• MeSH
• metaanalýza jako téma * MeSH
• statistika jako téma MeSH
• Publikační typ
• metaanalýza MeSH
• příručky MeSH

• Konspekt
• Statistika
• NLK Obory
• statistika, zdravotnická statistika

• MeSH
• lékařství MeSH
• metaanalýza jako téma MeSH
• náklady a analýza nákladů MeSH
• Publikační typ
• metaanalýza MeSH

• Konspekt
• Lékařské vědy. Lékařství
• NLK Obory
• lékařství
• management, organizace a řízení zdravotnictví

Introduction: It has been hypothesized that transurethral en bloc (TUEB) of bladder tumor offers benefits over conventional transurethral resection of bladder tumor (cTURBT). This study aimed to compare disease outcomes of TUEB and cTURBT with focus on the different energy sources. Methods: A systematic search was performed using PubMed and Web of Science databases in June 2021. Studies that compared the pathological (detrusor muscle presence), oncological (recurrence rates) efficacy, and safety (serious adverse events [SAEs]) of TUEB and cTURBT were included. Random- and fixed-effects meta-analytic models and Bayesian approach in the network meta-analysis was used. Results: Seven randomized clinical trials (RCTs) and seven non-RCTs (NRCT), with a total of 2092 patients. The pooled 3- and 12-month recurrence risk ratios (RR) of five and four NRCTs were 0.46 (95% CI 0.29-0.73) and 0.56 (95% CI 0.33-0.96), respectively. The pooled 3- and 12-month recurrence RRs of four and seven RCTs were 0.57 (95% CI 0.25-1.27) and 0.89 (95% CI 0.69-1.15), respectively. The pooled RR for SAEs such as prolonged hematuria and bladder perforation of seven RCTs was 0.16 (95% CI 0.06-0.41) in benefit of TUEB. Seven RCTs (n = 1077) met our eligibility criteria for network meta-analysis. There was no difference in 12-month recurrence rates between hybridknife, laser, and bipolar TUEB compared with cTURBT. Contrary, laser TUEB was significantly associated with lower SAEs compared with cTURBT. Surface under the cumulative ranking curve ranking analyses showed with high certainty that laser TUEB was the best treatment option to access all endpoints. Conclusion: While NRCTs suggested a recurrence-free benefit to TUEB compared with cTURBT, RCTs failed to confirm this. Conversely, SAEs were consistently and clinically significantly better for TUEB. Network meta-analyses suggested laser TUEB has the best performance compared with other energy sources. These early findings need to be confirmed and expanded upon.

• MeSH
• cystektomie škodlivé účinky   MeSH
• lidé MeSH
• nádory močového měchýře * patologie   chirurgie   MeSH
• síťová metaanalýza MeSH
• urologické chirurgické výkony MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• metaanalýza MeSH
• systematický přehled MeSH

• MeSH
• lékařství MeSH
• metaanalýza jako téma MeSH
• výzkum MeSH

• Konspekt
• Lékařské vědy. Lékařství
• NLK Obory
• management, organizace a řízení zdravotnictví
• lékařství

• MeSH
• klinické zkoušky jako téma MeSH
• metaanalýza jako téma MeSH
• Publikační typ
• klinické zkoušky MeSH

• Konspekt
• Statistika
• NLK Obory
• statistika, zdravotnická statistika
• diagnostika

