P031: Naltrexone initiation for alcohol use disorder in the emergency department: A systematic review

Introduction: Alcohol use disorder (AUD) is a chronic relapsing and highly comorbid disease. Patients suffering from AUD are frequently seen in the emergency department (ED) presenting intoxicated or in withdrawal. Brief interactions in the ED are often the only portal of entry to the healthcare system for many of these patients. Oral naltrexone and long acting injectable naltrexone are effective treatment options for AUD associated with decreased cravings, shorter length of hospital stay, and lower cost of healthcare utilization. This study's objective was to perform a systematic review of the literature evaluating initiation of naltrexone in the ED. Methods: Electronic searches of Medline, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews and CINAHL were conducted and reference lists were hand-searched. Randomized controlled trials (RCTs) comparing initiation of naltrexone in patients (≥18 years) to standard care in the ED were included. Two reviewers independently screened titles and abstracts, reviewed full text articles for inclusion, assessed quality of the studies, and extracted data. Results: The search strategy yielded 183 potentially relevant citations. After eliminating duplicate citations and studies that did not meet eligibility criteria, 10 articles were retrieved for full text review. There were no published RCTs that examined naltrexone initiation in the ED. There is one ongoing study being conducted in New York, which aims to assess naltrexone initiation in the ED and measure health outcomes and quality of life of study participants, as well as potential healthcare cost savings. Conclusion: The lack of published research in this area demonstrates a significant gap in knowledge. It is clear that well-designed RCTs are needed to evaluate the effectiveness of initiating naltrexone for those with AUD at the ED visit.

Download Full-text

Modified valsalva versus standard valsalva for cardioversion of supraventricular tachycardia: systematic review and meta-analysis

International Journal of Arrhythmia ◽

10.1186/s42444-021-00030-2 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Ahmed S. Abdulhamid ◽

Fahad Almehmadi ◽

Abdullah A. Ghaddaf ◽

Mohammed S. Alomari ◽

Amin Zagzoog ◽

...

Keyword(s):

Systematic Review ◽

Emergency Department ◽

Emergency Room ◽

Supraventricular Tachycardia ◽

Valsalva Maneuver ◽

Meta Analysis ◽

Controlled Trials ◽

Cochrane Central Register ◽

First Line ◽

Eligibility Criteria

Abstract Background Supraventricular tachycardia (SVT) is a major cause of emergency room visits where vagal maneuver is used as first-line therapy. The valsalva maneuver (VM) is proven to be safe and, to some extent, effective in terminating SVT episodes. We aimed to compare the standard VM (SVM) to the modified valsalva maneuver (MVM). We hypothesized that MVM is more effective in terminating SVT episodes and reducing the time spent in the emergency department. Methods In this systematic review and meta-analysis, we searched Medline/PubMed, Ovid, Web of Science, and Cochrane Central Register of Controlled trials. We included only randomized controlled trials (RCTs) that compared the modified valsalva to the standard valsalva maneuver in treating SVT. Our main outcome was the termination of SVT within 1 min. Results Four articles met the eligibility criteria of our review. Sinus rhythm was achieved 2.5 times more in the MVM group compared to the SVM group (risk ratio (RR) = 2.54, CI 1.98–3.24, P < 0.001) and thus lowered the need of intravenous SVT termination medication without any significant increase in adverse events or time spent in the emergency department. Conclusion Our review found MVM to be more effective than the SVM in terminating SVT. This should encourage broader adoption of the MVM as a first-line vagal maneuver in subjects presenting with SVT in the emergency room.

Download Full-text

Relationship between hormonal contraceptives and sleep among women of reproductive age: a systematic review protocol

BMJ Open ◽

10.1136/bmjopen-2020-045819 ◽

2021 ◽

Vol 11 (10) ◽

pp. e045819

Author(s):

Jinhui Ma ◽

Megan Cheng ◽

Lehana Thabane ◽

Caihong Ma ◽

Ning Zhang ◽

...

