Internal medicine journal
-
Internal medicine journal · Feb 2024
Review Meta AnalysisEfficacy and safety of prophylactic anticoagulation in patients with primary nephrotic syndrome: a systematic review and meta-analysis.
Nephrotic syndrome (NS) is associated with an increased incidence of venous thromboembolism (VTE), approximately 10%. We performed a systematic review to evaluate the efficacy and safety of prophylactic anticoagulation in patients with NS. ⋯ Our findings suggest that prophylactic anticoagulation in adult patients with primary NS may reduce the risk of VTE, even if it may be associated with a not negligible bleeding risk.
-
Internal medicine journal · Nov 2023
Meta AnalysisDiagnostic test accuracy of D-dimer with or without a clinical decision rule in peripartum patients with suspected venous thromboembolism: A systematic review and meta-analysis.
Pregnancy and the peripartum period is a hypercoagulable state increasing the risk of venous thromboembolism (VTE). There may be a role in utilising D-dimer in the peripartum setting. ⋯ This review highlighted that D-dimer use in the peripartum period for detection of VTE had a high sensitivity and high DOR but a poor area under ROC, which may limit its use in clinical practice.
-
Internal medicine journal · Sep 2023
Review Meta AnalysisEfficacy and safety of non-vitamin K antagonist oral anticoagulants in patients(≥80 Years of Age) with atrial fibrillation: systematic review and meta-analysis.
Findings of prior studies about the efficacy and safety of non-vitamin K antagonist oral anticoagulants (NOACs) in patients (≥80 years of age) with atrial fibrillation (AF) are controversial. So we performed a meta-analysis to evaluate the efficacy and safety of NOACs versus vitamin K antagonists (VKAs) in patients (≥80 years of age) with AF. A systematic review of PubMed, Cochrane, Embase, Web of Science and Chinese BioMedical databases was conducted until 1 October 2022. ⋯ In conclusion, for patients (≥80 years of age) with AF, the risks of stroke and systemic embolism, all-cause mortality, were lower in NOACs compared to warfarin. The risks of major bleeding and ICH were also lower in NOACs compared to warfarin. NOACs showed better efficacy and safety than warfarin.
-
Internal medicine journal · Aug 2023
Review Meta AnalysisWeight Loss With Subcutaneous Semaglutide Versus Other Glucagon Like Peptide-1 Receptor Agonists In Type 2 Diabetes: A Systematic Review.
Glucagon-like peptide 1 receptor agonists (GLP-1 RAs) reduce elevated blood glucose levels and induce weight loss. Multiple GLP-1 RAs and one combined GLP-1/glucose-dependent insulinotropic polypeptide agonist are currently available. This review was conducted with the aim of summarising direct comparisons between subcutaneous semaglutide and other GLP-1 RAs in individuals with type 2 diabetes (T2D), particularly with respect to efficacy for inducing weight loss and improving other markers of metabolic health. ⋯ Comparators included liraglutide, exenatide, dulaglutide and tirzepatide. In the identified studies, multiple dosing regimens were utilised for semaglutide. Randomised trials support the superior efficacy of semaglutide over other GLP-1 RAs with respect to weight loss in T2D, but tirzepatide is more effective than semaglutide.
-
Internal medicine journal · May 2023
Review Meta AnalysisOne-Minute Preceptor and SNAPPS for clinical reasoning: a systematic review and meta-analysis.
Clinical reasoning teaching strategies could be important models to teach healthcare trainees. This study aims to assess the effectiveness of clinical reasoning teaching strategies (one-minute preceptor (OMP) and SNAPPS) for developing clinical reasoning skills, attitudes and satisfaction of medical/healthcare students and post-graduate trainees as compared to controls. A systematic review and meta-analysis of randomised controlled studies, with no restriction on language or publication date, were carried out by searching the PubMed, SCOPUS, ERIC, Web of Science, Embase and Cochrane Library databases. ⋯ The strategies for teaching clinical reasoning improved the performance of healthcare students and professionals on this skill, promoting deeper discussion of clinical cases and a higher number of differential diagnoses. Further good-quality trials are needed to corroborate these findings. PROSPERO Registration: CRD42020175992.