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Network meta-analyses: Methodological prerequisites and clinical usefulness

World Journal of Methodology 2022年第3期12卷 92-98页

作者： savvas Ilias Christofilos Konstantinos Tsikopoulos Alexios Tsikopoulos Dimitrios Kitridis Konstantinos Sidiropoulos Panagiotis Nikolaos Stoikos Venu Kavarthapu Department of Genetics Evolutionand EnvironmentUniversity College LondonLondon WC1E 6BTUnited Kingdom Department of Pharmacology School of MedicineFaculty of Health Sciences Aristotle University of ThessalonikiThessaloniki 54124Greece Department of Otolaryngology-Head and Neck Surgery AHEPA University General HospitalAristotle University of ThessalonikiThessaloniki 57010Greece Department of Orthopaedics Aristotle University of ThessalonikiSchool of MedicineGeorge Papanikolaou Hospital ThessalonikiThessaloniki 57010Greece Department of Orthopedics General Hospital of SerresSerres 62100Greece Department of Medicine University of ThessalyLarissa 41500Greece Department of Trauma and Orthopaedics King’s College Hospital NHS Foundation TrustLondon SE59RSUnited Kingdom

It is an undeniable fact that systematic reviews play a crucial role in informing clinical practice;however,conventional head-to-head meta-analyses do have *** particular,studies can only be compared in a pair-wise fashion,and conclusions can only be drawn in the light of direct *** contrast,network meta-analyses can not only compare multiple interventions but also utilize indirect evidence which increases their *** top of that,they can also rank competing *** this mini-review,we have aimed to elaborate on the principles and techniques governing network meta-analyses to achieve a methodologically sound synthesis,thus enabling safe conclusions to be drawn in clinical *** have emphasized the prerequisites of a well-conducted Network Meta-Analysis(NMA),the value of selecting appropriate outcomes according to guidelines for transparent reporting,and the clarity achieved via sophisticated graphical *** is more,we have addressed the importance of incorporating the level of evidence into the results and interpreting the findings according to validated appraisal systems(i.e.,the Grade of Recommendations,Assessment,Development,and Evaluation system-GRADE).Lastly,we have addressed the possibility of planning future research via ***,we can conclude that NMAs could be of great value to clinical practice.

关键词： Network meta-analysis Quality of evidence Evidence-based medicine Systematic reviews

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急性卒中时的胆汁淤积症:一项发病率和病因学调查

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世界核心医学期刊文摘（胃肠病学分册） 2005年第12期1卷 55-56页

作者： Sevastos N. savvas S.P. Rafailidis P.I. Manesis E.K. 樊菁 Academic Department of Me- dicine Hippokration General Hospital 114 Vas. Sophias Street 115 27 Athens Greece Dr.

Objective. Liver cholestatic enzymes and/or bilirubin occasionally occur in acute stroke and are usually, but not always, ascribed to comorbid conditions. We investigated the frequency and possible etiology of this phenomenon. Material and methods. Prospective evaluation of post- admission biochemical cholestasis of all patients hospitalized with acute stroke was conducted during a 21- month period. Results. Of 169 consecutive patients, 18 (10.7% ) developed cholestasis. In 7 of the patients (4.1% ; 4 M, 3 F, median age 70 years, range 57- 82 years) no apparent cause of cholestasis could be found, and they were further evaluated (Group A). These patients were compared with 21 randomly selected stroke patients without cholestasis, matched for age and gender, and who acted as controls (Group B). Group A patients were in a deeper coma than the controls (Glasgow Coma Scale 3.4 ± 0.8 versus 1.9 ± 0.7, p < 0.001), associated with severe autonomic and hypothalamic involvement, while no such manifestations were present in Group B (p < 0.001). Cholestasis started on the 3rd- 6th day and lasted up to the 11th- 25th day, with maximum median levels of γ - GT and serum alkaline phosphatase (SAP) of up to 4.38 (range 2.33- 8.25) and 1.49 (range 0.63- 2.56) times the upper limit of normal, respectively. Serum alanine aminotransferase (ALAT), total and direct bilirubin increased in Group A but not in Group B. The common bile duct was significantly wider in Group A than in Group B (7.7 ± 0.5 versus 4.7 ± 0.6 mm, p < 0.001) and within Group A during and after cholestasis (7.7 ± 0.5 versus 4.7 ± 0.5 mm, p < 0.001). Conclusions. Transient cholestasis may occur in 4.1% of patients following acute stroke. Cholestasis is associated with deeper coma, autonomic and hypothalamic involvement and common bile duct dilatation without obstruction, possibly related to inordinate hypertonia of the sphincter of Oddi.

关键词：急性卒中胆汁淤积症病因学胆汁淤积性丘脑受累性别匹配直接胆红素胆总管直径胆总管扩张正常高限

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Visual Loss after Cardiopulmonary Bypass (CABG) for Coronary Artery Disease: A Report of Case

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World Journal of Cardiovascular Surgery 2015年第5期5卷 45-48页

作者： Christos Simoglou Fotios Konstantinou Dimitrios Mikroulis savvas Elefteriadis Georgios Bougioukas Department of Cardiothoracic Surgery University Hospital of Evros Democritous University of Thrace Alexandroupolis Greece

We are reporting a 59-year-old male who presented with features of bilateral anterior ischaemic optic neuropathy after coronary artery bypass grafting. Postoperative vision loss after major nonocular surgery is a very rare but devastating complication since it has the potential to cause bilateral, severe and permanent loss of vision.

关键词： Cardiopulmonary Bypass Visual Loss Ophthalmological Test Cross-Clamp Extracorporeal Circulation

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