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Selected AbstractsSources of information on adverse effects: a systematic reviewHEALTH INFORMATION & LIBRARIES JOURNAL, Issue 3 2010Su Golder Background:, Systematic reviews can provide accurate and timely information on adverse effects. An essential part of the systematic review process is a thorough search of the literature. This often requires searching many different sources. However, it is unclear which sources are most effective at providing information on adverse effects. Objective:, To identify and summarise studies that have evaluated sources of information on adverse effects. Methods:, Studies were located by searching in 10 databases as well as by reference checking, hand searching, citation searching and contacting experts. Results:, A total of 6218 citations were retrieved yielding 19 studies which met the inclusion criteria. The included studies tended to focus on the adverse effects of drug interventions and compare the relative value of different sources using the number of relevant references retrieved from searches of each source. However, few studies were conducted recently with a large sample of references. Conclusions:, This review suggests that embase, Derwent Drug File, medline and industry submissions may potentially provide the greatest number of relevant references for information on adverse effects of drugs. However, a systematic evaluation of the current value of different sources of information for adverse effects is urgently required. [source] The effectiveness of silver-releasing dressings in the management of non-healing chronic wounds: a meta-analysisJOURNAL OF CLINICAL NURSING, Issue 5 2009Shu-Fen Lo Aim., The purpose of this study was to examine the efficacy of silver-releasing dressings in the management of non-healing chronic wounds. Background., Non-healing chronic wounds often have a negative physical impact on patients and place a financial burden on healthcare systems. Silver dressings are wound products designed to control infection and provide a wound environment conducive to healing. However, validation of the clinical efficacy of these dressings is lacking. Design., Systematic review and meta-analysis. Methods., A systematic search of the major electronic databases PubMed, CINAHL, Cochrane, MEDLINE, British Nursing Index, EBSCO, OCLC and Proquest between 1950,June 2007 was conducted. Hand searches of selected periodicals, textbooks and checking reference lists and contacting experts was also performed. Results., Eight studies were selected from a potentially relevant 1957 references screened. Analysis incorporated data from 1399 participants in the eight randomised control trials. We found that silver dressings significantly improved wound healing (CI95: 0·16,0·39, p < 0·001), reduced odour (CI95: 0·24,0·52, p < 0·001) and pain-related symptoms (CI95: 0·18,0·47, p < 0·001), decreased wound exudates (CI95: 0·17,0·44, p < 0·001) and had a prolonged dressing wear time (CI95: 0·19,0·48, p = 0·028) when compared with alternative wound management approaches. An analysis of sensitivity in these studies by subgroup analysis generally supported these associations. Furthermore, studies indicated an improvement in quality of life (CI95: 0·04,0·33, p = 0·013) using silver dressings in wound management with no associated severe adverse events. Conclusion., This meta-analysis confirms the effectiveness of silver dressings in wound healing and improving patients' quality of life. However, it also highlights the need for additional well-designed randomised controlled trials to evaluate the effectiveness of silver-related dressings further. Relevance to clinical practice., The results of this study provide objective data on the effectiveness of silver-related dressing when applied to non-healing chronic wounds. [source] Antibiotics for Reduction of Posttonsillectomy Morbidity: A Meta-Analysis,THE LARYNGOSCOPE, Issue 6 2005Collin M. Burkart BS Abstract Objective: To reconcile conflicting published reports regarding the clinical efficacy of postoperative antibiotics for reduction of posttonsillectomy morbidity. Study Design: Systematic review (meta-analysis). Methods: Meta-analysis of seven randomized controlled trials of postoperative oral antibiotics in patients undergoing tonsillectomy or adenotonsillectomy. Postoperative pain and time to return to normal activity and diet were studied as distinct end points using a random effects model with weighted mean difference (RevMan 4.2). Search strategy included electronic searches of PubMed and Cochrane library databases; cross-referencing textbooks, reviews, and original trials; and contacting experts in the field. Results: Subjects treated with antibiotics experienced an earlier return to a normal diet (,1.22 days; 95% confidence interval [CI] = ,1.97, ,0.48; P = .001) and an earlier return to normal activity (,0.99 days; 95% CI = ,1.80, ,0.17; P = .02). Evaluation of mean pain visual analogue scores (VAS 0,10) over the first 5 and 7 postoperative days failed to demonstrate any significant effect of antibiotic therapy (VAS difference over 5 days = 0.41; ,1.18, 2.00; P = .61) (VAS difference over 7 days = ,0.64; ,3.46, 2.18; P = .66). Cost analysis suggests routine therapy may be cost-effective but did not include analysis of side effects or resistance resulting from antibiotic usage. Conclusion: The results of this systematic meta-analysis suggest that postoperative oral antibiotics do not significantly reduce posttonsillectomy pain but result in an earlier return to normal activity and diet by approximately 1 day. Given the frequency that tonsillectomy is performed, this possible benefit should be weighed against the cost and potential side effects of routine antibiotic therapy. [source] Folic acid,containing supplement consumption during pregnancy and risk for oral clefts: A meta-analysis,BIRTH DEFECTS RESEARCH, Issue 1 2007Rachel L. Badovinac Abstract BACKGROUND: There is equivocal evidence in the published literature that folic acid supplementation during pregnancy may protect against the common congenital anomalies cleft lip with or without cleft palate (CLP) and cleft palate alone (CP). We undertook this meta-analysis to test the hypothesis that nonsyndromic oral cleft birth prevalences are different for those whose mothers took folic acid,containing supplements and for those whose mothers did not. METHODS: Human studies published in English were identified through MEDLINE, bibliography reviews, and contacting experts in the field. Within strata of prospective and case-control studies, CLP, CP, and all clefts, respectively, were analyzed using either a fixed or random effects model, as appropriate. We assessed for publication bias using Begg and Mazumdar's rank correlation and Egger's regression-based tests. RESULTS: Five prospective studies were analyzed, yielding combined relative risks of 0.51 (95% CI: 0.32, 0.95) for CLP, 1.19 (95% CI: 0.43, 3.28) for CP, and 0.55 (95% CI: 0.32, 0.95) for all clefts. Twelve case-control studies were assessed, which resulted in combined relative risks of 0.77 (95% CI: 0.65, 0.90) for CLP, 0.80 (95% CI: 0.69, 0.93) for CP, and 0.78 (95% CI: 0.71, 0.85) for all clefts. CONCLUSIONS: In aggregate, our results support the hypothesis of a protective effect of folic acid,containing supplement intake during pregnancy on the risk for oral clefts, although this conclusion is tempered by the potential for bias and uncontrolled confounding. Birth Defects Research (Part A), 2007. © 2006 Wiley-Liss, Inc. [source] | ||||||||||