The impact of alfentanil supplementation on the sedation of bronchoscopy: A meta-analysis of randomized controlled trials.

BACKGROUND: The efficacy of alfentanil supplementation for the sedation of bronchoscopy remains controversial. We conduct a systematic review and meta-analysis to explore the influence of alfentanil supplementation on the sedation during bronchoscopy. METHODS: We search PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases through December 2019 for randomized controlled trials (RCTs) assessing the effect of alfentanil supplementation versus placebo for the sedation during bronchoscopy. This meta-analysis is performed using the random-effect model. RESULTS: Five RCTs are included in the meta-analysis. Overall, compared with control group for bronchoscopy, alfentanyl supplementation is associated with significantly reduced coughing scores (Std. MD = -0.55; 95% CI = -0.96 to -0.14; P = 0.009) and dose of propofol (Std. MD = -0.34; 95% CI = -0.64 to -0.04; P = 0.03), but reveals the increase in hypoxemia (RR = 1.56; 95% CI = 1.17 to 2.08; P = 0.002). CONCLUSIONS: Alfentanyl supplementation benefits to reduce coughing scores and dose of propofol for bronchoscopy, but increases the incidence of hypoxemia. The use of alfentanyl supplementation for bronchoscopy should be with caution.

Efficacy and Safety of Vitamin D Supplementation for Pulmonary Tuberculosis: A Systematic Review and Meta-analysis.

BACKGROUND: Vitamin D might be promising to serve as an adjunctive therapy for pulmonary tuberculosis (TB). However, the results remained controversial. We conducted a systematic review and meta-analysis to evaluate the efficacy and safety of vitamin D in patients with pulmonary TB. METHODS: Medline, SCOPUS, Google Scholar, EMBASE, Springer, and Science Direct were searched electronically from inception to Oct 2016. Randomized controlled trials (RCTs) and controlled clinical trials (CCTs) assessing the effect of vitamin D plus anti-tuberculosis treatment (ATT) versus placebo plus ATT on the treatment of pulmonary TB were included. Two investigators independently searched articles, extracted data, and assessed the quality of included studies. Data were analyzed using RevMan 5.3 software. RESULTS: Five studies were included in this meta-analysis. Overall, compared with placebo intervention, vitamin D supplementation was found to have no significant effect on sputum smear negative conversion rates (RR=0.99; 95% CI=0.91 to 1.07; P=0.77), BMI (MD=0.11; 95% CI=-0.85 to 1.07; P=0.82) and ESR (MD=-2.29; 95% CI=-8.87 to 4.30; P=0.50). CONCLUSION: Vitamin D supplementation showed no influence on the improvement of sputum smear-negative conversion rates and BMI, as well as the decrease in ESR.