P.110 Systematic review of civilian pediatric intracranial gunshot wounds

Background: Pediatric craniocerebral gunshot wounds occur in the context of both accidental and intentional trauma. Unique physiologic factors merited research into prognostic factors and treatment priorities in the pediatric population. Methods: A systematic search of MEDLINE, EMBASE, Web of Science, LILACS, Cochrane Registered Trials and Systematic Reviews, ISRCTN, and ClinicalTrials.gov was conducted. Selection criteria included all studies published in any language since 2000 which described intracranial isolated gunshot wounds in a civilian individual or population of pediatric age. Post-mortem and epidemiological studies were excluded. Screening was conducted through Covidence. Results: Initial database search revealed 349 unique studies for abstract and title screening. Fifty studies were selected for full text screening. Nine studies were included in the final review. Study quality was assessed with the Newcastle-Ottawa Scale. Case series noted bullet migration, pituitary deficiency, neurovascular and neuropsychological concerns. Three single-center retrospective studies of 71, 30, and 48 pediatric patients suggested multiple negative prognostic signs on initial presentation. Early aggressive surgical treatment was recommended by some authors. Conclusions: This systematic review analyzed the best current understanding of evidence for prognostic factors and treatment considerations of intracranial gunshot wounds in the pediatric neurotrauma context. Areas for future research with larger multi-center studies were highlighted.

Download Full-text

Prognostic factors for chronic post-surgical pain after lung or pleural surgery: a protocol for a systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2021-051554 ◽

2021 ◽

Vol 11 (6) ◽

pp. e051554

Author(s):

Pascal Richard David Clephas ◽

Sanne Elisabeth Hoeks ◽

Marialena Trivella ◽

Christian S Guay ◽

Preet Mohinder Singh ◽

...

Keyword(s):

Systematic Review ◽

Prognostic Factors ◽

Prognostic Factor ◽

Meta Analysis ◽

Case Series ◽

Related Factors ◽

Surgical Pain ◽

Literature Reviews ◽

Chronic Post Surgical Pain

IntroductionChronic post-surgical pain (CPSP) after lung or pleural surgery is a common complication and associated with a decrease in quality of life, long-term use of pain medication and substantial economic costs. An abundant number of primary prognostic factor studies are published each year, but findings are often inconsistent, methods heterogeneous and the methodological quality questionable. Systematic reviews and meta-analyses are therefore needed to summarise the evidence.Methods and analysisThe reporting of this protocol adheres to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) checklist. We will include retrospective and prospective studies with a follow-up of at least 3 months reporting patient-related factors and surgery-related factors for any adult population. Randomised controlled trials will be included if they report on prognostic factors for CPSP after lung or pleural surgery. We will exclude case series, case reports, literature reviews, studies that do not report results for lung or pleural surgery separately and studies that modified the treatment or prognostic factor based on pain during the observation period. MEDLINE, Scopus, Web of Science, Embase, Cochrane, CINAHL, Google Scholar and relevant literature reviews will be searched. Independent pairs of two reviewers will assess studies in two stages based on the PICOTS criteria. We will use the Quality in Prognostic Studies tool for the quality assessment and the CHARMS-PF checklist for the data extraction of the included studies. The analyses will all be conducted separately for each identified prognostic factor. We will analyse adjusted and unadjusted estimated measures separately. When possible, evidence will be summarised with a meta-analysis and otherwise narratively. We will quantify heterogeneity by calculating the Q and I2 statistics. The heterogeneity will be further explored with meta-regression and subgroup analyses based on clinical knowledge. The quality of the evidence obtained will be evaluated according to the Grades of Recommendation Assessment, Development and Evaluation guideline 28.Ethics and disseminationEthical approval will not be necessary, as all data are already in the public domain. Results will be published in a peer-reviewed scientific journal.PROSPERO registration numberCRD42021227888.

