INTRODUCTION: Collecting information about drugs in clinical practice is essential for ongoing riskbenefit analysis of the drug use. Medical literature is an important source of new information on drug safety, in particular for the signal assessment. A signal is an information about a new potentially causal association, or a new aspect of a known association (e.g. change in frequency or severity of the reaction) between a drug and an adverse event (AE). AIM OF THE STUDY: To verify the effectiveness of the identification of adverse drug reaction (ADR) reports published in the local medical literature using MEDLINE and Embase, versus manual full text review of journals. MATERIAL AND METHODS: The study was performed for 20 randomly selected drugs and 84 Polish medical journals and covers a review of 1,576 individual journal issues with 20,146 articles. Retrospective analysis of literature reports collected during manual full text review was performed and compared to the outcome of database search. RESULTS: ADRs for analyzed drugs were identified only in 17 out of 84 journals, as a result of which 66 reports were analyzed. The majority of reports (55%) were found in local non-indexed journals. Three reports originated from journals indexed in MEDLINE and 9 reports from journals indexed in Embase were not found in these databases because databases do not fully cover conference abstracts and journal supplements. Moreover, while using databases for ADR report search there is a risk of missing up to 30% of ADR reports. The average gap between article publication date and database entry was 119 days. CONCLUSIONS: We verified that the effectiveness of the identification of ADR reports published in the local medical literature is more accurate based on manual full text review than by searching in bibliographic databases.
- MeSH
- Humans MeSH
- MEDLINE MeSH
- Drug-Related Side Effects and Adverse Reactions * MeSH
- Periodicals as Topic * MeSH
- Retrospective Studies MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Review MeSH
- Geographicals
- Poland MeSH
The Diabetes and Nutrition Study Group (DNSG) of the European Association for the Study of Diabetes (EASD) conducted a review of existing systematic reviews and meta-analyses to explain the relationship between different dietary patterns and patient-important cardiometabolic outcomes. To update the clinical practice guidelines for nutrition therapy in the prevention and management of diabetes, we summarize the evidence from these evidence syntheses for the Mediterranean, Dietary Approaches to Stop Hypertension (DASH), Portfolio, Nordic, liquid meal replacement, and vegetarian dietary patterns. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was used to assess the quality of evidence. We summarized the evidence for disease incidence outcomes and risk factor outcomes using risk ratios (RRs) and mean differences (MDs) with 95% confidence intervals (CIs), respectively. The Mediterranean diet showed a cardiovascular disease (CVD) incidence (RR: 0.62; 95%CI, 0.50, 0.78), and non-significant CVD mortality (RR: 0.67; 95%CI, 0.45, 1.00) benefit. The DASH dietary pattern improved cardiometabolic risk factors (P < 0.05) and was associated with the decreased incidence of CVD (RR, 0.80; 95%CI, 0.76, 0.85). Vegetarian dietary patterns were associated with improved cardiometabolic risk factors (P < 0.05) and the reduced incidence (0.72; 95%CI: 0.61, 0.85) and mortality (RR, 0.78; 95%CI, 0.69, 0.88) of coronary heart disease. The Portfolio dietary pattern improved cardiometabolic risk factors and reduced estimated 10-year coronary heart disease (CHD) risk by 13% (-1.34% (95%CI, -2.19 to -0.49)). The Nordic dietary pattern was correlated with decreased CVD (0.93 (95%CI, 0.88, 0.99)) and stroke incidence (0.87 (95%CI, 0.77, 0.97)) and, along with liquid meal replacements, improved cardiometabolic risk factors (P < 0.05). The evidence was assessed as low to moderate certainty for most dietary patterns and outcome pairs. Current evidence suggests that the Mediterranean, DASH, Portfolio, Nordic, liquid meal replacement and vegetarian dietary patterns have cardiometabolic advantages in populations inclusive of diabetes.
