scholarly journals Health effects of a low-inflammatory diet in adults with arthritis: a systematic review and meta-analysis

2020 ◽  
Vol 9 ◽  
Author(s):  
Furkan Genel ◽  
Michael Kale ◽  
Natalie Pavlovic ◽  
Victoria M. Flood ◽  
Justine M. Naylor ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Health Effects ◽  
Dietary Intervention ◽  
Meta Analysis ◽  
Grey Literature ◽  
Inflammatory Biomarkers ◽  
Dietary Compliance ◽  
Full Diet ◽  
Prospective Trials

Abstract The aim is to systematically assess the health impact of a low-inflammatory diet intervention (full-diet or supplement), compared to usual diet or other dietary interventions, on weight change, inflammatory biomarkers, joint symptoms, and quality of life in adults with osteoarthritis, rheumatoid arthritis or seronegative arthropathy (psoriatic, reactive, ankylosing spondylitis or IBD-related), on outcomes assessed in prospective studies within 6 months of intervention commencement (PROSPERO CRD42019136567). Search of multiple electronic library databases from inception to July 2019, supplemented by grey literature searches, for randomised and prospective trials assessing the above objective. After exclusion of 446 ineligible studies, five randomised and two prospective trials involving 468 participants with either osteoarthritis or rheumatoid arthritis were included. GRADE assessment for all outcomes was very low. Meta-analyses produced the following standardised mean differences (SMD) and 95 % confidence interval (CI) 2–4 months following commencement of the diets favouring the low-inflammatory diet: weight SMD −0⋅45 (CI −0⋅71, −0⋅18); inflammatory biomarkers SMD −2⋅33 (CI −3⋅82, −0⋅84). No significant effects were found for physical function (SMD −0⋅62; CI −1⋅39, 0⋅14), general health (SMD 0⋅89; CI −0⋅39, 2⋅16) and joint pain (SMD −0⋅98; CI −2⋅90, 0⋅93). In most studies, the quality of dietary intervention (dietitian input, use of validated dietary compliance tool) could not be gauged. In conclusion, very low-level evidence suggests that low-inflammatory diets or supplements compared to usual diets are associated with greater weight loss and improvement in inflammatory biomarkers. More high-quality trials are needed to assess the health effects of a low-inflammatory diet more comprehensively and conclusively in arthritic conditions.

scholarly journals Factors associated with mortality due to neonatal pneumonia in India: a protocol for systematic review and planned meta-analysis

BMJ Open ◽  
2017 ◽  
Vol 7 (9) ◽  
pp. e017616 ◽  
Author(s):  
N Sreekumaran Nair ◽  
Leslie Edward Lewis ◽  
Theophilus Lakiang ◽  
Myron Godinho ◽  
Shruti Murthy ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Grey Literature ◽  
Secondary Data ◽  
Research Knowledge ◽  
Neonatal Deaths ◽  
Factors Associated ◽  
Assessment Development ◽  
Indian Context ◽  
Ethical Approval

IntroductionIndia contributes to the highest number of neonatal deaths globally. It also has the greatest number of pneumonia-related neonatal deaths in the developing world. We aim to systematically review the evidence for the factors associated with mortality due to neonatal pneumonia in the Indian context, to address the lack of consolidated evidence on this important issue.Methods and analysisThis protocol is part of a series of three reviews on neonatal pneumonia in India. Observational studies reporting on outcome of neonatal pneumonia in the Indian context, and published in English in peer-reviewed and indexed journals will be eligible for inclusion. Outcomes of this review will be the factors determining mortality due to neonatal pneumonia. A total of nine databases will be searched. Electronic and hand searching of published and grey literature will be performed. Selection of studies will be done in title, abstract and full text screening stages. Risk of bias, independently assessed by two authors, will be evaluated. Meta-analysis will be performed and heterogeneity assessed. Pooled effect estimates will be stated with 95% confidence intervals. Narrative synthesis will be done where meta-analysis cannot be performed. Publication bias will be evaluated and sensitivity analysis performed according to study quality. Quality of this review will be evaluated using AMSTAR (Assessing the Methodological quality of Systematic Reviews) and GRADE (Grades of Recommendation, Assessment, Development & Evaluation). A summary of findings table will be reported using GRADEPro.Ethics and disseminationSince this is a review involving analysis of secondary data which is available in the public domain, and does not involve human participants, ethical approval was not required. The findings of the study will be shared with all stakeholders of this research. Knowledge dissemination workshops will be conducted with relevant stakeholders to transfer the evidence, tailored to the stakeholder (eg, policy briefs, publications, information booklets, etc).

