AimWe assessed the efficacy and safety of 5-hydroxytryptamine (5-HT 3 ) receptor antagonists in adults with non-constipated irritable bowel syndrome (IBS) or diarrhea-predominant IBS (IBS-D).
MethodsWe searched PubMed, MEDLINE, EMBASE, and the Cochrane Controlled Trials Register for randomized controlled trials (RCTs) involving adults with non-constipated IBS or IBS-D that compared 5-HT 3 receptor antagonists with placebo or other conventional treatment. Dichotomous symptom data were pooled to obtain the relative risk (RR) and 95% confidence intervals (CIs) for improving global IBS symptoms, abdominal pain and abnormal bowel habits, or stool consistency symptoms after therapy, and adverse events, including constipation. Meta-analysis was performed with Mantel Haenszel method using Revman 5.3 software.
ResultsWe included 21 RCTs; 16 were high quality (Jadad score ! 4). The pooled RR of global IBS symptoms improved by 5-HT 3 receptor antagonists versus placebo or mebeverine was 1.56 (95% CI: 1.43-1.71); alosetron, ramosetron, and cilansetron had similar treatment effects. The pooled RR of abdominal pain relieved by 5-HT 3 receptor antagonists versus placebo was 1.33 (95% CI: 1.26-1.39). The pooled RR showed that 5-HT 3 receptor antagonists improved abnormal bowel habits or stool consistency symptoms (RR = 1.63, 95% CI: 1.33, 1.99). The pooled RR of adverse events following 5-HT 3 receptor antagonist treatment was 1.15 (95% CI: 1.08, 1.22). Subgroup analysis indicated that alosetron had a high rate of adverse effects (RR = 1.16, 95% CI: 1.08, 1.25); adverse events following ramosetron treatment were not statistically significantly different.
ConclusionsRamosetron, cilansetron, ondansetron, and alosetron are effective for treating non-constipated IBS and IBS-D. Our systematic review found rare serious adverse events.
Only 27 patients aged ≥ 15 years with hepatoblastoma were identified in this study, the existence of adult hepatoblastoma still requires novel molecular tools to elucidate. The association between the upward trend of hepatoblastoma incidence in boys and increased survival of prematurity in Taiwan warrants further investigations.
Peripheral venous blood markers may reflect the systematic inflammatory response condition. Various indices have been used to evaluate Inflammatory Bowel Disease (IBD), however, there is no ideal maker to assess the IBD activity and severity. We aim to investigate the potential value of Systemic Inflammation Response Index (SIRI) in IBD patients, and use it to predict the disease activity and severity. We designed a retrospective study to evaluate the SIRI in estimating disease severity in patients with IBD. We enrolled 210 patients with IBD, included 110 cases of Ulcerative Colitis (UC) and 100 cases of Crohn's Disease (
A 2-year-old Asian girl presented to our facility for the evaluation of thrombocytopenia. She was treated with intravenous immunoglobulin under the impression of immune thrombocytopenia. However, her body temperature spiked and progressive pancytopenia, hepatosplenomegaly, abnormal liver function, coagulopathy, and pulmonary infiltration developed. The final diagnosis was systemic Epstein-Barr virus (EBV)-positive T-cell lymphoma of childhood with hemophagocytic syndrome. This type of cancer is extremely rare but occurs more commonly in Asians. Its prognosis is generally poor, and a treatment strategy is yet to be established. Double staining for EBV-encoded RNA and CD3 or CD8 is crucial for diagnosis. This type of lymphoma must be diagnosed differentially from acute EBV-associated hemophagocytic lymphohistiocytosis, which is considered nonmalignant. This case report highlights the importance of awareness of this type of rare cancer, a comprehensive diagnostic approach, and close communication between primary care physicians and pathologists.
Background: The optimum number of oocytes retrieved by the follicular phase long-acting long protocol is still unknown. This study aimed to analyze the optimum oocyte number in patients with polycystic ovary syndrome (PCOS) undergoing this protocol.Methods: A total of 1816 PCOS patients aged <35 years who were undergoing their first cycle of in vitro fertilization or intracytoplasmic sperm injection (IVF/ICSI) between January 2017 and June 2019 were identified and reviewed. All patients underwent stimulation using a follicular phase long-acting long protocol. In this retrospective cohort study, patients were categorized into seven groups according to the number of oocytes retrieved (group A, 1–5; group B, 6–10; group C, 11–15; group D, 16–20; group E, 21–25; group F, 26–30; group G, >30). The main outcome indicators were the rates of high-quality embryo, fresh cycle pregnancy, cumulative pregnancy, and “freezing all” for high ovarian response. The cumulative pregnancy and “freezing all” rates for high ovarian response were analyzed using multivariate logistic analysis.Results: The high-quality embryo rate decreased with the increase in the number of oocytes retrieved (P<0.001). In the <20 oocyte group, the clinical and cumulative pregnancy rates increased with the number of oocytes retrieved, and the “freezing all” rate for high response was within 30%. In the >20 oocyte group, with an increase in the number of oocytes retrieved, no significant change was found in the clinical and cumulative pregnancy rates (P>0.05); however, the incidence of “freezing all” rate for high response was significantly increased (P<0.001). After correcting for confounding factors, the number of oocytes retrieved was an independent predictor of the “freezing all” rate for high ovarian response (odds ratio [OR], 1.085; 95% confidence interval [CI] 1.057–1.113) and cumulative pregnancy rate (OR 1.091, 95% CI 1.057–1.126). The high-quality embryo rate was significantly affected by the cumulative pregnancy rate (OR, 59.076; 95% CI: 29.591–117.938).Conclusion: In PCOS patients aged <35 years treated using the follicular phase long-acting long protocol, considering clinical outcomes, laboratory indicators, and safety, appropriate ovarian stimulation should be used to control the number of oocytes retrieved at 11–20.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.