluate the efficacy of the intercalated combination of these two treatments in NSCLC. ⋯ The statistical results showed that the intercalated combination of chemotherapy and EGFR TKIs significantly improved overall survival (OS) (hazard ratio (HR) = 0.83, 95% confidence interval (CI): 0.70-0.98), progression-free survival (PFS) (HR = 0.65, 95% CI: 0.51-0.84), and the objective response rate (ORR) (risk ratio (RR) = 1.90, 95% CI: 1.22-2.98) compared to chemotherapy alone. Similarly, compared to EGFR TKIs monotherapy, the intercalated combination of chemotherapy and EGFR TKIs seemed superior to EGFR TKIs alone in terms of PFS, ORR and DCR (PFS: HR = 0.75, 95% CI: 0.62-0.91, ORR: RR = 1.49, 95% CI: 1.12-2.00 and DCR: RR = 1.33, 95% CI: 1.15-1.54) in advanced NSCLC therapy.