Silver Diamine Fluoride Has Efficacy in Controlling Caries Progression in Primary Teeth: A Systematic Review and Meta-Analysis

2017 ◽  
Vol 51 (5) ◽  
pp. 527-541 ◽  
Author(s):  
Ana Cláudia Chibinski ◽  
Letícia Maíra Wambier ◽  
Juliana Feltrin ◽  
Alessandro Dourado Loguercio ◽  
Denise Stadler Wambier ◽  
...  
Keyword(s):  
Systematic Review ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Grey Literature ◽  
Active Material ◽  
Risk Of Bias ◽  
Cochrane Library ◽  
Silver Diamine Fluoride ◽  
Caries Progression

A systematic review was performed to evaluate the efficacy of silver diamine fluoride (SDF) in controlling caries progression in children when compared with active treatments or placebos. A search for randomized clinical trials that evaluate the effectiveness of SDF for caries control in children compared to active treatments or placebos with follow-ups longer than 6 months was performed in PubMed, Scopus, Web of Science, LILACS, BBO, Cochrane Library, and grey literature. The risk of bias tool from the Cochrane Collaboration was used for quality assessment of the studies. The quality of the evidence was evaluated using the GRADE approach. Meta-analysis was performed on studies considered at low risk of bias. A total of 5,980 articles were identified. Eleven remained in the qualitative synthesis. Five studies were at “low,” 2 at “unclear,” and 4 studies at “high” risk of bias in the key domains. The studies from which the information could be extracted were included for meta-analysis. The arrestment of caries at 12 months promoted by SDF was 66% higher (95% CI 41-91%; p < 0.00001) than by other active material, but it was 154% higher (95% CI 67-85%; p < 0.00001) than by placebos. Overall, the caries arrestment was 89% higher (95% CI 49-138%; p < 0.00001) than using active materials/placebo. No heterogeneity was detected. The evidence was graded as high quality. The use of SDF is 89% more effective in controlling/arresting caries than other treatments or placebos. The quality of the evidence was graded as high.

scholarly journals Efficacy of Oral Ginger (Zingiber officinale) for Dysmenorrhea: A Systematic Review and Meta-Analysis

2016 ◽  
Vol 2016 ◽  
pp. 1-10 ◽  
Author(s):  
Chen X. Chen ◽  
Bruce Barrett ◽  
Kristine L. Kwekkeboom
Keyword(s):  
Systematic Review ◽  
Methodological Quality ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Grey Literature ◽  
Zingiber Officinale ◽  
Mean Difference ◽  
Significant Difference ◽  
Meta Analyses

This systematic review examines the efficacy of oral ginger for dysmenorrhea. Key biomedical databases and grey literature were searched. We included randomized controlled trials comparing oral ginger against placebo or active treatment in women with dysmenorrhea. Six trials were identified. Two authors independently reviewed the articles, extracted data, and assessed risk of bias. Discrepancies were resolved by consensus with a third reviewer. We completed a narrative synthesis of all six studies and exploratory meta-analyses of three studies comparing ginger with placebo and two studies comparing ginger with a nonsteroidal anti-inflammatory drug (NSAID). Ginger appeared more effective for reducing pain severity than placebo. The weighted mean difference on a 10 cm visual analogue scale was 1.55 cm (favoring ginger) (95% CI 0.68 to 2.43). No significant difference was found between ginger and mefenamic acid (an NSAID). The standardized mean difference was 0 (95% CI −0.40 to 0.41). Available data suggest that oral ginger could be an effective treatment for menstrual pain in dysmenorrhea. Findings, however, need to be interpreted with caution because of the small number of studies, poor methodological quality of the studies, and high heterogeneity across trials. The review highlights the need for future trials with high methodological quality.