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Research Question ◽

Risk Of Bias ◽

Reproductive Age ◽

Hormonal Contraceptives ◽

Controlled Trials ◽

Cochrane Central Register ◽

Women Of Reproductive Age

IntroductionThe aetiology of sleep disruptions is unknown, but hormonal fluctuations during the menstrual cycle, pregnancy and menopause have been shown to potentially affect how well a woman sleeps. The aim of this systematic review was to investigate whether hormonal contraceptives are associated with a decreased quality of sleep and increased sleep duration in women of reproductive age.MethodsThis review will analyse data from randomised controlled trials or non-randomised comparative studies investigating the association between hormonal contraceptives and sleep outcomes among women of reproductive age. Reviews addressing the same research question with similar eligibility criteria will be included. A literature search will be performed using the MEDLINE, Embase and Cochrane Central Register of Controlled Trials databases from inception to 7 March 2021. The Cochrane Collaboration’s Risk of Bias for Randomised Trials V.2.0 and The Risk of Bias for Non-randomised Studies of Interventions tool will be used to assess risk of bias for each outcome in eligible studies. Two reviewers will independently assess eligibility of studies and risk of bias and extract the data. All extracted data will be presented in tables and narrative form. For sleep measures investigated by two or more studies with low heterogeneity, we will conduct random-effects meta-analysis to estimate the magnitude of the overall effect of hormonal contraceptives. If studies included in this systematic review form a connected network, a network meta-analysis will be conducted to estimate the comparative effect of different contraceptives. The Grading of Recommendations, Assessment, Development, and Evaluation approach will be used to summarise the quality of evidence. Our protocol follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Protocols 2015 guidelines.Ethics and disseminationEthics approval is not required as data were sourced from previously reported studies. The findings of this review will be published in a peer-reviewed journal and presented at relevant conferences.PROSPERO registration numberCRD42020199958.

Download Full-text

Protocol for a systematic review and meta-analysis of respiratory rehabilitation following intensive care unit discharge for COVID-19 survivors

BMJ Open ◽

10.1136/bmjopen-2020-041184 ◽

2020 ◽

Vol 10 (12) ◽

pp. e041184

Author(s):

Dan Wang ◽

Jin Li ◽

Feilong Zhu ◽

Qianqin Hong ◽

Ming Zhang ◽

...

Keyword(s):

Systematic Review ◽

Intensive Care Unit ◽

Intensive Care ◽

Meta Analysis ◽

Biomedical Literature ◽

Controlled Trials ◽

Cochrane Central Register ◽

The Impact ◽

Respiratory Rehabilitation

IntroductionBoth physical and mental disorders may be exacerbated in patients with COVID-19 due to the experience of receiving intensive care; undergoing prolonged mechanical ventilation, sedation, proning and paralysis. Pulmonary rehabilitation is aimed to improve dyspnoea, relieve anxiety and depression, reduce the incidence of related complications, as well as prevent and improve dysfunction. However, the impact of respiratory rehabilitation on discharged patients with COVID-19 is currently unclear, especially on patients who have been mechanically ventilated over 24 hours. Therefore, we aim to investigate the efficacy of respiratory rehabilitation programmes, initiated after discharge from the intensive care unit, on the physical and mental health and health-related quality of life in critical patients with COVID-19.Methods and analysisWe have registered the protocol on PROSPERO and in the process of drafting it, we strictly followed the checklist of Preferred Reporting Items for Systematic Review and Meta-Analysis Potocols. We will search the PubMed, EMBASE, Web of Science, the Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure, WanFang, VIP information databases and Chinese Biomedical Literature Database. Additionally, ongoing trials in the WHO International Clinical Trials Registry Platform, ClinicalTrials.gov and ISRCTN registry will be searched as well. Studies in English or Chinese and from any country will be accepted regardless of study design. Two review authors will independently extract data and assess the quality of included studies. Continuous data are described as standard mean differences (SMDs) with 95% CIs. Dichotomous data from randomised controlled trials are described as risk ratio(RR) with 95% CIs; otherwise, it is described as odds ratio(OR) with 95% CIs. I2 and the Cochrane’s Q statistic will be used to conduct heterogeneity assessment. The quality of evidence of main outcomes will be evaluated according to the Grading of Recommendations, Assessment, Development and Evaluation(GRADE) criteria. When included studies are sufficient, we will conduct subgroup analysis and sensitivity analysis; the publication bias will be statistically analysed using a funnel plot analysis and Egger’s test.Ethics and disseminationOur review, planning to include published studies, does not need the request to the ethical committee. The final results of this review will be published in a peer-reviewed journal after completion.Patient and public involvementNo patient involved.PROSPERO registration numberCRD42020186791.

