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Results for “comparative effectiveness”

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PubMed2026

Comparative effectiveness of percutaneous coronary intervention strategies for coronary small-vessel disease: a network meta-analysis of randomized trials.

BACKGROUND: Coronary small-vessel disease (SVD) remains challenging for percutaneous coronary intervention (PCI) because small lumens magnify restenosis and ischemic risk. Multiple devices are available, yet their comparative performance is uncertain. This study evaluated and ranked PCI strategies for SVD. METHODS: A systematic review and network meta-analysis was conducted in accordance with PRISMA. PubMed, Embase, the Cochrane Central Register of Controlled Trials, Web of Science, and Google Scholar were searched from inception to 15 August 2025. Eligible studies were English-language randomized controlled trials enrolling adults with angiographic SVD defined as reference vessel diameter ≤3.0 mm, comparing PCI strategies, and reporting target lesion revascularization (TLR), binary restenosis (BR), or myocardial infarction (MI). A frequentist random-effects network meta-analysis generated odds ratios (ORs) with 95% confidence intervals (CIs) and treatment rankings using the surface under the cumulative ranking curve (SUCRA). RESULTS: Thirty-nine trials including 14,503 patients met the criteria. For TLR (37 studies; 11,980 patients), the highest SUCRA values were observed with sirolimus-eluting stents (SES 90.1%), zotarolimus-eluting stents (ZES 83.9%), and everolimus-eluting stents (EES 82.2%). For BR (32; 6,468), SES, ZES, and paclitaxel-coated balloons (DCB-PTX) ranked highest (95.0%, 80.0%, and 78.3%). For MI (37; 11,602), SES, DCB-PTX, and ZES ranked highest (79.0%, 78.7%, and 68.5%). Representative effects showed SES reduced TLR versus bare-metal stents (BMS) (OR, 0.25; 95% CI, 0.15-0.43) and MI versus BMS (OR, 0.41; 95% CI, 0.21-0.79). Conventional approaches such as BMS, plain old balloon angioplasty (POBA), and gold-plated balloon angioplasty (GPBA) ranked lowest across outcomes. CONCLUSION: SES provides the most consistent clinical benefit for coronary SVD. ZES, EES, and DCB-PTX are effective alternatives in selected settings, whereas BMS, POBA, and GPBA are less effective. These findings offer comparative evidence to guide device selection in SVD.

Humans↗

PubMed1978

Comparative effect of calcium and of the adrenergic system on calcitonin secretion in man.

This study evaluated the effects of adrenergic agents on immunoreactive calcitonin (iCT) secretion in normal man, and compared the time course and magnitude of these adrenergic effects with those caused by modifying calcium (Ca) ion concentration. Ca infusion (15 mg Ca++/kg iv in 4 h) significantly increased plasma iCT within 1 h, reaching 140 +/- 8% of baseline at 4 h. EDTA (50 mg/kg iv in 2 h) significantly decreased plasma iCT within 15 min, with nadir value of 53 +/- 4.9% of baseline at 2 h. The beta-adrenergic agonist, isoproterenol, significantly increased plasma iCT with 5 min, reaching 136 +/- 5.9% of baseline at 30 min. The alpha-adrenergic antagonist, phentolamine, significantly increased iCT within 15 min, reaching 132 +/- 8.6% of baseline at 45 min. The beta-adrenergic antagonist, propranolol, significantly suppressed iCT with 15 min, reaching 51.8 +/-6.3% of baseline at 2 h. Therefore, 1) the adrenergic system (without induced change in serum Ca) can modify CT secretion to as great a degree as can change in Ca ion concentration induced by standard Ca and EDTA infusion tests and 2) even basal secretion of CT can be modified by adrenergic influences. These data strongly suggest 1) that the adrenergic system is an effective modifier of CT secretion and 2) that the adrenergic system, as well as Ca ion concentration, may play an improtant physiological role in control of CT secretion in man.

Adult↗

PubMed1978

Comparative effectiveness of benzoyl peroxide and tretinoin in acne vulgaris.