scholarly journals Awake prone positioning in non-intubated patients for the management of hypoxemia in COVID-19: A systematic review and meta-analysis

2021 ◽  
Vol 91 (2) ◽  
Author(s):  
Sryma PB ◽  
Saurabh Mittal ◽  
Karan Madan ◽  
Anant Mohan ◽  
Pawan Tiwari ◽  
...  
Keyword(s):  
Systematic Review ◽  
Mechanical Ventilation ◽  
Therapeutic Strategy ◽  
Meta Analysis ◽  
Prone Positioning ◽  
Limited Evidence ◽  
Prospective Trials ◽  
Respiratory Outcomes ◽  
The Impact

Coronavirus disease-2019 (COVID-19) may lead to hypoxemia, requiring intensive care in many patients. Awake prone positioning (PP) is reported to improve oxygenation and is a relatively safe modality. We performed a systematic review of the literature to evaluate the available evidence and performed meta-analysis of the effect of awake PP in non-intubated patients on improvement in oxygenation and reducing the need for intubation. We searched the PubMed and EMBASE databases to identify studies using awake PP as a therapeutic strategy in the management of COVID-19. Studies were included if they reported respiratory outcomes and included five or more subjects. The quality of individual studies was assessed by the Qualsyst tool. A meta-analysis was performed to estimate the proportion of patients requiring intubation. The degree of improvement in oxygenation parameters (PaO2: FiO2 or PaO2 or SpO2) was also calculated. Sixteen studies (seven prospective trials, three before-after studies, six retrospective series) were selected for review. The pooled proportion of patients who required mechanical ventilation was 0.25 (95% confidence interval (CI) 0.16-0.34). There was a significant improvement in PaO2: FiO2 ratio, PaO2, and SpO2 during awake PP. To conclude, there is limited evidence to support the efficacy of awake PP for the management of hypoxemia in COVID-19. Further RCTs are required to study the impact of awake PP on key parameters like avoidance of mechanical ventilation, length of stay, and mortality.

scholarly journals Effectiveness of interventions for the prevention of occupational violence against professionals in health services: a protocol for a systematic review

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e036558
Author(s):  
Caroline Vieira Cláudio Okubo ◽  
Renata Cristina Campos Pereira Silveira ◽  
Maria José Quina Galdino ◽  
Daiane Rubinato Fernandes ◽  
Aline Aparecida Oliveira Moreira ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Grey Literature ◽  
Cochrane Review ◽  
Health Sector ◽  
Risk Of Bias ◽  
Cochrane Library ◽  
Eligibility Criteria ◽  
Occupational Violence

IntroductionOccupational violence affects several categories of workers; however, the health sector category has been considered at a high risk, exposing workers to physical and psychological abuse. Thus, occupational violence has decreased the quality of care in health service. This review aims to evaluate the effectiveness of interventions for the prevention and reduction of occupational violence against health professionals.Methods and analysisThis protocol is consistent with the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols. Searches will be conducted in PubMed, Embase, Cochrane Library, LILACS, Web of Science, Scopus, CINAHL and LIVIVO along with a comprehensive review of grey literature. The search will be conducted on August 1 st 2020, without language and time restrictions. Following the eligibility criteria, two independent reviewers will select the titles and abstracts and subsequently screen the full articles. If necessary, a third reviewer will assess any disagreements. All references will be imported into EndNote, and any duplicates will be removed. The data will be extracted using an extraction-based form from Cochrane. Statistical analyses will be performed using the software Cochrane Review Manager, and a meta-analysis will be performed if possible for the statistical combination of at least two studies. The risk of bias of the randomised clinical trials will be evaluated by the Risk of Bias tool from Cochrane, and the risk of bias of the non-randomised intervention studies will be evaluated using the Downs and Black scale. The quality of the evidence and strength of the classification recommendations will be assessed by the Grading of Recommendations, Assessment, Development and Evaluation.Ethics and disseminationThis review will not evaluate individual patient information and therefore does not require ethical approval. The results will be disseminated through publications in peer-reviewed journals, presentations at conferences and the doctoral thesis of the leading author.PROSPERO registration numberCRD42018111383.