Download Full-text

Interpersonal psychotherapy for perinatal women: a systematic review and meta-analysis protocol

Systematic Reviews ◽

10.1186/s13643-019-1158-6 ◽

2019 ◽

Vol 8 (1) ◽

Cited By ~ 2

Author(s):

Katherine S. Bright ◽

Elyse M. Charrois ◽

Muhammad Kashif Mughal ◽

Abdul Wajid ◽

Deborah McNeil ◽

...

Keyword(s):

Systematic Review ◽

Full Text ◽

Data Extraction ◽

Meta Analysis ◽

Mode Of Delivery ◽

Well Being ◽

Interpersonal Psychotherapy ◽

Controlled Trials ◽

Cochrane Central Register ◽

Perinatal Women

Abstract Background Interpersonal psychotherapy (IPT) is an intervention that has established efficacy in the prevention and treatment of depressive disorders. Previous systematic reviews have not evaluated the effectiveness of IPT on symptoms of stress, anxiety, depression, quality of life, relationship satisfaction/quality, social supports, and an improved psychological sense of well-being. There is limited data regarding factors that moderate and mediate the effectiveness of IPT including the timing of the intervention or the mode of delivery of IPT intervention. The objective of this systematic review and meta-analysis is to evaluate the effectiveness, feasibility, and acceptability of IPT interventions to treat perinatal psychological distress and to summarize the evidence on predictors, mediators, and moderators of IPT. Methods We will include peer-reviewed studies that recruited perinatal women. The search strategy will involve the following databases: MEDLINE (Ovid), EMBASE (Ovid), PsycINFO (Ovid), Cochrane Central Register of Controlled Trials (Ovid), CINAHL with Full Text (EBSCO), Social Work Abstracts (EBSCO), SocINDEX with Full Text (EBSCO), Academic Search Complete (EBSCO), Family & Society Studies Worldwide (EBSCO), Family Studies Abstracts (EBSCO), and Scopus. Study inclusion criteria include (1) randomized controlled trials, quasi-experimental studies, and pre-post studies that evaluated the effectiveness of IPT; (2) qualitative studies that evaluated feasibility and acceptability of IPT; (3) study sample included and analyzed perinatal women; and (4) publication language was English. Using pilot-tested screening and data extraction forms, two reviewers will independently review studies in three steps: (1) abstract/title screening, (2) full-text screening of potentially accepted studies, and (3) data extraction of accepted studies. Disagreements will be resolved by a third reviewer. Studies will be aggregated for meta-synthesis and meta-analysis should the data allow for this. Two independent reviewers will grade methodological quality. Discussion Findings from this review will inform future development and implementation of IPT intervention research for perinatal women. Identifying key factors of successful IPT interventions will inform intervention design and adaptation of IPT interventions to increase the likelihood that perinatal women will engage in and benefit from IPT interventions. This review will also identify key considerations for increasing the effectiveness of IPT interventions during the perinatal period. Systematic review registration PROSPERO CRD42019114292

Download Full-text

Interventions to facilitate return to work in adults with chronic non-malignant pain: a protocol for a systematic review and network meta-analysis

BMJ Open ◽

10.1136/bmjopen-2020-040962 ◽

2020 ◽

Vol 10 (11) ◽

pp. e040962

Author(s):

Mathilda Björk ◽

Björn Gerdle ◽

Gunilla Liedberg ◽

Frida Svanholm ◽

Marco Solmi ◽

...

