Articles: pediatrics.
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Heart failure (HF) in pediatric populations is a major public health concern. It is associated with high rates of hospital admissions, disability, and mortality in high-income countries (HIC), but its burden is poorly documented in low- and middle-income countries (LMICs). We present a protocol for a systematic review and meta-analysis to summarize available data on the prevalence, incidence, etiologies, treatment, and outcomes including hospital admission and mortality and economic burden of HF in neonates, infants, children, and adolescents in LMICs. ⋯ PROSPERO CRD42017070189.
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Critical care medicine · Jan 2018
Review Meta Analysis Comparative StudyVancomycin Plus Piperacillin-Tazobactam and Acute Kidney Injury in Adults: A Systematic Review and Meta-Analysis.
The objective of this systematic review and meta-analysis was to assess acute kidney injury with combination therapy of vancomycin plus piperacillin-tazobactam, in general, adult patients and in critically ill adults. Rates of acute kidney injury, time to acute kidney injury, and odds of acute kidney injury were compared with vancomycin monotherapy, vancomycin plus cefepime or carbapenem, or piperacillin-tazobactam monotherapy. ⋯ The combination of vancomycin plus piperacillin-tazobactam increased the odds of acute kidney injury over vancomycin monotherapy, vancomycin plus cefepime or carbapenem, and piperacillin-tazobactam monotherapy. Limited data in critically ill patients suggest the odds of acute kidney injury are increased versus vancomycin monotherapy, and mitigated versus the other comparators. Further research in the critically ill population is needed.
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Review Meta Analysis
Physiologic Growth Hormone Replacement Therapy and Craniopharyngioma Recurrence in Pediatric Patients: A Meta-Analysis.
A systematic review and meta-analysis were conducted to examine the effect of growth hormone-replacement therapy (GHRT) on the recurrence of craniopharyngioma in children. ⋯ This meta-analysis demonstrated a lower recurrence rate of craniopharyngioma among children treated with GHRT than those who were not.
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Review Meta Analysis
Is topiramate effective for migraine prevention in patients less than 18 years of age? A meta-analysis of randomized controlled trials.
Mainly based on evidence of success in adults, various medications are commonly used to prevent pediatric migraines. Topiramate has been approved for migraine prevention in children as young as 12 years of age. In this meta-analysis, we aimed to assess the currently published data pertaining to the efficacy of topiramate for migraine prevention in patients less than 18 years of age. ⋯ Topiramate may not achieve a more effective clinical trial endpoint than placebo in the prevention of migraines in patients less than 18 years of age, and topiramate may lead to more side effects or adverse events in the included patients.
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Review Meta Analysis
Vitamin D deficiency in critically ill children: a systematic review and meta-analysis.
Vitamin D deficiency (VDD) has been hypothesized not only to be common but also to represent a potentially modifiable risk factor for greater illness severity and clinical outcome during critical illness. The objective of this systematic review was to determine the frequency of VDD in pediatric critical illness and its association with clinical outcomes. ⋯ Approximately 50% of critically ill children have VDD at the time of PICU admission, defined as a blood total 25(OH)D concentration under 50 nmol/L. VDD was further determined to be associated with greater illness severity, multiple organ dysfunction, and mortality in the PICU setting. Clinical trials are required to determine if optimization of vitamin D status improves patient outcome.