Recently, concerns regarding the safety of red yeast rice (RYR) have been raised after the publication of some case reports claiming toxicity. Since the previous meta-analyses on the effects of RYR were mainly focused on its efficacy to improve lipid profile and other cardiovascular parameters, we carried out a meta-analysis on safety data derived from the available randomized controlled clinical trials (RCTs). Primary outcomes were musculoskeletal disorders (MuD). Secondary outcomes were non-musculoskeletal adverse events (Non-MuD) and serious adverse events (SAE). Subgroups analyses were carried out considering the intervention (RYR alone or in association with other nutraceutical compounds), monacolin K administered daily dose (≤3, 3.1-5 or >5 mg/day), follow-up (>12 or ≤12 weeks), with statin therapy or statin-intolerance and type of control treatment (placebo or statin treatment). Data were pooled from 53 RCTs comprising 112 treatment arms, which included 8535 subjects, with 4437 in the RYR arm and 4303 in the control one. Monacolin K administration was not associated with increased risk of MuD (odds ratio (OR) = 0.94, 95% confidence interval (CI) 0.53,1.65). Moreover, we showed reduced risk of Non-MuD (OR = 0.59, 95%CI 0.50, 0.69) and SAE (OR = 0.54, 95%CI 0.46, 0.64) vs. control. Subgroups analyses confirmed the high tolerability profile of RYR. Furthermore, increasing daily doses of monacolin K were negatively associated with increasing risk of Non-MuD (slope: -0.10; 95%CI: -0.17, -0.03; two-tailed p < 0.01). Based on our data, RYR use as lipid-lowering dietary supplement seems to be overall tolerable and safe in a large kind of moderately hypercolesterolaemic subjects.

• MeSH
• biologické přípravky škodlivé účinky   MeSH
• lidé MeSH
• muskuloskeletální nemoci MeSH
• potravní doplňky škodlivé účinky   MeSH
• randomizované kontrolované studie jako téma MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• metaanalýza MeSH
• systematický přehled MeSH

Systematické přehledy se široce využívají jako prostředek medicíny založené na důkazech. Systematický přehled je metoda hledání, hodnocení a syntéza evidence. Meta-analýza znamená kvantitativní syntézu výsledků klinických pokusů nebo jiných primárních studií. Podáváme jednoduchý úvod do této metody, popisujeme dva příklady aplikace v medicíně, její přednosti a slabostí.

Systematic reviews are widely used in medicine as a method of decision making based on evidences. The systematic review is a method of locating and evaluation of a synthesising evidence. Meta-analysis refers to quantitative synthesis of the results of clinical trials or other primary studdis. Simple introductory account about meta-analysis is given. We describe two examples of meta-analysis application and strengths and weaknesses of this research method.

• MeSH
• finanční podpora výzkumu jako téma MeSH
• homeopatie MeSH
• lidé MeSH
• medicína založená na důkazech MeSH
• statistika jako téma MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• klinické zkoušky MeSH
• metaanalýza MeSH
• přehledy MeSH

The nutrition of soccer players is an important topic and its knowledge may help to increase the quality of this popular game and prevent possible health problems and injuries in players. This meta-analysis aims to estimate the current dietary trends of three basic macronutrients in junior and senior soccer players during the first two decades of the 21st century. We analyzed data from 647 junior players (mean age 10.0-19.3) from 27 groups, and 277 senior (mean age 20.7-27.1) players from 8 groups from altogether 21 papers in this meta-analysis. Weighted averages were calculated for each macronutrients. Protein intake is higher than recommended in both juniors, 1.9 95% confidence interval (CI) 1.8-2.0 g/kg/day, and seniors 1.8 95% CI 1.6-2.0 g/kg/day. However, carbohydrate intake is still below the recommended values in both groups (5.7 95% CI 5.5-5.9 g/kg/day in junior and 4.7 95% CI 4.3-5.0 g/kg/day in senior players). The proportion of fat as total energy intake is in concordance with the recommendations (31.5 95% CI 32.0-35.9% in junior and 33.1 95% CI 29.9-36.2% in senior players). In particular, due to possible health complications, the small carbohydrate intake should be alarming for coaches, nutritional experts, and parents.

• MeSH
• dieta * MeSH
• dietní proteiny aplikace a dávkování   MeSH
• dietní sacharidy aplikace a dávkování   MeSH
• dietní tuky aplikace a dávkování   MeSH
• dítě MeSH
• dospělí MeSH
• energetický příjem MeSH
• fotbal * MeSH
• fyziologie sportovní výživy MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• nutriční nároky * MeSH
• sportovci MeSH
• stravovací zvyklosti * MeSH
• výživová politika MeSH
• živiny MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• Publikační typ
• časopisecké články MeSH
• metaanalýza MeSH

