ABSTRACT
OBJECTIVE: The aim of this study was to make an indirect comparison of the results from meta-analyses that evaluated the severity of hot flushes in postmenopausal women exposed to hormone therapy (HT) or soy extracts. METHODS: A systematic review and meta-analysis of HT and soy extracts related to the reduction of hot flushes in postmenopausal women versus the same control (placebo) were conducted. In addition, the combination of the overall results obtained from these two meta-analyses (indirect comparison) was adjusted to the common control (placebo). RESULTS: The indirect standardized mean difference (SMD) obtained from the combination of both individual meta-analyses was calculated by using the following equation: SMD(indirect SOY vs HT) = SMD(soy) - SMD(HT), with a total indirect variance (var) equivalent to the following equation: var(total) = var(soy) + var(HT). These calculations yielded a point estimate of -0.84 (95% CI, -1.33 to -0.35) for the indirect SMD favorable to HT. CONCLUSIONS: HT and soy interventions showed a significant difference in efficacy for the reduction of hot flushes in postmenopausal women when each treatment was compared with placebo. However, using indirect comparison, there is a statistically significant difference between HT and soy extracts in their effects on hot flushes.
Subject(s)
Estrogen Replacement Therapy/standards , Estrogens , Glycine max , Hot Flashes/drug therapy , Isoflavones , Plant Extracts , Estrogens/administration & dosage , Estrogens/pharmacokinetics , Female , Humans , Isoflavones/administration & dosage , Isoflavones/pharmacokinetics , Menopause/drug effects , Meta-Analysis as Topic , Middle Aged , Plant Extracts/administration & dosage , Plant Extracts/pharmacokinetics , Reference Standards , Statistics as Topic , Therapeutic Equivalency , Vasomotor System/drug effectsABSTRACT
Se reportan ocho casos clínicos de pacientes portadores de Strongyloidiasis en presentación atípica. Se revisan las historias clínicas, se documenta al nematodo mediante coproparasitológico seriado con métodos de Baermann modificado y en algunos casos, el factor predisponente ha sido deficiencia inmunológica, sea nutricional, neoplasia, enfermedad autoinmune y terapía inmunosupresora, siendo la más frecuente la falla nutricional moderada a severa, a diferencia de la literatura extranjera. Todos tuvieron buena evolución clínica con el uso de Albendazol a dosis altas o Ivermectina. Se concluye que la strongyloidiasis con manifestaciones sistémicas no es aleatoria, sino que tiene una base fisiopatológica clara en relación a la inmunodeficiencia celular y que se debe buscar cuidadosamente en nuestros pacientes, en que la autoinfección crónica, es un estado clínico frecuente y que estan inmersos en algún tipo de inmunodificiencia, que en nuestro medio, generalmente es nutricional