Pre-operative counselling for laryngectomy patients: a systematic review

2015 ◽  
Vol 130 (1) ◽  
pp. 15-20 ◽  
Author(s):  
E Fitzgerald ◽  
A Perry

AbstractObjectives:This study aimed to undertake a systematic review of the literature about pre-operative counselling for laryngectomy patients, identify its practice and patient and (where possible) carer perceptions.Methods:A search strategy was formulated using a concept map and a Population, Intervention, Comparative Interaction and Outcomes (‘PICO’) schema. All publications from 1975 to 2015 reporting pre-operative counselling of laryngectomy patients were included. Papers were retrieved and critiqued, and those included were assigned a level of evidence (according to the Joanna Briggs Institute schema).Results:Of the 56 papers retrieved, 21 were included in the review. The literature is limited: studies demonstrate bias and are of poor methodological quality. There are clear, persistent reports by patients and carers of shortfalls in clinical practice.Conclusion:Studies on pre-operative counselling for laryngectomees are flawed in design and represent weak levels of evidence. Pre-operative counselling has not been operationalised, resulting in differing paradigms being examined. Aggregation of data and/or results is not possible and the veracity of many studies is questioned.

Author(s):  
Lin Lu ◽  
Fadel M. Megahed ◽  
Lora A. Cavuoto

Objective:We present a literature review on workplace physical fatigue interventions, focusing on evaluating the methodological quality and strength of evidence.Background:Physical fatigue is a recognized workplace problem, with negative effects on performance and health-related complaints. Although many studies have focused on the mechanisms and consequences of fatigue, few have considered the effectiveness of interventions to mitigate fatigue.Method:A systematic review of the workplace safety literature for controlled trials of physical fatigue interventions was conducted. Data on intervention type, subject characteristics, targeted tasks and body locations, outcome measures, and study design were extracted. The methodological quality for each study was evaluated using the PEDro scale, and the level of evidence was based on quality, amount, and consistency.Results:Forty-five controlled trials were reviewed, examining 18 interventions. We categorized those interventions into individual-focused ( N = 28 studies, nine interventions), workplace-focused ( N = 12 studies, five interventions), and multiple interventions ( N = 5 studies, four interventions). We identified moderate evidence for interventions related to assistive devices and task variation. There was moderate evidence supporting no fatigue attenuation for the garment change category of interventions. The interventions in the remaining categories had limited to minimal evidence of efficacy. The heterogeneity of the included trials precludes the determination of effect size.Conclusion:This review showed a lack of high levels of evidence for the effectiveness of most physical fatigue interventions.Application:Due to a lack of high levels of evidence for any category of reviewed physical fatigue interventions, further high-quality studies are needed to establish the efficacy of others.


2020 ◽  
Vol 12 (3) ◽  
pp. 77-88
Author(s):  
Bruno Corrado ◽  
Gianluca Ciardi ◽  
Laura Lucignano

Objective: to find the most up-to-date evidence of the effectiveness and safety of supervised physical therapy in polymyositis/dermatomyositis patients. Methods: a systematic review of the literature in the main scientific databases was carried out. We searched for randomized controlled trials concerning supervised physical therapy and polymyositis/dermatomyositis. The PICOS method was used for the formulation of the clinical query. Methodological quality and the level of evidence of the included studies were assessed using the modified Jadad scale and the Oxford Centre for Evidence-Based Medicine Levels of Evidence guide, respectively. Results: a total of 2591 articles were found. By applying the inclusion/exclusion criteria, six randomized controlled clinical trials were admitted to the final phase of the review. The compared approaches concerned supervised exercise programs based on strategies of muscle strengthening or aerobic work. Following these exercises, an increase in the maximum rate of oxygen consumption, a decrease in creatine phosphokinase levels, an enhancement in the patient’s aerobic performance and an improvement in the quality of life indexes were registered. The methodological quality of the included studies ranged from 3 to 4.5. All the studies were classified as presenting an evidence level of 2b. Conclusions: supervised physical therapy in polymyositis/dermatomyositis is an effective, safe and free-of-contraindications tool to be used both in the acute and in the established phases of the pathology. However, further and higher-quality studies are necessary to confirm those findings, to clarify the timing of exercise delivery and to guide the choice towards different types of muscle contraction exercises.


BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Stefano Granieri ◽  
Francesco Sessa ◽  
Alessandro Bonomi ◽  
Sissi Paleino ◽  
Federica Bruno ◽  
...  

