scholarly journals Effectiveness of endoscopic cricopharyngeal myotomy in adults with neurological disease: systematic review

2016 ◽  
Vol 130 (12) ◽  
pp. 1077-1085 ◽  
Author(s):  
Ó Gilheaney ◽  
P Kerr ◽  
S Béchet ◽  
M Walshe
Keyword(s):  
Neurological Disease ◽  
Grey Literature ◽  
Operative Management ◽  
Cricopharyngeal Myotomy ◽  
Management Protocol ◽  
Laryngeal Penetration ◽  
Upper Oesophageal Sphincter ◽  
Quasi Experimental ◽  
Resting Pressure ◽  
Methodological Concern

AbstractObjective:To determine the effectiveness of endoscopic cricopharyngeal myotomy on upper oesophageal sphincter dysfunction in adults with upper oesophageal sphincter dysfunction and neurological disease.Data sources:Published and unpublished studies with a quasi-experimental design investigating endoscopic cricopharyngeal myotomy effects on upper oesophageal sphincter dysfunction in humans were considered eligible. Electronic databases, grey literature and reference lists of included studies were systematically searched.Review methods:Data were extracted by two independent reviewers. Methodological quality was assessed independently using the PEDro scale and MINORS tool.Results:Of 2938 records identified, 2 studies were eligible. Risk of bias assessment indicated areas of methodological concern in the literature. Statistical analysis was not possible because of the limited number of eligible studies.Conclusion:No determinations could be made regarding endoscopic cricopharyngeal myotomy effectiveness in the cohort of interest. Reliable and valid evidence on the following is required to support increasing clinical usage of endoscopic cricopharyngeal myotomy: optimal candidacy selection; standardised post-operative management protocol; complications; and endoscopic cricopharyngeal myotomy effects on aspiration of food and laryngeal penetration, mean upper oesophageal sphincter resting pressure and quality of life.

Psychosocial Depression Interventions for Dialysis Patients, With Attention to Latinos: A Scoping Review

2019 ◽  
Vol 29 (8) ◽  
pp. 910-923 ◽  
Author(s):  
John E. Sullivan ◽  
Namkee G. Choi ◽  
Christian E. Vazquez ◽  
Margaret A. Neaves
Keyword(s):  
Scoping Review ◽  
Expressive Writing ◽  
Behavioral Therapy ◽  
Grey Literature ◽  
Behavioral Problem ◽  
Experimental Studies ◽  
The United States ◽  
Cognitive Behavioral ◽  
Dialysis Patients ◽  
Quasi Experimental

Purpose: Depression is a common and debilitating condition that often goes undetected and untreated among people with end-stage renal disease (ESRD). We conducted a scoping review to identify psychosocial depression interventions for adult dialysis patients and gaps in depression care, with particular attention to Latinos, a group disproportionately affected by ESRD in the United States. Methods: We searched electronic databases and grey literature sources for studies in English and Spanish. Results: We found 36 studies including cognitive behavioral, problem-solving, hope, psychoeducation, expressive writing, and physical activity interventions. Twelve studies (33%) were U.S.-based, while the rest were conducted elsewhere. U.S.-based studies involved mostly individual-format cognitive behavioral therapy (CBT) interventions carried out during dialysis. CBTs showed the most promising effect on depression in both randomized clinical and quasi-experimental studies. Among 22 randomized trials reviewed, 1 reported participants with Latino/Hispanic ethnicity. Conclusions: More intervention research is needed for depression treatment with ESRD patients, especially Latinos.

scholarly journals Protocol for a systematic review of the incidence of infection in operative vs non-operative management of Seymour fractures in children and adolescents

2020 ◽  
Author(s):  
Ailbhe Lynda Kiely ◽  
Grant Switzer Nolan ◽  
Lilli Cooper
Keyword(s):  
Systematic Review ◽  
Soft Tissue ◽  
Children And Adolescents ◽  
Grey Literature ◽  
Operative Management ◽  
Fracture Pattern ◽  
Cochrane Library ◽  
Non Union ◽  
Fractures In Children ◽  
Non Operative Management

