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  1. Article ; Online: Impact of iron supplementation on patient outcomes for women with abnormal uterine bleeding: a protocol for a systematic review and meta-analysis.

    Nazaryan, Hasmik / Watson, Megan / Ellingham, Dana / Thakar, Swarni / Wang, Andrea / Pai, Menaka / Liu, Yang / Rochwerg, Bram / Gabarin, Nadia / Arnold, Donald / Sirotich, Emily / Zeller, Michelle P

    Systematic reviews

    2023  Volume 12, Issue 1, Page(s) 121

    Abstract: Background: Abnormal uterine bleeding (AUB), which includes heavy menstrual bleeding (HMB), is a common condition placing women at increased risk for developing iron deficiency and iron deficiency anemia (IDA). Depletion of iron stores has negative ... ...

    Abstract Background: Abnormal uterine bleeding (AUB), which includes heavy menstrual bleeding (HMB), is a common condition placing women at increased risk for developing iron deficiency and iron deficiency anemia (IDA). Depletion of iron stores has negative implications on physical, social, and emotional health, as well as quality of life. Iron supplements are safe, effective, and readily available, while red blood cell (RBC) transfusions have inherent risks including infectious and immune reactions. Despite high prevalence of IDA among women with AUB, there are limited studies on the impact of iron therapies on patient outcomes. This systematic review and meta-analysis will evaluate the impact of iron supplementation on patient outcomes for women with AUB, when compared to combination therapy, no intervention, placebo, or standard of care.
    Methods: We will conduct a systematic review and meta-analysis of randomized controlled trials and observational studies evaluating the impact of iron interventions on patient outcomes for women with AUB. Systematic literature searches will be conducted in major databases including MEDLINE, EMBASE, CENTRAL, CINAHL, and Web of Science. Studies assessing the impact of iron interventions on patient outcomes in women experiencing AUB, in comparison to combination therapy, no intervention, placebo, or standard of care, will be included in the review. Independent reviewers will screen for eligibility, assess risk of bias, and abstract data. Overall certainty of evidence for each outcome will be assessed using the GRADE approach. We will meta-analyze outcomes which are sufficiently homogeneous to summarize intervention effects and narratively synthesize nonhomogeneous outcomes. The main outcomes of interest are hemoglobin levels immediately prior to surgery and post-operatively, number of RBC transfusions, and adverse effects. Secondary outcomes will include length of hospital stay, intraoperative blood loss, adverse and side effects, quality of life, and iron indices.
    Discussion: This review will evaluate the impact of iron interventions on patient outcomes in women with IDA secondary to AUB with focus on changes in hematological and iron indices, red blood cell utilization, quality of life, cost of treatment, and adverse events. The results will inform evidence-based clinical practice for the management of iron deficiency and IDA secondary to AUB.
    Systematic review registration: PROSPERO CRD42019137282.
    MeSH term(s) Female ; Humans ; Iron/therapeutic use ; Quality of Life ; Systematic Reviews as Topic ; Meta-Analysis as Topic ; Anemia, Iron-Deficiency/drug therapy ; Iron Deficiencies ; Uterine Hemorrhage/drug therapy ; Dietary Supplements ; Review Literature as Topic
    Chemical Substances Iron (E1UOL152H7)
    Language English
    Publishing date 2023-07-14
    Publishing country England
    Document type Journal Article
    ZDB-ID 2662257-9
    ISSN 2046-4053 ; 2046-4053
    ISSN (online) 2046-4053
    ISSN 2046-4053
    DOI 10.1186/s13643-023-02222-4
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Treatment of critical bleeding events in patients with immune thrombocytopenia: a protocol for a systematic review and meta-analysis.

    Sirotich, Emily / Nazaryan, Hasmik / Chowdhury, Saifur Rahman / Guyatt, Gordon / Agarwal, Arnav / Leong, Russell / Wen, Aaron / Xu, Emily / Liu, Bonnie / Pallapothu, Sushmitha / Rathod, Preksha / Kwon, Henry Y / Dookie, Jared / Shafiee, Amirmohammad / Charness, Jay / DiRaimo, Jennifer / Paynter, Dale / Pruitt, Barbara / Strachan, Gail /
    Couban, Rachel / Ye, Zhikang / Arnold, Donald M

    Systematic reviews

    2024  Volume 13, Issue 1, Page(s) 21

    Abstract: Background: Critical bleeding events in adults and children with ITP are medical emergencies; however, evidence-based treatment protocols are lacking. Due to the severe thrombocytopenia, (typically platelet count less than 20 × 10: Methods: ... ...

    Abstract Background: Critical bleeding events in adults and children with ITP are medical emergencies; however, evidence-based treatment protocols are lacking. Due to the severe thrombocytopenia, (typically platelet count less than 20 × 10
    Methods: Literature searches will be conducted in four electronic databases: Ovid MEDLINE, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), and PubMed. Eligible studies will be randomized controlled trials or observational studies that enrolled patients with ITP describing one or more interventions for the management of critical bleeding. Title and abstract screening, full-text screening, data extraction, and risk of bias evaluation will be conducted independently and in duplicate using Covidence and Excel. Outcomes will be pooled for meta-analysis where appropriate or summarized descriptively. Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology will be used to evaluate the certainty of the evidence. Primary outcomes of interest will include frequency of critical bleeds, mortality and bleeding-related mortality, bleeding resolution, platelet count, and disability.
    Discussion: Evidence-based treatments for critical bleeding in patients with ITP are needed to improve patient outcomes and standardize care in the emergency setting.
    Systematic review registration: CRD42020161206.
    MeSH term(s) Adult ; Child ; Humans ; Hemorrhage/therapy ; Meta-Analysis as Topic ; Purpura, Thrombocytopenic, Idiopathic/complications ; Purpura, Thrombocytopenic, Idiopathic/therapy ; Systematic Reviews as Topic ; Thrombocytopenia/complications ; Thrombocytopenia/therapy
    Language English
    Publishing date 2024-01-06
    Publishing country England
    Document type Journal Article
    ZDB-ID 2662257-9
    ISSN 2046-4053 ; 2046-4053
    ISSN (online) 2046-4053
    ISSN 2046-4053
    DOI 10.1186/s13643-023-02436-6
    Database MEDical Literature Analysis and Retrieval System OnLINE

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