Download Full-text

Association between cancer and neurodegenerative disorders including dementias; a systematic review

European Journal of Public Health ◽

10.1093/eurpub/ckz185.124 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

L G Gagatsis ◽

E F Ford ◽

S B Bremner ◽

P P Paudyal

Keyword(s):

Systematic Review ◽

Neurodegenerative Disorders ◽

Outcome Measurement ◽

Future Research ◽

Inverse Association ◽

Mesh Terms ◽

Newcastle Ottawa Scale ◽

Cancer Types ◽

Current Context

Abstract Background Several studies have examined associations between neurodegenerative disorders (ND) including dementia, and cancer. However, the associations and directions of these relationships vary by types of ND and cancer. In the current context of ageing populations and increased incidence of ND, dementia and cancer, and existing comorbidity between these disease groups, a better understanding of these relationships could, in future, inform prevention and therapeutics. This systematic review summarises the epidemiological evidence on these associations. Methods PubMed, MEDLINE, Embase, Scopus and Web of Science were searched to identify relevant studies published by 31/12/2018. The search strategy included a combination of search and MESH terms related to ND (e.g. Alzheimer’s, dementia), cancer and study design (case-control, cohort). The quality of included studies was assessed using the Newcastle-Ottawa scale (NOS). Results 77 studies were eligible for inclusion. The majority of studies scored 6+ on the NOS scale and some reported significant associations between ND and cancer. The association with specific types of cancer was not as evident as with all cancers. An inverse relationship was found between NDs and particularly Alzheimer’s, Parkinson’s, and Dementia and Cancer. Only one study found no association between Vascular Dementia and Cancer. Conclusions The findings report an overall inverse association between NDs and all cancers but associations are less evident with specific cancer types. Results from this review can be helpful in recommending reporting standards for future research to reduce heterogeneity between studies. Key messages Exploring the intersection of neurodegenerative disorders/dementia and cancer might help redirect research to novel therapeutic approaches. A standardised approach in design and outcome measurement is necessary to reduce heterogeneity across the studies.

Download Full-text

Is Non-Chlamydial Non-Gonococcal Urethritis Associated with Significant Clinical Complications in Men? A Systematic Review

Current Urology ◽

10.1159/000499266 ◽

2020 ◽

Vol 14 (1) ◽

pp. 1-13 ◽

Cited By ~ 1

Author(s):

Cassandra E.L. Fairhead ◽

Alexander Hampson ◽

Louis Dwyer-Hemmings ◽

Nikhil Vasdev

Keyword(s):

Systematic Review ◽

Reactive Arthritis ◽

Case Reports ◽

Case Series ◽

Current Evidence ◽

Future Research ◽

Qualitative Synthesis ◽

Cross Sectional ◽

Gonococcal Urethritis ◽

Clinical Complications

Background: It is estimated that between 50 and 89% of non-gonococcal urethritis is not caused by Chlamydia trachomatis. Associations between non-chlamydial non-gonococcal urethritis (NCNGU) with balanoposthitis, epididymo-orchitis and reactive arthritis have been suggested, but evidence to support these often-theoretical relationships is sparse and further investigation is called for. Concerns over increasing antimicrobial resistance has rendered the need for clarity over this question ever more pressing in recent years. A review of the current evidence on the complications of NCNGU in men is therefore urgently warranted. Objective: This systematic review summarizes and evaluates the available evidence that NCNGU, whether symptomatic or asymptomatic, causes the significant complications that are already well-recognized to be associated with non-gonococcal urethritis. These significant complications are epididymo-orchitis, balanoposthitis, and sexually-acquired reactive arthritis (Reiter's syndrome) including arthritis or conjunctivitis. Summary: We conducted a systematic review and qualitative synthesis using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis framework. Five databases (PubMed, EMBASE, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, and British Nursing Index) were searched. We included studies that measured clinical outcome after diagnosis of NCNGU in men. Bias was assessed using variations of the Newcastle-Ottawa scale. Data were extracted and entered into a pre-written data abstraction proforma. Seven peer-review studies were included. This included 2 retrospective cohort studies, 1 case series, 2 case reports and 2 cross-sectional studies. The studies described and analyzed 3 types of complication: balanitis, posthitis and/or meatitis; reactive arthritis and/or conjunctivitis; and epididymitis. All studies reported one or more complications. Key Messages: This review identifies an important avenue for future research: while the available evidence suggests that NCNGU has the potential to cause significant complications in men, with the strongest evidence existing for balanitis, posthitis and/or meatitis, the nature and significance of these relationships is far from clear. The findings of this review suggest that prospective, adequately powered research into whether there is a causal link between NCNGU and significant clinical complications in men would be highly worthwhile. The findings of this review raise important questions about the utility of the term NCNGU in research and clinical practice.

Download Full-text

Efficacy of Ayurveda Interventions Specifically on Weight Gain in the Management of Protein Energy Malnutrition in Children: A Systematic Review Protocol

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2021/v33i52b33624 ◽

2021 ◽

pp. 252-258

Author(s):

Sumod Khedekar ◽

Renu Rathi ◽

Bharat Rathi ◽

Heramb Hattikar ◽

Suraj Patlekar ◽

...