Abstract Background Seymour fractures are open, displaced juxta-epiphyseal fractures of the distal phalanx, with an overlying nail bed laceration that occur in children and adolescents with an open physis. This fracture occurs rarely, but its potential consequences are clinically significant. Due to anatomical particulars and proximity to the growth plate, this open fracture may result in soft tissue infection and osteomyelitis, leading to growth arrest and persistent mallet deformity. At present, there is no consensus as to the optimal management of Seymour fractures. The objective of this study will be to systematically evaluate the existing evidence to establish whether operative or non-operative management of Seymore fractures is associated with a lower incidence of infection. Methods We designed and registered a study protocol for a systematic review of comparative and observational studies. A comprehensive literature search will be conducted (from 1966 to present) in MEDLINE, EMBASE, CINAHL, Cochrane Library and Google Scholar databases. Grey literature will be identified through searching Open Grey and dissertation databases using an exhaustive search strategy. All clinical studies examining the management of Seymour fractures in children & adolescents will be included, comparing operative and non-operative groups. Operative management will be defined as formal washout and soft tissue debridement prior to reduction, whether in the emergency department or operating theatre. Non-operative management refers to washout without surgical debridement. Primary outcome measures will be the incidence of superficial and deep infection. Secondary outcomes will include adverse events such mal-union, non-union, need for re-operation, physeal disturbance, nail dystrophy/atrophy. Two independent reviewers will screen all citations, full-text articles, and abstract data. Conflicts will be resolved through discussion. The study methodological quality (or bias) will be appraised using an appropriate tool. A narrative synthesis will be performed and if two or more studies with comparable design and reporting the same outcome are identified, data will be pooled for comparative analysis. Discussion This review will provide robust evidence for the management of Seymour fractures, based on a cumulation of existing studies. Due to the rarity of this fracture pattern, included studies are expected to be mainly observational and prone to bias; however, there is value in summarising the evidence, assessing its risk of bias and performing meta-analysis where possible to guide clinicians. Registration PROSPERO CRD42020153726

Videomanometry of the pharynx in dysphagic patients with laryngeal barium penetration during swallowing

1998 ◽  
Vol 39 (4) ◽  
pp. 405-409 ◽  
Author(s):  
R. Olsson ◽  
J. Castell ◽  
O. Ekberg ◽  
D. O. Castell
Keyword(s):  
Healthy Volunteers ◽  
Peak Pressure ◽  
Oropharyngeal Dysphagia ◽  
Barium Swallow ◽  
Mean Values ◽  
Contraction Duration ◽  
Laryngeal Penetration ◽  
Resting Pressure ◽  
Laryngeal Vestibule ◽  
Dysphagic Patients

Purpose: This study used simultaneous videomanometry to measure pressure characteristics in a group of patients with evidence of laryngeal and/or tracheal barium penetration, and to compare the results to those of one group of healthy volunteers and one group of patients with dysphagia but a normal barium swallow. Material and Methods: Videomanometry during barium swallowing was performed in 25 patients who showed penetration of barium into the laryngeal vestibule. Manometric abnormalities were determined by comparing these mean values with those of 25 healthy volunteers, and the frequency of manometric abnormalities was compared to that of 19 patients presenting with oropharyngeal dysphagia with a normal barium swallow. Results: The frequency of abnormalities for four parameters (pharyngo-eso-phageal segment (PES) resting pressure, PES relaxation duration, pharyngeal peak pressure, pharyngeal contraction duration) differed significantly between the patients with penetration and those with normal barium studies. There was, however, no association between manometric abnormalities and the degree of barium penetration. Conclusion: The differences in manometric abnormalities between patients with laryngeal penetration and patients with normal barium swallows may be useful in identifying the mechanisms of laryngeal penetration.

scholarly journals Web-Based Interventions to Promote Healthy Lifestyles for Older Adults: Protocol for a Scoping Review

10.2196/23207 ◽  
2021 ◽  
Vol 10 (1) ◽  
pp. e23207
Author(s):  
Audrey Lavoie ◽  
Véronique Dubé
Keyword(s):  
Older Adults ◽  
Scoping Review ◽  
Grey Literature ◽  
Healthy Lifestyles ◽  
Behavior Change Techniques ◽  
Web Based ◽  
Quantitative Studies ◽  
Cochrane Database ◽  
Need Support ◽  
Quasi Experimental