Keyword(s):

Systematic Review ◽

Return To Work ◽

Meta Analysis ◽

Indirect Evidence ◽

Controlled Trials ◽

Analysis Tool ◽

Cochrane Central Register ◽

Full Time ◽

Private Patient

IntroductionWork absenteeism due to chronic non-malignant pain (CNMP) is a major societal and individual cause of concern that requires effective treatments.ObjectiveWe present a protocol for a systematic review and network meta-analysis (NMA) aiming to compare available interventions for return to work (RTW) in adults with CNMP.Methods and analysisPubMed, Embase, PsycINFO, Web of Knowledge and Cochrane Central Register of Controlled Trials databases will be searched till 31 August 2020 for randomised controlled trials (RCTs) examining interventions for RTW outcomes among patients with CNMP. Two independent investigators will search the databases, perform data extraction and assess the methodological quality of the selected RCTs. The primary outcome will be RTW, if possible, full-time or part-time after work absence due to chronic pain from baseline to the last available follow-up. Secondary outcomes will include self-reported workability or work capacity, or self-reported physical functioning and quality of life as measured by any validated scale. Pairwise meta-analysis and NMA will be conducted for each outcome using a random-effects model. For the primary outcomes, we will also obtain the ranking of all competing interventions within each NMA using surface under the cumulative ranking curve. The assumption of coherence (ie, that direct and indirect evidence are in statistical agreement) will be examined using both a local and a global approach. We will also conduct subgroup and meta-regression analyses, whenever feasible, to investigate the unexplained variation in effect size. The comparison-adjusted funnel plot will be used to evaluate small-study effects. The overall quality of evidence will be rated with the Confidence in Network Meta-Analysis tool. Data analysis will be conducted using Stata V.16.0.Ethics and disseminationThis systematic review does not require ethical approval since it will not disseminate any private patient data. The results of this study will be disseminated through peer-reviewed publication.PROSPERO registration numberCRD42020171429.

Download Full-text

Efficacy of foot orthoses for the treatment of plantar heel pain: a systematic review and meta-analysis

British Journal of Sports Medicine ◽

10.1136/bjsports-2017-097892 ◽

2018 ◽

Vol 52 (16) ◽

pp. 1040-1046 ◽

Cited By ~ 13

Author(s):

Nadine Rasenberg ◽

Henrik Riel ◽

Michael S Rathleff ◽

Sita M A Bierma-Zeinstra ◽

Marienke van Middelkoop

Keyword(s):

Systematic Review ◽

Conservative Treatment ◽

Meta Analysis ◽

Heel Pain ◽

Controlled Trials ◽

Cochrane Central Register ◽

Foot Orthoses ◽

Short Term ◽

Eligibility Criteria ◽

Plantar Heel Pain

BackgroundPlantar heel pain (PHP) is common. Foot orthoses are often applied as treatment for PHP, even though there is little evidence to support this.ObjectiveTo investigate the effects of different orthoses on pain, function and self-reported recovery in patients with PHP and compare them with other conservative interventions.DesignSystematic review and meta-analysis.Data sourcesA systematic literature search was conducted in MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Web of Science, CINAHL and Google Scholar up to January 2017.Eligibility criteria for selecting studiesRandomised controlled trials comparing foot orthoses with a control (defined as no intervention, sham or other type of conservative treatment) reporting on pain, function or self-reported recovery in patients with PHP.ResultsTwenty studies investigating eight different types of foot orthoses were included in the review. Most studies were of high quality. Pooled data from six studies showed no difference between prefabricated orthoses and sham orthoses for pain at short term (mean difference (MD) of 0.26 (95% CI −0.09 to 0.60)). No difference was found between sham orthoses and custom orthoses for pain at short term (MD 0.22 (95% CI −0.05 to 0.50)), nor was there a difference between prefabricated orthoses and custom orthoses for pain at short term (MD 0.03 (95% CI −0.15 to 0.22)). For the majority of other interventions, no significant differences were found.ConclusionsFoot orthoses are not superior for improving pain and function compared with sham or other conservative treatment in patients with PHP.PROSPERO registration numberCRD42015029659.