Keyword(s):

Systematic Review ◽

Weight Gain ◽

Case Reports ◽

Protein Energy Malnutrition ◽

Case Series ◽

Clinical Work ◽

Treatment Modalities ◽

Public Health Issue ◽

Future Research ◽

Protein Energy

Background: In India, Protein Energy Malnutrition (PEM)remains a significant and challenging public health issue despite implementing different nutritional policies over the period. It is also accompanying with aggravated risk of all-cause morbidity, as well as fatality Ayurveda mentions about various nutritional disorders such as karshya, balashosha, phakka, yakshma which are having similar symptomatology and treatment approach as that of the PEM. Several clinical studies have been conducted and some are under trial but systematic review is still pending to explore an effective treatment modality to combat PEM in Children. Aim: A systematic review to evaluate the efficacy of Ayurveda Interventions specifically on weight gain in the Management of Protein Energy Malnutrition in Children. Materials and Methods: A systematic review which will evaluate published clinical work of Ayurveda treatment modalities specifically for weight gain in the management of PEM in children that will involve “The randomized controlled trials (RCTs), multiple-arms clinical trials, quasi-experimental trials, observational studies (case series and case reports) through databases like PubMed, COCHRANE, AYUSH Research Portal, DHARA; Google Scholar; etc. and Ayurveda compendia to fetch complete available literature.” Observations and Discussion: The work of selection of the studies, data extraction, and synthesis will be taken up. Established guidelines for study selection, quality assessment, and narrative synthesis will be followed. Risk of bias assessment will be performed. A protocol will be designed that will ensure transparency for the completed review. Results of the study will be elaborately synthesized. The data will be presented in percentage, count and frequency; and if we find the data to be sufficiently homogeneous then meta-analysis will be carried out. Conclusion: The results obtained from this systematic review will be useful in identifying the evidence-based efficacy of Ayurveda interventions on weight gain in the Management of PEM. It will also provide substratum for future research studies for generating good-quality evidence that can be helpful to design new health policy to combat PEM effectively.

Download Full-text

A systematic review identifying outcomes and outcome measures in Dupuytren’s disease research

Journal of Hand Surgery (European Volume) ◽

10.1177/1753193420903624 ◽

2020 ◽

Vol 45 (5) ◽

pp. 513-520 ◽

Cited By ~ 1

Author(s):

Marta Karpinski ◽

Syena Moltaji ◽

Charmaine Baxter ◽

Jessica Murphy ◽

Jo-Anne Petropoulos ◽

...

Keyword(s):

Systematic Review ◽

Range Of Motion ◽

Clinical Success ◽

Case Series ◽

Dupuytren’S Disease ◽

Future Research ◽

Multiple Time ◽

Dupuytren's Disease ◽

Outcome Reporting ◽

Treatment Research

This systematic review summarizes the outcome reporting standards in Dupuytren’s disease treatment research. A search of Ovid Medline, Ovid Embase, and CINAHL was conducted. Randomized controlled trials, cohort studies, and case series published between 1997 and 2017, investigating treatment of Dupuytren’s disease with fasciectomy, fasciotomy, or collagenase, were eligible for inclusion. Range of motion was the most commonly reported outcome, appearing in 77% of included studies. Outcomes, such as range of motion, recurrence, and clinical success, were frequently defined, however many different definitions were used. We identified 37 unique measurement methods for range of motion, 28 for recurrence, and 25 for clinical success. Most outcomes were assessed at multiple time points, and only a few studies reported results according to established clinical significance thresholds. Development of a core outcome set will help standardize outcome reporting, and ensure future research in this field is relevant, interpretable, and amenable to systematic review and/or meta-analysis.

Download Full-text

A systematic review of the effectiveness of palliative interventions to treat rectal tenesmus in cancer

Palliative Medicine ◽

10.1177/0269216317697897 ◽

2017 ◽

Vol 31 (10) ◽

pp. 975-981 ◽

Cited By ~ 3

Author(s):

Áine Ní Laoire ◽

Lucy Fettes ◽

Fliss EM Murtagh

Keyword(s):