Background With the aging of the population and rising rates of chronic diseases, older adults need support if they are to adopt healthy lifestyles. Web-based interventions should be considered for this purpose, since they are easily accessed and can foster healthy lifestyles among older adults. However, the literature on such interventions discusses a variety of components and effects and provides only 2 syntheses of knowledge on web-based interventions with older adults. These studies focus on populations aged 50 years and older, whereas the components and effects of interventions for a population of older adults (ie, 65 years and older) may differ. In addition, these 2 syntheses examined only quantitative studies, although other types of studies (ie, qualitative) are available and could help advance knowledge in this field. A scoping review is therefore relevant in order to explore the extent of the literature on this subject. Objective The purpose of the study described by this protocol is to explore the extent of the literature (experimental, quasi-experimental, qualitative, systematic reviews, and grey literature) on the components and effects of web-based interventions as a way to promote healthy lifestyles among older adults. Methods The databases MEDLINE, CINAHL, PsycInfo, Web of Science, Cochrane Database of Systematic Review and Joanna Briggs Library will be searched, in addition to the grey literature using Google Scholar and OpenGrey. Studies will be selected for the review by 2 researchers, working independently. The data will be synthesized based on the conceptualization of web-based interventions (ie, behavior change techniques, dispensation modes, and theories). A thematic analysis will be performed to summarize the components of the interventions studied. Results The database search will begin in August 2020 and be completed in October 2020. Conclusions This scoping review should highlight web-based interventions designed to promote healthy lifestyles, as well as their components and effects, among people aged 65 years and older. These results could provide important guidance for intervention developers and designers in identifying the components of web-based interventions relevant to older adults and lead to further studies on this topic. International Registered Report Identifier (IRRID) PRR1-10.2196/23207

scholarly journals Evaluations of Interventions with Child Domestic Workers: A Rapid Systematic Review

2021 ◽  
Vol 18 (19) ◽  
pp. 10084
Author(s):  
Nambusi Kyegombe ◽  
Nicola S. Pocock ◽  
Clara W. Chan ◽  
Jonathan Blagbrough ◽  
Cathy Zimmerman
Keyword(s):  
Health Education ◽  
Grey Literature ◽  
Experimental Studies ◽  
Skills Training ◽  
Domestic Workers ◽  
Female Child ◽  
Economic Outcomes ◽  
Health Related ◽  
Quasi Experimental ◽  
Intervention Description

Little is known about interventions to support the education, skills training, and health of female child domestic workers (CDWs). This rapid systematic literature review followed PRISMA guidelines (PROSPERO registration: CRD42019148702) and summarises peer-reviewed and grey literature on health, education, and economic interventions for CDWs and interventions targeting employers. We searched six electronic databases and purposively searched grey literature. We included observational studies, which included an intervention, quasi-experimental, and experimental studies. Two reviewers independently screened articles. Data were extracted on intervention description, inputs, activities, type of evaluation, outcomes, effect size or impact where applicable, limitations, and ethical considerations. All studies were quality appraised. We identified eight papers from five studies. Six papers reported on health-related outcomes, two on education-related outcomes, and three on economic outcomes. No evaluations of employer-related interventions were identified. Only one intervention specifically targeted CDWs. Others included CDWs in their sample but did not disaggregate data for CDWs. Findings suggest that the evaluated interventions had a limited impact on CDW’s health, education, and economic outcomes. While it appears feasible to reach CDWs with outreach interventions, further work is needed to improve the consistency of their effectiveness and their ability to improve CDWs’ current and future prospects.

scholarly journals Outcomes of an accelerated nonsurgical management protocol for hip fractures in the elderly

2018 ◽  
Vol 26 (3) ◽  
pp. 230949901880340 ◽  
Author(s):  
Wei Xiang Lim ◽  
Ernest Beng Kee Kwek
Keyword(s):  
Length Of Stay ◽  
Elderly Patients ◽  
Hip Fractures ◽  
The Elderly ◽  
Operative Management ◽  
Nonsurgical Treatment ◽  
P Value ◽  
Complication Rates ◽  
Nonsurgical Management ◽  
Management Protocol

The majority of hip fractures in elderly patients are managed surgically with superior outcomes. However, for patients who refuse surgery or are deemed medically unfit, traction used to be the mainstay of nonsurgical treatment, which is associated with prolonged hospitalization and inpatient complications from immobility. This study, therefore, aims to evaluate the outcomes of an early wheelchair mobilization protocol as an alternative nonsurgical treatment option. This is a retrospective study of 87 elderly patients who were managed nonsurgically for their hip fractures over a 1-year period. The accelerated rehabilitation protocol did not have them on traction but were instead mobilized with assistance as soon as possible after admission. Variables collected electronically include patient demographics, fracture characteristics, inpatient mobilization milestones, inpatient complications, Modified Functional Ambulation Classification (MFAC), Modified Barthel Index (MBI) scores, and radiological findings. Patients who were younger, could sit up earlier and had a shorter length of stay, were able to ambulate better at 6 months ( p value < 0.05). Patients with femoral neck fractures and shorter length of stay had better MFAC scores. A total of 58% of patients with radiological follow-up had displacement of their fractures with age, type of fracture, and length of stay as predictors ( p value < 0.05) The Charlson’s score, day to sitting up, and day to transfer affect fracture healing ( p value < 0.05). The mean length of stay was 17 days and the 1-year mortality was 18%. Surgical therapy remains the preferred choice of management for patients with hip fractures. Early wheelchair mobilization leads to a shorter length of stay compared to traditional traction methods and comparable 1-year mortality rates with operative management. Despite this, complication rates remain high and only 48% of patients achieved ambulation by 1 year, with healing in only 24% of fractures.