Abstract Background Entero-colovesical fistula is a rare complication of various benign and malignant diseases. The diagnosis is prominently based on clinical symptoms; imaging studies are necessary not only to confirm the presence of the fistula, but more importantly to demonstrate the extent and the nature of the fistula. There is still a lack of consensus regarding the if, when and how to repair the fistula. The aim of the study is to review the different surgical treatment options, focus on surgical indications, and explore cumulative recurrence, morbidity, and mortality rates of entero-vesical and colo-vesical fistula patients. Methods A systematic review of the literature was conducted according to PRISMA guidelines. Random effects meta-analyses of proportions were developed to assess primary and secondary endpoints. I2 statistic and Cochran’s Q test were computed to assess inter-studies’ heterogeneity. Results Twenty-two studies were included in the analysis with a total of 861 patients. Meta-analyses of proportions pointed out 5, 22.2, and 4.9% rates for recurrence, complications, and mortality respectively. A single-stage procedure was performed in 75.5% of the cases, whereas a multi-stage operation in 15.5% of patients. Palliative surgery was performed in 6.2% of the cases. In 2.3% of the cases, the surgical procedure was not specified. Simple and advanced repair of the bladder was performed in 84.3% and 15.6% of the cases respectively. Conclusions Although burdened by a non-negligible rate of complications, surgical repair of entero-colovesical fistula leads to excellent results in terms of primary healing. Our review offers opportunities for significant further research in this field. Level of Evidence Level III according to ELIS (SR/MA with up to two negative criteria).


2021 ◽  
Vol 29 (1) ◽  
Author(s):  
Pierre Côté ◽  
Jan Hartvigsen ◽  
Iben Axén ◽  
Charlotte Leboeuf-Yde ◽  
Melissa Corso ◽  
...  

Abstract Background A small proportion of chiropractors, osteopaths, and other manual medicine providers use spinal manipulative therapy (SMT) to manage non-musculoskeletal disorders. However, the efficacy and effectiveness of these interventions to prevent or treat non-musculoskeletal disorders remain controversial. Objectives We convened a Global Summit of international scientists to conduct a systematic review of the literature to determine the efficacy and effectiveness of SMT for the primary, secondary and tertiary prevention of non-musculoskeletal disorders. Global summit The Global Summit took place on September 14–15, 2019 in Toronto, Canada. It was attended by 50 researchers from 8 countries and 28 observers from 18 chiropractic organizations. At the summit, participants critically appraised the literature and synthesized the evidence. Systematic review of the literature We searched MEDLINE, Embase, the Cochrane Central Register of Controlled Trials, the Cumulative Index to Nursing and Allied Health, and the Index to Chiropractic Literature from inception to May 15, 2019 using subject headings specific to each database and free text words relevant to manipulation/manual therapy, effectiveness, prevention, treatment, and non-musculoskeletal disorders. Eligible for review were randomized controlled trials published in English. The methodological quality of eligible studies was assessed independently by reviewers using the Scottish Intercollegiate Guidelines Network (SIGN) criteria for randomized controlled trials. We synthesized the evidence from articles with high or acceptable methodological quality according to the Synthesis without Meta-Analysis (SWiM) Guideline. The final risk of bias and evidence tables were reviewed by researchers who attended the Global Summit and 75% (38/50) had to approve the content to reach consensus. Results We retrieved 4997 citations, removed 1123 duplicates and screened 3874 citations. Of those, the eligibility of 32 articles was evaluated at the Global Summit and 16 articles were included in our systematic review. Our synthesis included six randomized controlled trials with acceptable or high methodological quality (reported in seven articles). These trials investigated the efficacy or effectiveness of SMT for the management of infantile colic, childhood asthma, hypertension, primary dysmenorrhea, and migraine. None of the trials evaluated the effectiveness of SMT in preventing the occurrence of non-musculoskeletal disorders. Consensus was reached on the content of all risk of bias and evidence tables. All randomized controlled trials with high or acceptable quality found that SMT was not superior to sham interventions for the treatment of these non-musculoskeletal disorders. Six of 50 participants (12%) in the Global Summit did not approve the final report. Conclusion Our systematic review included six randomized clinical trials (534 participants) of acceptable or high quality investigating the efficacy or effectiveness of SMT for the treatment of non-musculoskeletal disorders. We found no evidence of an effect of SMT for the management of non-musculoskeletal disorders including infantile colic, childhood asthma, hypertension, primary dysmenorrhea, and migraine. This finding challenges the validity of the theory that treating spinal dysfunctions with SMT has a physiological effect on organs and their function. Governments, payers, regulators, educators, and clinicians should consider this evidence when developing policies about the use and reimbursement of SMT for non-musculoskeletal disorders.


2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Matteo Buda ◽  
Riccardo D’Ambrosi ◽  
Enrico Bellato ◽  
Davide Blonna ◽  
Alessandro Cappellari ◽  
...  