A controlled, randomized clinical study comparing different commercially available benzoly peroxide gels and tretinoin cream was undertaken by four investigators using similar protocols and case report forms. Results were based on lesion-count reduction over an 8-week period. No significant difference in reduction of total acne lesions was detected between the benzoyl peroxide gels and tretinoin cream. However, benzoyl peroxide was significantly better (P less than .02) in reduction of papules and as good as tretinoin in reduction of comedones. Results of this study suggest that excessive drying and peeling are not essential in the reduction of acne lesions.

Acne Vulgaris↗

PubMed1977

[Comparative effects of pentagastrin and caerulein on the insulin secretion in the anesthesized dog].

The insulin-secretory effect of pentagastrin (5-G) and caerulein (CRL) was studied comparatively in the anesthesized dog. Both peptides, infused into the femoral vein for 30 minutes in doses of 0.20 microng/kg/min and 0.035 microng/kg/min respectively, caused a significant increase in plasma IRI without simultaneously modifying blood glucose. The insulin-secretory activity is however transitory for both, being a little more prolonged for CRL. On a molar basis the latter is almost 50 times more active than 5-G. The mechanism of the beta-cytotropic action of CRL and the different behaviour of the two peptides is discussed.

Anesthesia↗

PubMedDate not supplied

Comparative effects of chloralose anesthesia and Sernylan analgesia on cerebral blood flow, CO2 responsiveness, and brain metabolism in the baboon.

A comparison was made between the effects of two different anesthetics, alpha-D-gluco-chloralose and 1-1-phenylcyclohexyl piperidine hydrochloride (Sernylan), on cerebral blood flow (CBF), brain metabolism and cerebrovascular CO2 responsiveness in primates. The experiments were carried out on immobilized and artificially ventilated baboons. Anesthesia was induced either with 100/mg/kg chloralose (i.p.) or with 1 mg/kg Sernylan (i.m.). CBF in 8 different brain regions was measured by the intra-arterial 133Xe clearance technique. The CO2 responsiveness of the cerebrovascular bed was tested by a gas mixture containing 5% CO2. Chloralose depressed total as well as regional CBF compared to the effect of Sernylan. A significant shift occurred toward lower CBF values in the grey matter while white matter flow was identical in the two groups. Brain O2 consumption was significantly higher during Sernylan analgesia (3.35 +/- 0.34 ml/100 g/min) than during chloralose anesthesia (2.42 +/- 0.22 ml/100 g/min). There were no differences in glucose uptake, lactate and pyruvate production, or in arterial and cerebral venous blood gases in the two types of anesthesia. The cerebrovascular CO2 sensitivity of the Sernylan-treated baboons was higher than that of the chloralose-anesthetized animals, in both the grey and white matter.

Animals↗

PubMed1978

[Comparative effects of ajmaline and lidocaine on hemodynamics in myocardial infarct].

Haemodynamic changes after single intravenous injection of antiarhythmic doses of ajmaline (50 mg) and lidocain (100 mg) were measured comparatively in 10 patients with acute myocardial infarction, stable cardiac rhythm and without manifest left heart failure. The effects of ajmaline were characterized by a significant decrease of systolic arterial pressure (9%), of left ventricular stroke work index (15%) as well as by an increase of the mean pressure of the pulmonary artery (7%) in the early phase after application. No significant changes in cardiac index, stroke volume index, systemic vascular resistance, right and left ventricular filling pressures and heart rate occurred. The effects of lidocain on the cardiac circulation were comparatively small. The intravenous administration of lidocain did not result in significant changes of the cardiac index or left and right ventricular filling pressures. Diastolic arterial pressure increased significantly (5%), while the heart rate decreased (5%).

Ajmaline↗

PubMed1976

The comparative effects of barbituric acid phenobarbital on blood glucose and insulin secretion in mice.

The effects of barbituric acid and phenobarbital upon carbohydrate metabolism in mice were compared. An intraperitoneal dose of 100 mg/kg of barbituric acid increased blood glucose concentrations during an intravenous glucose tolerance test, but did not alter the rate of glucose disappearance from the blood. Barbituric acid also antagonized the hypoglycemic effect of intravenously administered tolbutamide. The same dose of phenobarbital had no effect. An in vitro concentration of 100 mug/ml of barbituric acid decreased the responsiveness of isolated mouse pancreatic islets to glucose stimulation (3.0 mg/ml D-glucose). Again phenobarbital, 100 mug/ml, was without effect. The structural similarities between barbituric acid, tolbutamide and alloxan suggest that the effects observed in these experiments might reflect a competition for binding to reactive sites on or within the pancreatic B-cell.