- MeSH
- Dietary Approaches To Stop Hypertension MeSH
- Diabetes Mellitus diet therapy MeSH
- Diet, Vegetarian MeSH
- Diet * MeSH
- Cardiovascular Diseases epidemiology mortality prevention & control MeSH
- Diabetes Complications epidemiology prevention & control MeSH
- Humans MeSH
- MEDLINE MeSH
- Meta-Analysis as Topic MeSH
- Metabolic Diseases epidemiology prevention & control MeSH
- Nutrition Therapy methods MeSH
- Risk Factors MeSH
- Diet, Mediterranean MeSH
- Systematic Reviews as Topic MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Review MeSH
- Geographicals
- Scandinavian and Nordic Countries MeSH
Účel přehledu: U většiny pacientů lze astma snadno zvládat standardní kombinací léčiv, která zahrnuje inhalačně podávané kontrolující a úlevová léčiva, avšak v oblasti onemocnění těžkého stupně nejsou potřeby léčby dosud naplněny. U pacientů s těžkým refrakterním astmatem zůstává hlavní prioritou vývoj bezpečnějších a účinnějších léčivých prostředků. V tomto článku podáváme přehled o léčivech vyvíjených pro léčbu těžkého astmatu, přičemž vysvětlujeme jejich specifický mechanismus účinku a zaměřujeme se na biologická léčiva. Literární zdroje byly vyhledány pomocí databáze publikací Medline a práce byly vybrány na základě relevance tématu. Prozkoumáváme existující údaje o účinnosti a bezpečnosti na základě klinických studií s některými novými biologickými léčivy, která jsou vyvíjena pro léčbu astmatu. Nové poznatky: Přestože jsou k dispozici silné preklinické údaje pro mnohé nedávno identifikované cíle léčby astmatu, zejména ty, které se vztahují k alergické Th2‑dráze, výsledky klinických studií se specifickými biologickými léčivy jsou prozatím spíše zklamáním. Prostor pro jejich využití by však mohl být v určitých přesně definovaných skupinách pacientů s těžkým astmatem. Souhrn: Je jasné, že bude nutné vyvinout další značné úsilí ke stanovení nových a účinnějších cílů léčby. K dosažení úspěchu je nutná úzká spolupráce mezi průmyslem, akademickou obcí a zdravotníky.
- MeSH
- Biological Therapy * methods trends MeSH
- Asthma * immunology therapy MeSH
- Clinical Trials as Topic MeSH
- Humans MeSH
- MEDLINE MeSH
- Th2 Cells * immunology MeSH
- Check Tag
- Humans MeSH
- Publication type
- Review MeSH
- MeSH
- Biomedical Research methods trends MeSH
- Health Care Economics and Organizations MeSH
- Epidemiologic Methods MeSH
- Holistic Health classification standards trends MeSH
- Quality of Life MeSH
- Libraries, Medical * MeSH
- Humans MeSH
- Medical Subject Headings MeSH
- Evidence-Based Medicine MeSH
- MEDLINE MeSH
- United Nations MeSH
- Surveys and Questionnaires standards utilization MeSH
- PubMed MeSH
- Statistics as Topic MeSH
- World Health Organization MeSH
- Public Health Systems Research methods trends MeSH
- Investigative Techniques * MeSH
- Health Behavior classification MeSH
- Health * classification standards trends MeSH
- Check Tag
- Humans MeSH
OBJECTIVE: The aim of the present systematic review and meta-analysis was to evaluate the safety and efficacy of intensive blood pressure (BP) reduction in patients with acute-onset intracerebral hemorrhage (ICH) using data from randomized controlled trials. METHODS: We conducted a systematic review and meta-analysis according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines of all available randomized controlled trials that randomized patients with acute ICH to either intensive or guideline BP-reduction protocols. RESULTS: We identified 4 eligible studies, including a total of 3,315 patients (mean age 63.4 ± 1.4 years, 64% men). Death rates were similar between patients randomized to intensive BP-lowering treatment and those receiving guideline BP-lowering treatment (odds ratio = 1.01, 95% confidence interval: 0.83-1.23; p = 0.914). Intensive BP-lowering treatment tended to be associated with lower 3-month death or dependency (modified Rankin Scale grades 3-6) compared with guideline treatment (odds ratio = 0.87, 95% confidence interval: 0.76-1.01; p = 0.062). No evidence of heterogeneity between estimates (I(2) = 0%; p = 0.723), or publication bias in the funnel plots (p = 0.993, Egger statistical test), was detected. Intensive BP reduction was also associated with a greater attenuation of absolute hematoma growth at 24 hours (standardized mean difference ± SE: -0.110 ± 0.053; p = 0.038). CONCLUSIONS: Our findings indicate that intensive BP management in patients with acute ICH is safe. Fewer intensively treated patients had unfavorable 3-month functional outcome although this finding did not reach significance. Moreover, intensive BP reduction appears to be associated with a greater attenuation of absolute hematoma growth at 24 hours.