Abstract Background Revision surgery after the Latarjet procedure is a rare and challenging surgical problem, and various bony or capsular procedures have been proposed. This systematic review examines clinical and radiographic outcomes of different procedures for treating persistent pain or recurrent instability after a Latarjet procedure. Methods A systematic review of the literature was performed using the Medline, Cochrane, EMBASE, Google Scholar and Ovid databases with the combined keywords “failed”, “failure”, “revision”, “Latarjet”, “shoulder stabilization” and “shoulder instability” to identify articles published in English that deal with failed Latarjet procedures. Results A total of 11 studies (five retrospective and six case series investigations), all published between 2008 and 2020, fulfilled our inclusion criteria. For the study, 253 patients (254 shoulders, 79.8% male) with a mean age of 29.6 years (range: 16–54 years) were reviewed at an average follow-up of 51.5 months (range: 24–208 months). Conclusions Eden–Hybinette and arthroscopic capsuloplasty are the most popular and safe procedures to treat recurrent instability after a failed Latarjet procedure, and yield reasonable clinical outcomes. A bone graft procedure and capsuloplasty were proposed but there was no clear consensus on their efficacy and indication. Level of evidence Level IV Trial registration PROSPERO 2020 CRD42020185090—www.crd.york.ac.uk/prospero/


2015 ◽  
Vol 105 (4) ◽  
pp. 357-366 ◽  
Author(s):  
Aditya K. Gupta ◽  
Deanne Daigle ◽  
Maryse Paquet

New therapies for onychomycosis continue to be developed, yet treatments are seldom directly compared in randomized controlled trials. The objective of this study was to compare the rates of mycological cure for oral and topical onychomycosis treatments using network meta-analysis. A systematic review of the literature on onychomycosis treatments published before March 25, 2013, was performed, and data were analyzed using network meta-analysis. Terbinafine, 250 mg, therapy was significantly superior to all treatments except itraconazole, 400 mg, pulse therapy; itraconazole, 200 mg, therapy was significantly superior to fluconazole and the topical treatments; and fluconazole, efinaconazole, ciclopirox, terbinafine nail solution, and amorolfine treatments were significantly superior to only placebo. These results support the superiority of 12-week continuous terbinafine, 250 mg, therapy and itraconazole, 400 mg, pulse therapy (1 week per month for 3 months) while suggesting the equivalence of topical therapies. These results reflect findings from the literature and treatment efficacy observed in clinical practice.


2020 ◽  
Vol 25 (264) ◽  
pp. 139-152
Author(s):  
Manoela Abreu ◽  
Franciele Carvalho Santos ◽  
Ana Laura Nogueira ◽  
Matheus Lima Zampieri ◽  
Dernival Bertoncello

The aim of this study was to perform a systematic review of the literature in order to investigate the effects of the Pilates Method on athletes of different sports. Methods: Researches were carried out in databases (SciELO, LILACS, PubMed, Web of Science and SCOPUS) and to evaluate the methodological quality of the studies, the PEDro scale was used. Results: Of the 87 studies found, only four were included. Meta-analyzes to assess flexibility using the Wells Bank's Sit and Reach test and a fleximeter indicated improvement after Pilates application, although there were no statistically significant differences compared to the control groups (Wells Bank's Sit and Reach test: 2 , 83 95% CI: -0.73 to 6.38, I² = 99%; Fleximeter: -0.78, 95% CI: -1.84 to 0.27, I² = 0%). Conclusion: There is evidence of benefits after Pilates intervention. Future studies with standardized protocols, according to the chosen sport, are necessary to determine how the Pilates Method can improve athletes' performance.


Author(s):  
Norah L. Johnson ◽  
Abir K. Bekhet ◽  
Rachel Sawdy ◽  
Emily Zint ◽  
June Wang ◽  
...  

Background: The aims of this review were to describe exercise interventions, facilitators, and barriers to physical activity for parents of children with autism spectrum disorder. Methods: A systematic review of the literature, appraising the validity of each article with Melnyk and Fineout-Overholt’s level of evidence, from different databases CINAHL, Cochrane, PsycINFO, PubMed, ProQuest, and Web of Science between 2000 and 2020 was conducted. As the initial search revealed no articles on exercise interventions and only 2 articles with children with autism spectrum disorder, the aim was widened to all parents of children. Results: Forty-five articles were identified on barriers to physical activity including being the primary caregiving parent, perception of guilt and selfishness, and adhering to exercise programs they do as part of research, once research ends. Facilitators for physical activity including parents being more likely to exercise if they can bring their child with them and parents preferring exercise that is a lifelong habit, such as walking. Conclusions: Due to the lack of research on parents of children with autism spectrum disorder, recommendations include development and testing of interventions for parents of children with this condition including family-based exercise interventions where children and parents have a choice to exercise together.


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