Animals↗

PubMed1976

Comparative effects of anticalculus management in the rat.

Utilizing a low pyridoxine, ethylene glycol-fed rat model, various modes of anticalculus therapy were compared. Prophylactic papillary and parenchymal oxalate stone therapy is most effective with magnesium oxide. Hydrochlorothiazide is next in order as the therapy of choice in this group. A high calcium diet seems to negate the effect of magnesium oxide. Methylene blue, magnesium oxide, and even sodium phosphate, are not as effective as hydrochlorothiazide in the combined prevention and treatment of preformed parencymal calcium oxalate stones. No agent seems to have a profound effect on preformed apical papillary calculi.

Animals↗

PubMed1976

Reason and remedy for conflicting reports on comparative effects of steel scalpel and electrosurgical cutting on gingival tissues and alveolar bone.

The fact that electrosurgical cutting is governed by factors that have no influence on steel scalpel cutting is responsible for discrepancies among the results of investigations of the modalities. The investigator's equal expertise in the use of both modalities is a prerequisite for accurate comparative investigations of the effects of electrosurgical and steel scalpel cutting. Eleven specific factors that govern the efficacy and quality of electrosurgical cutting and that can, therefore, ensure consistently reliable histologic results and accurate conclusions have been mentioned.

Alveolectomy↗

PubMed1979

Comparative effects of cyclophosphamide, isophosphamide, 4-methylcyclophosphamide, and phosphoramide mustard on murine hematopoietic and immunocompetent cells.

The effects of equimolal doses of cyclophosphamide (CY), isophosphamide (IP), 4-methylcyclophosphamide (4-MCY), and phosphoramide mustard (PM) on murine hematopoietic spleen colonies and adoptively transferred antibody-forming cells in vivo were compared. Equimolal doses of the drugs produced significantly different effects. All the drugs exerted an increasing effect against the ability of adoptively transferred immunocompetent cells to produce a significant anti-sheep red blood cell titer as the length of time between cell transfer and drug administration was increased. The maximum effect was seen when a drug was given 48--72 hours after antigen and spleen cell transfer. CY and IP produced significantly greater immunosuppressive effects than did the other drugs at all times after cell transfer and at all doses administered. PM had the least immunosuppressive effect at each dose evaluated. Against hematopoietic spleen colonies, the cytotoxic effects of 4-MCY and PM were similar and, at most doses studied, significantly greater than the effect of either CY or IP. Inasmuch as PM is an active metabolite of CY, it appeared either that one of the prior metabolites of CY was responsible for this marked immunosuppressive effect or that due to differences in polarity, PM was differentially distributed within the two cell systems as compared to CY. The differences in hematopoietic effects among all drugs were much less than those seen against immunocompetent cells and were not dependent on time of drug administration.

Animals↗

PubMed1977

Comparative effects of endoperoxide PGH2 and an analog on the pulmonary vascular bed.

The effects of the prostaglandin endoperoxide, PGH2, and a stable endoperoxide analog were compared on the canine pulmonary vascular bed under conditions of controlled blood flow. The analog produced dose-related increases in lobar arterial and small vein pressure when injected into the perfused lobar artery. The increase in resistance in response to the analog was greater during retrograde perfusion than during forward perfusion. These data suggest that the analog increases resistance to flow by constricting pulmonary veins and upstream vessels. The increase in resistance was similar when the lung was perfused with dextran or blood and the response was not different when the lung was ventilated or collapsed. The response was notattenuated by indomethacin, an inhibitor of prostaglandin synthesis. These data suggest that the response to the analog is not related to changes in bronchomotor tone, platelet aggregation, or enhanced prostaglandin synthesis. Although the analog was a potent pressor substance, PGH2 itself produced only small increases in pulmonary vascular resistance. However, PGH2 had greater contractile activity than the analog on isolated helical segments of canine intrapulmonary vein. The present study suggests that endoperoxides may represent an active form of the prostaglandins in the lung but that their effects would be localized in the tissue in which they are formed because of their extremely short biologic half-life.