A systematic review to explore the impact of anxiety on quality of life and treatment outcomes in rheumatoid arthritis

2018 ◽  
Vol 68 (suppl 1) ◽  
pp. bjgp18X697181
Author(s):  
Annabelle Machin ◽  
Randula Haththotuwa ◽  
Opeyemi Babatunde ◽  
Ian Scott ◽  
Nadia Corp ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Rheumatoid Arthritis ◽  
Systematic Review ◽  
Treatment Outcomes ◽  
Treatment Response ◽  
Data Extraction ◽  
Meta Analysis ◽  
Past Research ◽  
The Impact

BackgroundRheumatoid arthritis (RA) is the commonest inflammatory arthritis. Comorbid anxiety and depression are common, but under-recognised and under-treated. Depression in RA has been linked to reduced quality of life and treatment response and increased mortality. Past research into co-morbid mood problems in RA has mainly focused on the prevalence and impact of depression.AimTo complete a systematic review to explore the impact of anxiety on QOL and treatment outcomes in RA.MethodThe systematic review has been registered on PROSPERO. Databases (Web of Science, PsycINFO, CINAHL, Embase and Medline) have been systematically searched for relevant studies. Titles and abstracts have been independently screened by two reviewers. Data extraction and quality appraisal of studies will be carried out using a customized and piloted data extraction tool and the Newcastle-Ottawa Scale. Disagreements will be resolved through discussion or by a third reviewer. A narrative synthesis framework will be used to develop a theory of how anxiety impacts on QOL and treatment response and a meta-analysis performed.ResultsThe search has identified 6404 articles. After title screening, 284 abstracts have been reviewed and 48 full texts are being reviewed for inclusion. Full text review is ongoing, and results of the analysis will be presented.ConclusionHighlighting the impact of anxiety on outcomes in RA may suggest areas for future implementation studies to improve patient outcomes, potentially reducing associated morbidity and mortality.

scholarly journals Behaviour change interventions for the management of Raynaud's phenomenon: a systematic review protocol

BMJ Open ◽  
2017 ◽  
Vol 7 (8) ◽  
pp. e017039 ◽  
Author(s):  
Jo Daniels ◽  
John D Pauling ◽  
Christopher Eccelston
Keyword(s):  
Systematic Review ◽  
Behaviour Change ◽  
Raynaud’S Phenomenon ◽  
Meta Analysis ◽  
Grey Literature ◽  
Raynaud's Phenomenon ◽  
Risk Of Bias ◽  
Bias Assessment ◽  
Behaviour Change Interventions

IntroductionRaynaud's phenomenon (RP) describes excessive peripheral vasospasm to cold exposure and/or emotional stress. RP episodes are associated with digital colour changes, pain and reduced quality of life. Pharmacological interventions are of low to moderate efficacy and often result in adverse effects such as facial flushing and headaches. Recommended lifestyle and behavioural interventions have not been evaluated. The objectives of the proposed systematic review are to assess the comparative safety and efficacy of behaviour change interventions for RP and identify what we can learn to inform future interventions.Methods and analysisStudies eligible for inclusion include randomised controlled trials testing behaviour change interventions with a control comparator. A comprehensive search strategy will include peer review and grey literature up until 30 April 2017. Search databases will include Medline, Embase, PsychINFO and Cochrane. Initial sifting, eligibility, data extraction, risk of bias and quality assessment will be subject to review by two independent reviewers with a third reviewer resolving discrepancies. Risk of bias assessment will be performed using Cochrane risk of a bias assessment tool with quality of evidence assessed using Grading of Recommendations Assessment, Development and Evaluation(GRADE). A meta-analysis will be performed if there are sufficient data. Two subgroup analyses are planned: primary versus secondary RP outcomes; comparison of theoretically informed interventions with pragmatic interventions.Ethics and disseminationThis review does not require ethical approval as it will summarise published studies with non-identifiable data. This protocol complies with the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) guidelines. Findings will be disseminated in peer-reviewed articles and reported according to PRISMA. This review will make a significant contribution to the management of RP where no review of behaviour-change interventions currently exist. The synopsis and protocol for the proposed systematic review is registered in the International Prospective Register of Systematic Reviews (registration number CRD42017049643).

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