Quick diagnosis units-an effective alternative to hospitalization for diagnostic workup: A systematic review

Background: The World Health Organization (WHO) declared a pandemic in March 2020 caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Given the neurotropism feature of the coronavirus and growing number of COVID-19 associated neurological disorders, including Guillain Barre syndrome (GBS), we conducted a systematic review to thoroughly describe the clinical features, diagnostic workup, and clinical outcome of COVID-19 associated GBS in 78 cases. Methods: We identified case reports and case series of COVID-19 associated GBS by conducting a search in the PubMed/MEDLINE and EMBASE databases. We assessed the quality of studies using an appraisal checklist presented by Cochrane Murad et al. Extracted data included demographic characteristics, clinical presentation, diagnostic workup, and outcome. Results: The systematic search yielded a total of 60 articles reporting 78 patients with a diagnosis of COVID-19 associated GBS. The patients were mainly male (65.3%) with an average age of 57 years. The ascending symmetrical paresis was the most common presentation (79.4%), with demyelinating pattern in 54 patients (79.4%). The CSF analysis showed albuminocytologic dissociation in 48 patients (75%). The mortality of COVID-19 associated GBS was estimated as 6.4% attributable to progressive respiratory failure. Conclusion: Given the associated morbidities such as respiratory failure in patients with COVID-19 associated GBS, its timely detection is crucial to prevent poor clinical outcomes. On the other hand, clinicians must be vigilant to identify the clinical findings of SARS-CoV-2 infection in newly diagnosed GBS patients, as this might be a neurological complication of the subclinical viral infection.

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Web-Based Patient Education in Orthopedics: Systematic Review (Preprint)

10.2196/preprints.9013 ◽

2017 ◽

Author(s):

Tessa Dekkers ◽

Marijke Melles ◽

Bob Sander Groeneveld ◽

Huib de Ridder

Keyword(s):

Systematic Review ◽

Patient Education ◽

Health Information ◽

Cost Effective ◽

Educational Interventions ◽

Effective Alternative ◽

Cochrane Library ◽

The Internet ◽

Web Based ◽

Cost Effective Alternative

BACKGROUND Patients with orthopedic conditions frequently use the internet to find health information. Patient education that is distributed online may form an easily accessible, time- and cost-effective alternative to education delivered through traditional channels such as one-on-one consultations or booklets. However, no systematic evidence for the comparative effectiveness of Web-based educational interventions exists. OBJECTIVE The objective of this systematic review was to examine the effects of Web-based patient education interventions for adult orthopedic patients and to compare its effectiveness with generic health information websites and traditional forms of patient education. METHODS CINAHL, the Cochrane Library, EMBASE, MEDLINE, PsycINFO, PUBMED, ScienceDirect, Scopus, and Web of Science were searched covering the period from 1995 to 2016. Peer-reviewed English and Dutch studies were included if they delivered patient education via the internet to the adult orthopedic population and assessed its effects in a controlled or observational trial. RESULTS A total of 10 trials reported in 14 studies involving 4172 patients were identified. Nine trials provided evidence for increased patients’ knowledge after Web-based patient education. Seven trials reported increased satisfaction and good evaluations of Web-based patient education. No compelling evidence exists for an effect of Web-based patient education on anxiety, health attitudes and behavior, or clinical outcomes. CONCLUSIONS Web-based patient education may be offered as a time- and cost-effective alternative to current educational interventions when the objective is to improve patients’ knowledge and satisfaction. However, these findings may not be representative for the whole orthopedic patient population as most trials included considerably younger, higher-educated, and internet-savvy participants only.

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Peer-staffed crisis respite program effective alternative to hospitalization

Mental Health Weekly ◽

10.1002/mhw.31553 ◽

2018 ◽

Vol 28 (31) ◽

pp. 1-3

Author(s):

Valerie A. Canady

Keyword(s):

Effective Alternative ◽

Alternative To Hospitalization

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Systematic review of clinical evidence on postoperative delirium: literature search of original studies based on validated diagnostic scales

Journal of Anesthesia, Analgesia and Critical Care ◽

10.1186/s44158-021-00021-8 ◽

2021 ◽

Vol 1 (1) ◽

Author(s):

F. Bilotta ◽

G. Russo ◽

M. Verrengia ◽

A. Sportelli ◽

L. Foti ◽

...