- MeSH
- Antihypertensive Agents therapeutic use MeSH
- Cerebral Hemorrhage complications drug therapy MeSH
- Intracranial Hemorrhage, Hypertensive drug therapy etiology MeSH
- Blood Pressure drug effects physiology MeSH
- Humans MeSH
- MEDLINE statistics & numerical data MeSH
- Randomized Controlled Trials as Topic statistics & numerical data MeSH
- Check Tag
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Meta-Analysis MeSH
- Research Support, Non-U.S. Gov't MeSH
- Review MeSH
- MeSH
- Acquired Immunodeficiency Syndrome epidemiology prevention & control transmission MeSH
- Influenza, Human prevention & control MeSH
- Databases, Factual trends utilization MeSH
- Epidemics prevention & control MeSH
- Gonorrhea epidemiology prevention & control transmission MeSH
- Journal Impact Factor MeSH
- Congresses as Topic MeSH
- Communicable Disease Control methods organization & administration trends MeSH
- Humans MeSH
- Malaria epidemiology prevention & control transmission MeSH
- MEDLINE trends utilization MeSH
- International Agencies MeSH
- Pandemics prevention & control MeSH
- Periodicals as Topic MeSH
- PubMed trends utilization MeSH
- Shiga-Toxigenic Escherichia coli isolation & purification pathogenicity MeSH
- West Nile virus isolation & purification pathogenicity MeSH
- Anniversaries and Special Events MeSH
- Check Tag
- Humans MeSH
- MeSH
- Kidney Calculi MeSH
- Humans MeSH
- Evidence-Based Medicine MeSH
- MEDLINE utilization MeSH
- Kidney Neoplasms MeSH
- Nephrostomy, Percutaneous methods instrumentation utilization MeSH
- Tomography, X-Ray Computed methods utilization MeSH
- Postoperative Complications MeSH
- Radiography methods utilization MeSH
- Reference Standards MeSH
- Quality Control MeSH
- Statistics as Topic MeSH
- Ultrasonography methods utilization MeSH
- Check Tag
- Humans MeSH
- Publication type
- Practice Guideline MeSH
- MeSH
- Blood Pressure Monitoring, Ambulatory methods utilization MeSH
- Stroke complications mortality prevention & control MeSH
- Databases, Factual utilization MeSH
- Financing, Organized MeSH
- Myocardial Infarction complications mortality prevention & control MeSH
- Cardiovascular Diseases etiology mortality prevention & control MeSH
- Humans MeSH
- Masked Hypertension diagnosis MeSH
- Evidence-Based Medicine methods trends MeSH
- MEDLINE utilization MeSH
- Blood Pressure Determination methods trends utilization MeSH
- Prognosis MeSH
- Prospective Studies MeSH
- Statistics as Topic MeSH
- White Coat Hypertension diagnosis complications MeSH
- Check Tag
- Humans MeSH
- Publication type
- Meta-Analysis MeSH
- Review MeSH
- MeSH
- Cephalosporins contraindications MeSH
- Humans MeSH
- MEDLINE utilization MeSH
- Patients MeSH
- Penicillins MeSH
- Information Storage and Retrieval utilization MeSH
- Cross Reactions MeSH
- Check Tag
- Humans MeSH
- Publication type
- Newspaper Article MeSH
