Principles in the Evaluation of Systematic Reviews.

Literature reviews summarize information from individual studies and are an important tool in the practice of evidence-based medicine. Various types of reviews, including narrative and systematic reviews, may be found within the biomedical literature. Systematic reviews are the strongest type and are often rated as the highest level of evidence.

Remifentanil, fentanyl, or the combination in surgical procedures in the United States: predictors of use in patients with organ impairment or obesity.

Introduction: Remifentanil has a rapid onset and short duration of action, predictable pharmacokinetic/pharmacodynamic profile, and unlike fentanyl, does not accumulate with repeated or prolonged administration. This study evaluated predictors of remifentanil use in surgical patients with renal or hepatic impairment, or obesity in the United States who received remifentanil, fentanyl, or the combination.

Methods: Data (2010) from the US Healthcare National Inpatient Database, State Inpatient Database, State Ambulatory Surgery Database, and private hospital and Medicaid databases were used in this analysis.

Bioequivalence evaluation of epinephrine autoinjectors with attention to rapid delivery.

Timely and proper injection of epinephrine is critical to prevent serious consequences relating to anaphylaxis. In a recent bioavailability study comparing epinephrine delivery from the Auvi-Q™ and EpiPen(®) epinephrine autoinjectors, the Auvi-Q failed to meet the bioequivalence threshold when using partial area under the curve (AUC) analyses based on zero to Tmax recommended for highly variable drugs such as epinephrine. Peak plasma epinephrine concentrations for the EpiPen occurred 10 minutes (median Tmax) after dosing, while peak concentrations for the Auvi-Q occurred 20 minutes after dosing.

Fidaxomicin for Clostridium difficile-associated diarrhoea: epidemiological method for estimation of warranted price.

Background: Fidaxomicin is a macrocyclic antibiotic approved in 2011 by the US Food and Drug Administration for treatment of Clostridium difficile-associated diarrhoea (CDAD).

Objective: Herein, we present an epidemiological method to estimate, on a case mix basis, and from the perspective of the US health system, the warranted (justifiable) price per day for fidaxomicin, as a percent of the wholesale acquisition cost (WAC) per day for fidaxomicin ($US280).

Methods: Data from two randomized controlled studies (Optimer-003 [n = 596] and Optimer-004 [n = 509]) were used to discern the number-needed-to-treat (NNT = 7.

α1-Proteinase inhibitor (human) in the treatment of hereditary emphysema secondary to α1-antitrypsin deficiency: number and costs of years of life gained.

Background: α(1)-Antitrypsin deficiency (α-ATD) is a disorder inherited in an autosomal recessive pattern, with co-dominant alleles known as the protease inhibitor system (Pi). The main function of α(1)-antitrypsin (α-AT) is to protect the lungs against a powerful elastase released from neutrophil leucocytes. α-ATD typically presents with a serum α-AT level of <50 mg/dL.

The association between class of antipsychotic and rates of hospitalization: results of a retrospective analysis of data from the 2005 Medicare current beneficiary survey.

Background: When second-generation antipsychotics (SGAs), also called atypical antipsychotics, were introduced in the 1990s, early research suggested that these drugs offered better tolerability and adherence than first-generation antipsychotics (FGAs), or typical antipsychotics. This presumably would reduce the need for hospital services. However, health research to test this hypothesis has focused mostly on psychiatric readmissions.

The use of anticholinergic medications in homebound elderly patients with dementia.

Objective: Identify the number of homebound older adults admitted to a home-based health care agency in 2003 with a diagnosis of dementia. Compare the use of anticholinergic medications in older adults with a diagnosis of dementia to a matched comparison group without a diagnosis of dementia.

Design: Retrospective, cohort study.

Effectiveness of an osteoporosis intervention among older adults residing in assisted living facilities.

Objectives: To describe demographic and clinical risk factors for osteoporosis among persons aged 60 years and older residing in assisted living facilities and to compare the frequency of bone-mineral density (BMD) testing and initiation of pharmacotherapy for osteoporosis (prevention/treatment) in both a control and experimental cohort.

Design: Prospective cohort study.

Setting: Sixteen separate assisted living facilities from November 2001 through July 2002.

Aralast: a new alpha1-protease inhibitor for treatment of alpha-antitrypsin deficiency.

Objective: To review the epidemiology, pathogenesis, and management of patients with alpha-antitrypsin (AAT) deficiency syndrome and compare Aralast with Prolastin, 2 of the 3 available human plasma-derived AAT agents.

Data Sources: Articles were identified using a MEDLINE (1966-September 2005) search with MESH headings that included alpha-antitrypsin and emphysema.

Study Selection And Data Extraction: All papers from peer-reviewed journals on the laboratory or clinical efficacy of plasma-derived AAT (eg, Prolastin, Aralast) for patients with this autosomal recessive disorder were reviewed.