Download Full-text

Efficacy of Allergen Specific Immunotherapy for Treatment of Allergic Rhinitis: A Systematic Review and Meta-analysis

Journal of Advances in Medicine and Medical Research ◽

10.9734/jammr/2021/v33i2231172 ◽

2021 ◽

pp. 200-213

Author(s):

Madonna Nader Adly ◽

Mahmoud Fawzy Mandour ◽

Mahmoud Foad Abd Elaziz ◽

Magdy Eisa Saafan

Keyword(s):

Quality Of Life ◽

Systematic Review ◽

Allergic Rhinitis ◽

Sample Size ◽

Full Text ◽

Sublingual Immunotherapy ◽

Current Evidence ◽

Eligibility Criteria ◽

Allergen Specific Immunotherapy

Background: Allergic rhinitis is a common disease that affect nose causing sneezing, watery nose, nasal itching and redness that affect quality of life, productivity at work or school and may underlies complications (e.g. Asthma) for patients and are often accompanied by itchy eye, redness and lacrimation. Aim of the Work: The objective of this study is to systematically assess the efficacy and safety of immunotherapy treatment for patients with Allergic Rhinitis. Method: Our initial search generated a total of 23330 possible relevant titles. Titles, abstracts were preliminary screening so that 22565 were excluded. 154 articles were retrieved in full text the number of studies excluded after assessment of the full text 145, 9 articles met the eligibility criteria and fulfilled the inclusion and exclusion criteria for the review. Data Sources: Medline databases (PubMed, Medscape, ScienceDirect. EMF-Portal) and all materials available on the Internet upto 2018. Data Extraction: If the studies did not fulfill the inclusion criteria, they were excluded. Study quality assessment included whether ethical approval was gained, eligibility criteria specified, appropriate controls, and adequate information and defined assessment measures. Conclusion: Our systematic review provides evidence that Sublingual Immunotherapy (SLIT) tablets effectively relieve rhinitis symptoms in adults with allergic rhinitis, improve their quality of life and provide data about safety of Sublingual Immunotherapy as there were no serious side effects of using SLIT tablets. Nevertheless, the current evidence may be limited due to sample size and the heterogeneity between studies. Large sample size and multiple center RCTs on the efficacy of different formulations of SLIT drugs are still needed to provide further evidence and more precise recommendations.

Download Full-text

Tai Chi and other mind–body interventions for cancer-related fatigue: an updated systematic review and network meta-analyses protocol

BMJ Open ◽

10.1136/bmjopen-2021-052137 ◽

2022 ◽

Vol 12 (1) ◽

pp. e052137

Author(s):

Hong-Juan Fu ◽

Hao Zhou ◽

Yong Tang ◽

Jie Li ◽

Da Zhang ◽

...

Keyword(s):

Systematic Review ◽

Evaluation System ◽

Tai Chi ◽

Evidence Base ◽

Controlled Trials ◽

Cochrane Central Register ◽

China National Knowledge Infrastructure ◽

Cancer Related Fatigue ◽

Meta Analyses

IntroductionFatigue is one of the most common symptoms in patients with cancer and is responsible for a reduced quality of life. There is a strong evidence base for mind–body interventions (MBIs) to manage cancer-related fatigue (CRF). However, the efficacy of Tai Chi and other MBIs in the treatment of CRF remains controversial.Methods and analysisWe will perform a systematic review and network meta-analyses (NMAs) that aim to assess the effects of Tai Chi and other MBIs in patients with CRF. The following databases will be searched from their inception to 1 August 2021: PubMed, EMBASE, Scopus, OVID, Web of Science, Cochrane Central Register of Controlled Trials, the China National Knowledge Infrastructure, China Science and Technology Journal Database, Chinese Biomedical Database and Wan Fang Digital Journals. We will include randomised controlled trials that compare MBIs with no treatment, placebo and usual care in the treatment of CRF. The primary outcome will be changes in the fatigue state as evaluated by validated scales. We will perform a Bayesian NMA to analyse all the evidence for each outcome. The surface under the cumulative ranking curve and the mean ranks will be used to rank the various treatments. We will assess the quality of evidence contributing to network estimates of outcomes using the Grading of Recommendations Assessment, Development and Evaluation system framework.Ethics and disseminationThis NMAs will be disseminated through publication in a peer-reviewed journal. Since no individual patient data will be involved in the review, ethics approval and concerns about privacy are not needed.PROSPERO registration numberCRD42021244999.

