Effectiveness of the glutamine supplementation on morbidity in patients with colorectal cancer: a systematic review of randomised controlled trials

Objetivo: O proposito desta revisao sistematica e avaliar a efetividade da suplementacao de Gln em nutricao enteral ou parenteral, em pacientes com cancer colo retal, nas complicacoes desta doenca.Tipos de estudos : Todos ensaios clinicos randomizados elegiveis. Tipos de participantes : Pacientes com cancer colo retal. Intervencao: Suplementacao de Gln por via enteral ou parenteral comparado com placebo ou outra suplementacao nutricional.Desfechos : a)primarios: incidencia de diarreia; ma absorcao; desnutricao; perda de peso; infeccoes; b)secundarios: tempo de permanencia hospitalar; custos. Estrategia busca : a)bases de dados eletronicos: Embase; Lilacs; Medline; Organizacao Cochrane ; b)busca manual ; c)comunicacao pessoal d)contactos com industria farmaceutica. Metodos: dois revisores, independentemente, avaliarao as referencias encontradas com as estrategias de busca e aplicarao os criterios de inclusao. Avaliacao da qualidade metodologica dos ensaios selecionados sera feita usando os criterios descritos no Cochrane Handbook. A escala de Jaddad tambem sera utilizada. Apos reunir todos os trabalhos elegiveis, se possivel, os dados serao sumarizados em uma metanalise. Resultados: Ainda nao avaliado. Conclusoes: Ainda nao feitasBV UNIFESP: Teses e dissertaçõe

Does the use of paclitaxel or rapamycin-eluting stent decrease further need for coronary-artery bypass grafting when compared with bare-metal stent?

CONTEXT AND OBJECTIVE: The safety and efficacy of drug-eluting stents reduce the need for surgical revascularization. The objective of the present study was to investigate whether paclitaxel or rapamycin-eluting stent are effective in avoiding the need for coronary-artery bypass grafting. METHODS: This was a systematic review of the literature using the methodology of the Cochrane Collaboration. The type of study considered was controlled randomized trials; the type of intervention was drug-eluting or bare-metal stents; and the main outcome investigated was coronary-artery bypass grafting. RESULTS: The ten studies included in this systematic review did not show any statistically significant difference between the drug-eluting stents and the bare-metal stents with regard to the outcome of coronary-artery bypass grafting (confidence interval: 0.31 to 1.42). CONCLUSION: The surgical revascularization rate was not reduced by the use of drug-eluting stents

Cardiac resynchronization therapy in patients with heart failure: systematic review

CONTEXT AND OBJECTIVE: Cardiac resynchronization therapy (CRT) has emerged as the predominant electrical treatment strategy for patients on pharmacological therapy who present heart failure with wide QRS and low ejection fraction. The objective of this study was to investigate whether cardiac resynchronization therapy improved mortality and morbidity among patients with heart failure. METHODS: This was a systematic review using the Cochrane Collaboration's methodology. The online search strategy included the Cochrane Library, Medline (Medical Literature Analysis and Retrieval System Online), Lilacs (Literatura Latino-Americana e do Caribe em Ciências da Saúde) and cardiology congresses from 1990 to 2006. The criteria for considering studies for this review were as follows:-types of studies: randomized controlled trials; types of interventions: cardiac resynchronization therapy compared with other therapies; types of participants: patients with heart failure with low ejection fraction and wide QRS; outcomes: death or hospitalization. RESULTS: Seven trials met the selection criteria. The risk of death due to congestive heart failure was nonsignificant: relative risk (RR), 0.79; 95% confidence interval (CI): 0.60 to 1.03. There was an absolute risk reduction of 4% in all-cause mortality for the experimental group #&091;RR 0.70; CI: 0.60 to 0.83; number needed to treat (NNT) 25#&093;; sudden cardiac death showed a statistically significant difference favoring the experimental group, with absolute risk reduction of 1% (CI: 0.46 to 0.96; RR 0.67; NNT 100). There was an absolute risk reduction of 9% for hospitalization due to heart failure (RR 0.64; CI: 0.50 to 0.80; NNT 11) in the experimental group. CONCLUSIONS: Patients receiving CRT had a significantly lower risk of hospitalization due to heart failure, but death rates due to heart failure were similar