Systematic Review ◽

Advanced Cancer ◽

Assessment Tool ◽

Treatment Options ◽

Grey Literature ◽

Case Series ◽

Clinical Excellence ◽

Cochrane Library ◽

Future Research ◽

Systematic Review Methodology

Background: Rectal tenesmus is a distressing symptom in patients with advanced cancer and challenging to treat. There is lack of consensus on the appropriate management of tenesmus in this patient population. Aim: To identify and examine the effectiveness of interventions to palliate rectal tenesmus caused by advanced cancer when surgery, radiotherapy or chemotherapy are no longer treatment options. Design: A systematic review of the literature following standard systematic review methodology and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidance. Data sources: A comprehensive search of the electronic databases MEDLINE, EMBASE and the Cochrane Library was conducted from date of inception to April 2016. PubMed ‘related articles’ search, grey literature search and hand-searches of the bibliographies of relevant papers and textbooks were also performed. Non-cancer patients were excluded. Any studies involving surgery or radiotherapy to treat tenesmus were excluded. Studies involving interventions to treat pelvic pain syndromes without specific outcome measures on severity of tenesmus were excluded. The quality of the studies was assessed using a National Institute for Health and Clinical Excellence–recommended quality assessment tool. Results: From 861 studies, 9 met full criteria and were selected. All were case series investigating the use of pharmacological interventions (diltiazem, nifedipine, methadone, mexiletine hydrochloride, lidocaine and bupivacaine), anaesthetic interventions (lumbar sympathectomy, neurolytic superior hypogastric plexus block), and endoscopic laser interventions. The included studies showed substantial heterogeneity, and therefore, a meta-analysis was not feasible. Conclusion: From this review, we identified a significant gap in research into the palliation of rectal tenesmus. A multimodal approach may be necessary due to the complexity of the pathophysiology of tenesmus. Future research should focus on randomised controlled trials of drug therapies whose potential effectiveness is suggested by case series.

Download Full-text

COVID-19 and congenital heart disease: an insight of pathophysiology and associated risks

Cardiology in the Young ◽

10.1017/s1047951120003741 ◽

2020 ◽

pp. 1-8

Author(s):

Ana Alina Haiduc ◽

Michael Ogunjimi ◽

Rohma Shammus ◽

Saira Mahmood ◽

Ramesh Kutty ◽

...

Keyword(s):

Systematic Review ◽

Congenital Heart Disease ◽

Heart Disease ◽

Congenital Heart ◽

Case Reports ◽

Case Series ◽

Future Research ◽

Extensive Literature ◽

Mesh Terms ◽

Poor Outcomes

Abstract Objective: We aimed to examine the literature to determine if both paediatric and adult patients diagnosed with congenital heart disease (CHD) are at a higher risk of poor outcomes if they have the coronavirus disease 2019 (COVID-19), compared to those without CHD. Methods: A systematic review was executed using the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. To identify articles related to COVID-19 and CHD, an extensive literature search was performed on EMBASE, Medline, Scopus, and Global Health databases using keywords and MeSH terms. Results: A total of 12 articles met the inclusion criteria and were included for analysis in this systematic review. Two themes were identified for data extraction: evidence supporting higher risks in CHD patients and evidence against higher risks in CHD patients. After combining the data, there were 99 patients with CHDs out of which 12 required admissions to ICU. Conclusion: This systematic review suggests that CHD may increase the risk of poor outcomes for those with COVID-19, but also highlights the necessity for more research with larger sample sizes in order to make a more justified conclusion, as the majority of papers that were analysed were case series and case reports. Future research should aim to quantify the risks if possible whilst accounting for various confounding factors such as age and treatment history.

Download Full-text

Systematic review of musculoskeletal injuries in professional golfers

British Journal of Sports Medicine ◽

10.1136/bjsports-2018-099572 ◽

2018 ◽

Vol 53 (1) ◽

pp. 13-18 ◽

Cited By ~ 9

Author(s):

Patrick G Robinson ◽

Iain R Murray ◽

Andrew D Duckworth ◽

Roger Hawkes ◽

Danny Glover ◽

...

Keyword(s):