Download Full-text

Effect of Berry-Based Supplements and Foods on cognitive function: A Systematic Review

10.21203/rs.3.rs-571401/v1 ◽

2021 ◽

Author(s):

Negar Bonyadi ◽

Neda Dolatkhah ◽

Yaghoub Salekzamani ◽

Maryam Hashemian

Keyword(s):

Systematic Review ◽

Cognitive Impairment ◽

Cognitive Function ◽

Short Term Memory ◽

Brain Perfusion ◽

Controlled Trials ◽

Ageing Population ◽

Cochrane Central Register ◽

Eligibility Criteria ◽

Freeze Dried

Abstract In the current decade, a growing body of evidence proposes the correlation between diet and cognitive function or dementia in the ageing population. This study was designed to appraise discoveries from the randomized controlled trials (RCTs) to confirm the effects of Berry-Based supplements or foods on cognitive function in older adults. PubMed/MEDLINE, Cochrane Central Register of Controlled Trials, Web of Science, Scopus, EMBASE, Google Scholar, and ProQuest as well as SID, Magiran, and Iranmedex electronic databases were explored for human interventional studies up to March 2021. A total of 259 studies were recognized from the primary database searches, and after eliminating the duplicates, 225 studies remained. Of these, 102 were disqualified after screening the title and abstracts of studies. The lasting 17 studies were evaluated in full text and 10 studies (which include 583 participants) encountered the eligibility criteria. Of the included studies, seven were randomized parallel-group (n = 7), two were crossover (n = 2) and one was the pilot study (n = 1). In total, ten articles were identified using freeze-dried blueberries (n = 3 studies), blueberry concentrate (n = 2), beverage (n = 3), capsule (n = 1), extract and powder (n = 1). These studies were directed in older people with no recognized cognitive impairment or mild cognitive impairment (MCI). The primary outcomes included episodic memory, long-term and short-term memory, working memory, executive function, psychomotor reaction time and attention. To our knowledge, this is the first systematic review of available clinical trials on the effects of berry-based supplements and foods on cognitive performances and brain perfusion parameters in elderlies with normal cognition or MCI. Existing evidence concludes that berry-based supplements and foods have beneficial effects on resting brain perfusion, cognitive function, memory performance, executive functioning, processing speed, and attention indices.

Download Full-text

Effectiveness of eccentric-biased exercise interventions in reducing the incidence of falls and improving functional performance in older adults: a systematic review

European Geriatric Medicine ◽

10.1007/s41999-021-00571-8 ◽

2021 ◽

Author(s):

Durga Kulkarni ◽

Sarah Gregory ◽

Michelle Evans

Keyword(s):

Systematic Review ◽

Older Adults ◽

Eccentric Exercise ◽

Functional Performance ◽

Risk Of Bias ◽

Walking Distance ◽

Controlled Trials ◽

Cochrane Central Register ◽

Exercise Interventions

Abstract Background Exercise has been known to preserve and enhance functional performance in older adults. Eccentric exercise involves muscle contractions characterised by unique features such as lengthening of the muscle–tendon complex by a greater opposing force. Aims To systematically review randomised-controlled trials (RCTs) investigating the effectiveness of eccentric exercises in reducing the incidence of falls and improving the functional performance in older adults. Key methods We conducted a systematic review of RCTs following the PRISMA-P guidelines. Searches were completed in the Cochrane Central Register of Controlled Trials, Embase, CINAHL, Medline, and Global Health CABI. We included RCTs reporting at least one of the following outcomes—falls, Berg balance scale, timed-up and go test, chair stand test, stair climb test, maximal walking speed, and minute walking distance. Two reviewers screened papers for eligibility and assessed the quality of included papers using the Cochrane Collaborative risk-of-bias tool for randomised trials. Data were extracted by a single reviewer and cross-checked by the second reviewer. A narrative synthesis was undertaken, given the high level of heterogeneity across studies. Results Ten studies were assessed as eligible for inclusion in the review. Overall, eccentric exercises were as effective as conventional resistance exercises in improving the selected outcomes by most studies. Additionally, when pre-exercise and post-eccentric exercise functional performance measures were compared, there was a statistically significant improvement in nearly all measures. The quality of trials was mixed (one high, four moderate, two low–moderate, and three low risk of bias). Conclusions Our systematic review suggests that eccentric exercises can be as effective as conventional exercises in older adults. Evidence suggests that such exercise interventions can lead to an improvement in geriatric function.

Download Full-text