Animals↗

PubMed1978

Comparative effectiveness of two extracerebral DOPA decarboxylase inhibitors in Parkinson disease.

In four patients with Parkinson disease, we compared carbidopa combined with levodopa (Sinemet) and benserazide combined with levodopa (Madopar). All of these patients had responded to treatment, first with levodopa and then with Sinemet; after 6 years two continued to show a good response, while two developed marked "on-off" phenomena. Clinically, Sinemet and Madopar were similar; however, DOPA levels were higher, but with a shorter half-life, on Madopar. The higher DOPA levels may have been offset by the shorter half-life, resulting in no clinical change. DOPA levels were lower and half-life was shorter in patients with on-off phenomena. These differences may be responsible in part for the on-off phenomena.

Aromatic Amino Acid Decarboxylase Inhibitors↗

PubMedDate not supplied

Critical closing pressure in the fetal vessel of the human placenta in vitro. II. Compared effects of a beta adrenergic substance, Salbutamol, on the critical closing pressure and vascular resistance.

Salbutamol effects upon the fetal vessels of the human placenta were studied in vitro, comparing the changes induced upon the critical closing pressure (CCP) and viscous resistance (R). Four normal full-term placentas were used. In each of them, 4 cotyledonary areas were perfused, thus obtaining a total of 16 measurements for the observation of spontaneous variations (blank), by perfusion with Krebs solution, and the same amount for the variations due to Salbutamol. The concentration used was 10 microgram/ml, with a 4.25 ml/min flow. The relative effect of Salbutamol upon CCP was its decrease--30.4% against a relative spontaneous variation of --3.6%. The mean relative effect upon R was much lower, --9.4%. against a mean relative spontaneous variation of + 3.3%. The advantages of using CCP instead of R as a parameter of vascular contractility are discussed. Furthermore, Salbutamol is suggested to be useful in improving fetal placental circulation.

Albuterol↗

PubMed1979

Comparative effects of CO2 on the affinity for O2 of fetal and adult erythrocytes.

1. Oxygen-linked carbamino formation in fetal erythrocytes was compared to that measured in adult erythrocytes. 2. Whole oxygen binding curves were recorded on washed intact erythrocytes either fresh or D-glycerate-2,3-P depleted with a continuous recording technique. Erythrocytes were resuspended in buffer media of different pH and PCO2 varying from 0-10.7 kPa (80 torr) at physiological ionic strength. Oxygen linked carbamates were estimated as deltalog PO2/delta log PCO2 at constant pH and constant saturation levels from 10-90% oxygen saturation. 3. The overall CO2 effect (deltalog P50/deltalog PCO2) was consistently lower in fetal erythrocytes than in the adult. The deltalog PO2/deltalog PCO2 ratio was markedly dependent on oxygen saturation in both types of erythrocytes and highest at the early part of the oxygen binding curve. This was more so in fetal erythrocytes. 4. Carbamino formation was lower in fetal erythrocytes than in adult erythrocytes at any pH value, indicating a higher apparent pK of the alpha amino groups involved in CO2 binding in fetal erythrocytes. This may be related to the different primary structures of the non alpha chains of HbFII and HbAI. 5. The large effect of low PCO2 on both fetal and adult erythrocytes was related to the higher affinity for CO2 of deoxyhemoglobin compared to oxyhemoglobin and a model for CO2 binding analogous to that described by de Bruin et al. [6] for anion binding is proposed. 6. It is concluded that the lower CO2 binding to fetal erythrocytes is in keeping with the lower allosteric effect of other major effectors of hemoglobin within the cells. This leads to a higher affinity for O2 of fetal erythrocytes well suited for O2 transport in utero.

Adult↗

PubMed2026

Comparative effectiveness and safety of pharmacological interventions for sleep outcomes in chronic non-cancer pain: a systematic review and network meta-analysis.