Systematic Review ◽

English Language ◽

Assessment Tool ◽

Epidemiological Studies ◽

Musculoskeletal Injuries ◽

Observational Research ◽

Future Research ◽

Eligibility Criteria ◽

Professional Golfers ◽

Definition Of

ObjectiveThe distribution of injuries affecting professional golfers is yet to be fully understood. We performed a systematic review of the clinical literature to establish the epidemiology of musculoskeletal injuries affecting professional golfers.DesignSystematic review.Data sourcesSearched databases in July 2018 were PubMed, SPORTDiscus and Embase.Eligibility criteriaPublished observational research articles relating to the incidence or prevalence of musculoskeletal injuries in professional golfers, which were written in the English language and not restricted by age or gender.ResultsOf the 1863 studies identified on the initial search, 5 studies were found to satisfy the inclusion criteria for analysis. The mean age of the golfers in these studies was 34.8 (±3.6) years. The gender of patients in included studies compromised 72% males and 28% females. Four studies reported that lumbar spine injuries were the most common (range 22%–34%). Excluding injuries to the spine (lumbar, thoracic and cervical), the hand/wrist was the next most common region of injury (range 6%–37%). The quality of the studies was relatively poor with no study satisfying >50% of the quality assessment tool questions and only one study giving a clear definition of how they defined injury.ConclusionThere is a paucity of well-designed epidemiological studies evaluating musculoskeletal injuries affecting professional golfers. Injuries to the spine are the most frequently affected region, followed by the hand/wrist. This study has identified targeted areas of future research that aims to improve the management of injuries among professional golfers.

Download Full-text

Temporal Bone Fractures Caused by Ballistic Projectiles: A Systematic Review

Otolaryngology ◽

10.1177/0194599820968796 ◽

2020 ◽

pp. 019459982096879

Author(s):

Kenneth L. Kennedy ◽

Elizabeth Cash ◽

Jessica Petrey ◽

Jerry W. Lin

Keyword(s):

Temporal Bone ◽

Bone Fractures ◽

Case Reports ◽

Case Series ◽

Gunshot Wounds ◽

Individual Case ◽

Future Research ◽

Wide Range ◽

Intracranial Complications

Objective Ballistic injuries to the temporal bone are uncommon but devastating injuries that damage critical neurovascular structures. This review describes outcomes after ballistic injuries to the temporal bone and offers initiatives for standardized high-quality future research. Data Sources A systematic search of PubMed, Embase, and Cochrane. Review Methods Studies in the review included adults who experienced temporal bone fractures due to gunshot wounds and survived longer than 48 hours. Individual case reports were excluded. The various searches returned 139 results, of which 6 met inclusion criteria. Results Most of the included studies are case series with low-level evidence that report a wide range of outcomes and follow-up. Outcomes include demographic patient information, audiologic outcomes, vascular injuries, intracranial complications, facial nerve function, and surgical indications. Conclusion This review is the first to characterize the nature and progression of patients who experienced gunshot wounds to the temporal bone. Although all patients share an etiology of injury, they often have vastly different hospital courses and outcomes. This review provides a basis for future studies to guide care for these injuries, as most of the existing literature includes small dated case series.

Download Full-text

Vestibular Dysfunction and Gross Motor Milestone Acquisition in Children With Hearing Loss: A Systematic Review

Otolaryngology ◽

10.1177/0194599820983726 ◽

2021 ◽

pp. 019459982098372

Author(s):

Anisha Singh ◽

Eileen M. Raynor ◽

Janet W. Lee ◽

Sherri L. Smith ◽

Hannah Heet ◽

...

Keyword(s):

Systematic Review ◽

Hearing Loss ◽

Case Series ◽

Vestibular Function ◽

Vestibular Dysfunction ◽

Future Research ◽

Gross Motor ◽

Children With Hearing Loss ◽

The Impact ◽

Motor Milestone

Objective To describe the impact of vestibular dysfunction on gross motor development in children with hearing loss. Data Sources MEDLINE (PubMed), Embase (Elsevier), Web of Science (Clarivate), and the Cumulative Index of Nursing and Allied Health Literature (EBSCO). Review Methods A systematic review was reported in concordance with the PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-analyses). Articles on children with hearing loss who underwent at least 1 instrumented measure of vestibular function and had gross motor milestones assessed were included. The Downs and Black checklist was used to assess risk of bias and methodological quality. Results Eleven articles were included in the systematic review. Three articles stratified quantitative results of gross motor milestone acquisition by severity of vestibular impairment. Over half of studies were case series published within the last 5 years. This systematic review showed that children with hearing loss and severe, bilateral vestibular dysfunction demonstrate delayed gross motor milestones. However, it was difficult to draw conclusions on whether milder forms of vestibular dysfunction significantly affect gross motor milestone acquisition in children with hearing loss. The reason is that most studies were of low to moderate quality, used different assessment methods, and contained results that were descriptive in nature. Conclusions This emerging area would benefit from future research, such as higher-quality studies to assess vestibular function and gross motor milestones. This would allow for better characterization of the impacts of vestibular impairment, especially milder forms, in children with hearing loss.

Download Full-text