BACKGROUND: Laser therapy has emerged as a promising treatment modality for improving the appearance and symptoms associated with hypertrophic and keloid scars. In this network meta-analysis, we aimed to evaluate the efficacy of different laser types in treating hypertrophic and keloid scars. METHODS: A comprehensive search of four databases was conducted to identify relevant studies published up until July 2023. Data were extracted from eligible studies and pooled as mean difference (MD) for continuous outcomes and risk ratio (RR) for dichotomous data in a network meta-analysis (NMA) model, using R software. RESULTS: A total of 18 studies, comprising 550 patients, were included in the analysis. Pooling our data showed that fractional carbon dioxide (FCO2) plus 5-fluorouracil (5-FU) was superior to control in terms of Vancouver Scar Scale (VSS), pliability score, and thickness; [MD = - 5.97; 95% CI (- 7.30; - 4.65)], [MD = - 2.68; 95% CI (- 4.03; - 1.33)], [MD = - 2.22; 95% CI (- 3.13; - 1.31)], respectively. However, insignificant difference was observed among FCO2 plus 5-FU compared to control group in terms of erythema, vascularity, redness and perfusion, and pigmentation [MD = - 0.71; 95% CI (- 2.72; 1.30)], [MD = - 0.44; 95% CI (- 1.26; 0.38)], respectively. CONCLUSION: Our NMA found that the FCO2 plus 5-FU was the most effective intervention in decreasing the VSS and thickness, while FCO2 plus CO2 was the most effective intervention in decreasing the pliability score. Further research is needed to determine the optimal laser parameters and long-term efficacy of laser therapy in hypertrophic and keloid scars. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these evidence-based medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

• MeSH
• jizva hypertrofická * diagnóza   terapie   MeSH
• keloid * diagnóza   terapie   MeSH
• laserová terapie škodlivé účinky   přístrojové vybavení   metody   MeSH
• lidé MeSH
• síťová metaanalýza MeSH
• výsledek terapie MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• metaanalýza MeSH
• systematický přehled MeSH

OBJECTIVE: To perform a network meta-analysis of randomised controlled trials of different surfactant treatment strategies for respiratory distress syndrome (RDS) to assess if a certain fraction of inspired oxygen (FiO2) is optimal for selective surfactant therapy. DESIGN: Systematic review and network meta-analysis using Bayesian analysis of randomised trials of prophylactic versus selective surfactant for RDS. SETTING: Cochrane Central Register of Controlled Trials, MEDLINE, Embase and Science Citation Index Expanded. PATIENTS: Randomised trials including infants under 32 weeks of gestational age. INTERVENTIONS: Intratracheal surfactant, irrespective of type or dose. MAIN OUTCOME MEASURES: Our primary outcome was neonatal mortality, compared between groups treated with selective surfactant therapy at different thresholds of FiO2. Secondary outcomes included respiratory morbidity and major complications of prematurity. RESULTS: Of 4643 identified references, 14 studies involving 5298 participants were included. We found no statistically significant differences between 30%, 40% and 50% FiO2 thresholds. A sensitivity analysis of infants treated in the era of high antenatal steroid use and nasal continuous positive airway pressure as initial mode of respiratory support showed no difference in mortality, RDS or intraventricular haemorrhage alone but suggested an increase in the combined outcome of major morbidities in the 60% threshold. CONCLUSION: Our results do not show a clear benefit of surfactant treatment at any threshold of FiO2. The 60% threshold was suggestive of increased morbidity. There was no advantage seen with prophylactic treatment. Randomised trials of different thresholds for surfactant delivery are urgently needed to guide clinicians and provide robust evidence. PROSPERO REGISTRATION NUMBER: CRD42020166620.

• MeSH
• Bayesova věta MeSH
• lidé MeSH
• novorozenec nedonošený MeSH
• novorozenec MeSH
• plicní surfaktanty * terapeutické užití   MeSH
• povrchově aktivní látky MeSH
• síťová metaanalýza MeSH
• syndrom respirační tísně novorozenců * farmakoterapie   prevence a kontrola   MeSH
• těhotenství MeSH
• Check Tag
• lidé MeSH
• novorozenec MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• metaanalýza MeSH
• systematický přehled MeSH