Sleep disturbances are highly prevalent among individuals with chronic non-cancer pain and are associated with worse pain severity and poorer prognosis. The comparative trade-offs between the effectiveness and safety of available pharmacotherapies for sleep outcomes in this population remain poorly defined. Ninety-eight RCTs involving 28,920 participants (mean age 53.2 years, 71.2% female) were included. Moderate-certainty evidence demonstrated that melatonin significantly improved sleep quality compared with placebo (standardized mean difference [SMD] = -0.60, 95%CI: -0.98, -0.22). Ten agents (e.g., amitriptyline, oxycodone, gabapentin, pregabalin, duloxetine) also showed statistically significant improvements in subjective sleep quality (SMD = -0.24 to -1.07), but most effects were supported by low-certainty evidence and were accompanied by an increased risk of adverse events (odds ratio [OR] = 1.90 to 37.00). Conversely, melatonin was not associated with an increased risk (OR = 0.88, 95%CI: 0.19, 3.94). Our findings indicate that melatonin shows promise as a safe, adjunctive option for improving sleep quality in this population, but larger, condition-specific trials are warranted to confirm these effects. Other pharmacological agents are limited by lower-certainty and unfavorable safety profiles. These results should be interpreted cautiously given limited direct comparisons, heterogeneous chronic pain populations, the high proportion of trials at high risk of bias, and the predominance of subjective sleep outcomes.

Humans↗

PubMed1976

Comparative effects of various naturally occurring cannabinoids on food, sucrose and water consumption by rats.

The effects of intraperitoneally injected detla9-tetrahydrocannabinol (THC), cannabinol (CBN) and cannabidiol (CBD) were compared to d-amphetamine sulfate (d-AMP) on food and water consumption and intake of two different concentrations of sucrose solutions. Three groups of rats were given the following dietary regimens within a 6-hr feed period day: 1 - water and dry food; 2 - water, dry food and five percent sucrose solution; 3 - water, dry food and 20% sucrose solution. Food and water consumption were dramatically reduced by each test drug at feeding periods immediately following and in some instances up to 4 days after dosing in all 3 groups. However, sucrose consumption was much less affected by each cannabinoid, inidcating a preference for sweet calories, whereas d-AMP had an equal anorexic action on both food and sucrose consumption. These data suggest for the first time in rats that a preference for sweet calories occurs during an overall anorexic effect of THC, CBN and CBD.

Animals↗

PubMed1975

[Comparative effectiveness of pulmonary scintigraphy and radiography in detecting toxic side-effects of Bleomycin treatment (author's transl)].

Pulmonary toxic effects subsequent to intravenous injections of bleomycin in cancer therapy have well been demonstrated. In order to prevent the acute pathological pulmonary manifestations of the treatment, it is necessary that the patient be submitted to repeated controls of the lungs. As yet, the efficiency of the current diagnostic procedures for detecting the lesions dues to bleomycin injections is not clearly demonstrated. The authors present the results of a comparative study on the effectiveness of radiological and scintigraphic examination of the lung in detecting toxic side-effects of bleomycin. Both procedures were used repeatedly on rabbits, before, during and after the bleomycin treatment. The findings are discussed on the basis of the macroscopic and histological examination of the lungs. The results demonstrate that pulmonary scintigraphy with radioactive macroaggregates is more sensitive than radiography in detecting the early lesions of the lungs after bleomycin treatment.

Animals↗

PubMed1977

Comparative effect of food on absorption of ampicillin and pivampicillin.

The effect of food on the absorption of simultaneously ingested ampicillin or pivampicillin was compared in a crossover study in eight healthy volunteers. The absorption of both ampicillin and pivampicillin was delayed by simultaneous food intake as judged by serum concentration and urinary excretion of ampicillin. The total absorption of ampicillin, but not that of pivampicillin was decreased by simultaneous food intake as indicated by the are under the serum ampicillin concentration-time curves and by 24 hours urinary excretion of ampicillin. The excretion of ampicillin into urine was about 30% of the dose when ampicillin was ingested with water into an empty stomach and about 20% when ingested with food. The respective excretion of ampicillin following the ingestion of pivampicillin was about 60% of the dose taken either with or without food.

Adult↗