Keyword(s):

Systematic Review ◽

Literature Search ◽

Postoperative Delirium ◽

Data Extraction ◽

Methodological Approach ◽

Diagnostic Workup ◽

Routine Monitoring ◽

Clinical Literature ◽

Data Extraction Form ◽

Present Systematic Review

Abstract Background Postoperative delirium is a serious complication that can occur within the 5th postoperative day. In 2017, the European Society of Anesthesiologists delivered dedicated guidelines that reported the need for routine monitoring using validated scales. Objective Aim of this systematic review is to identify clinical studies related to postoperative delirium that included postoperative monitoring with validated scales. Design Systematic review Methods Searched keywords included the following terms: postoperative, postsurgical, post anesthesia, anesthesia recovery, delirium, and confusion. Two researchers independently screened retrieved studies using a data extraction form. Results Literature search led to retrieve 6475 hits; of these, 260 studies (5.6% of the retrieved), published between 1987 and 2021, included in their methods a diagnostic workup with the use of a postoperative delirium validated scale and monitored patients for more than 24 h, therefore are qualified to be included in the present systematic review. Conclusion In conclusion, available clinical literature on postoperative delirium relies on a limited number of studies, that included a validated diagnostic workup based on validated scales, extracted from a large series of studies that used inconsistent diagnostic criteria. In order to extract indications based on reliable evidence-based criteria, these are the studies that should be selectively considered. The analysis of these studies can also serve to design future projects and to test clinical hypothesis with a more standardized methodological approach.

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Laser pulpotomy—an effective alternative to conventional techniques—a systematic review of literature and meta-analysis

Lasers in Medical Science ◽

10.1007/s10103-018-2588-4 ◽

2018 ◽

Vol 33 (8) ◽

pp. 1621-1629 ◽

Cited By ~ 3

Author(s):

Ghassem Ansari ◽

Hanane Safi Aghdam ◽

Pardis Taheri ◽

Mitra Ghazizadeh Ahsaie

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Effective Alternative ◽

Review Of Literature

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Neurological manifestations of coronavirus infections: a systematic review

10.1101/2020.08.26.20182196 ◽

2020 ◽

Author(s):

Jesper Almqvist ◽

Tobias Granberg ◽

Antonios Tzortzakakis ◽

Stefanos Klironomos ◽

Evangelia Kollia ◽

...

Keyword(s):

Systematic Review ◽

Cerebrovascular Disorders ◽

Acute Disseminated Encephalomyelitis ◽

Neurological Complications ◽

Diagnostic Workup ◽

Neurological Manifestations ◽

Chronic Disability ◽

Neuropsychiatric Complications ◽

Immune Mediated ◽

Depth Analysis

In order to optimize diagnostic workup of the current severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, we systematically reviewed neurological and neuroradiological manifestations of SARS-CoV-2 and all other known human coronavirus species (HCoV). Which lessons can we learn? We identified relevant publications (until July 26h 2020) using systematic searches in PubMed, Web of Science and Ovid EMBASE with predefined search strings. A total of 4571 unique publications were retrieved, out of which 378 publications were selected for in-depth analysis by two raters, including a total of 17549 (out of which were 14418 SARS-CoV-2) patients. Neurological complications and associated neuroradiological manifestations are prevalent for all HCoVs (HCoV-229E, HKU1, NL63, OC43, Middle East respiratory syndrome (MERS)-CoV, SARS-CoV-1 and SARS-CoV-2). Moreover, there are similarities in symptomatology across different HCoVs, particularly between SARS-CoV-1 and SARS-CoV-2. Common neurological manifestations include fatigue, headache and smell/taste disorders. Additionally, clinicians need to be attentive for at least five classes of neurological complications: (1) Cerebrovascular disorders including ischemic stroke and macro/micro-hemorrhages, (2) encephalopathies, (3) para-/postinfectious immune-mediated complications such as Guillain-Barre syndrome and acute disseminated encephalomyelitis, (4) (meningo-)encephalitis, potentially with concomitant seizures and (5) neuropsychiatric complications such as psychosis and mood disorders. Our systematic review highlights the need for vigilance regarding neurological complications in patients infected by SARS-CoV-2 and other HCoVs, especially since some complications may result in chronic disability. Neuroimaging protocols should be designed to specifically screen for these complications. Therefore, we propose practical imaging guidelines to facilitate the diagnostic workup and monitoring of patients infected with HCoVs.

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