scholarly journals Built Environment Interventions to Increase Active Travel: a Critical Review and Discussion

2019 ◽  
Vol 6 (4) ◽  
pp. 309-315 ◽  
Author(s):  
Rachel Aldred
Keyword(s):  
Qualitative Research ◽  
Built Environment ◽  
Grey Literature ◽  
Active Travel ◽  
Data Sources ◽  
Relative Lack ◽  
Methodological Choices ◽  
Routine Monitoring ◽  
Data Gaps ◽  
Quasi Experimental

Abstract Purpose of Review To review the literature on built environment interventions to increase active travel, focusing on work since 2000 and on methodological choices and challenges affecting studies. Recent Findings Increasingly, there is evidence that built environment interventions can lead to more walking or cycling. Evidence is stronger for cycling than for walking interventions, and there is a relative lack of evidence around differential impacts of interventions. Some of the evidence remains methodologically weak, with much work in the ‘grey’ literature. Summary While evidence in the area continues to grow, data gaps remain. Greater use of quasi-experimental techniques, improvements in routine monitoring of smaller schemes, and the use of new big data sources are promising. More qualitative research could help develop a more sophisticated understanding of behaviour change.

scholarly journals Outpatient total knee arthroplasty leads to a higher number of complications: a meta-analysis

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Vittorio Bordoni ◽  
Alberto Poggi ◽  
Stefano Zaffagnini ◽  
Davide Previtali ◽  
Giuseppe Filardo ◽  
...  
Keyword(s):  
Complication Rate ◽  
Meta Analysis ◽  
Grey Literature ◽  
Operative Management ◽  
Risk Of Bias ◽  
Cochrane Library ◽  
Moderate Risk ◽  
Level Of Evidence ◽  
Quality Of Evidence

Abstract Background Careful pre- and post-operative management can allow surgeons to perform outpatient TKA, making this a more affordable procedure. The aim of the present meta-analysis is to compare outpatient and inpatient TKA. Methods A systematic search of the literature was performed in July 2020 on PubMed, Web of Science, Cochrane library, and on the grey literature databases. The papers collected were used for a meta-analysis comparing outpatient and inpatient TKA in terms of complication and readmission rates. Risk of bias and quality of evidence were defined according to Cochrane guidelines. Results The literature search resulted in 4107 articles; of these, 8 articles were used for the meta-analysis. A total of 212,632 patients were included, 6607 of whom were TKA outpatients. The overall complication rate for outpatient TKAs was 16.1%, while inpatient TKAs had an overall lower complication rate of 10.5% (p = 0.003). The readmission rate was 4.9% in outpatient TKAs and 5.9% in inpatient TKAs. Only 3 studies reported the number of deaths, which accounted for 0%. The included studies presented a moderate risk of bias, and according to GRADE guidelines, the level of evidence for complications and readmissions was very low. Conclusions This meta-analysis documented that outpatient TKA led to an increased number of complications although there were no differences in the number of readmissions. However, future high-level studies are needed to confirm results and indications for the outpatient approach, since the studies currently available have a moderate risk of bias and a very low quality of evidence.

scholarly journals Comparison of outcomes before and after establishing a regional trauma center and following a protocol to treat blunt splenic injury in South Korea: A retrospective study

2018 ◽  
Vol 25 (6) ◽  
pp. 343-349
Author(s):  
Min A Lee ◽  
Byungchul Yu ◽  
Jungnam Lee ◽  
Kang Kook Choi ◽  
Jae Jeong Park ◽  
...  
Keyword(s):  
South Korea ◽  
Trauma Center ◽  
Splenic Injury ◽  
Emergency Operation ◽  
Operative Management ◽  
Blunt Splenic Injury ◽  
Management Protocol ◽  
Before And After ◽  
Non Operative Management ◽  
Splenic Salvage

Background: Nonoperative management for hemodynamically stable splenic injury has been accepted as appropriate treatment. Objectives: This study aimed to investigate the changes in management and clinical outcomes of splenic injury by introducing a protocol for splenic injury at a newly established regional trauma center. Methods: From January 2005 to December 2016, we reviewed the outcomes of all 257 patients who sustained blunt trauma to the spleen at the first regional trauma center in South Korea. This 11-year period was divided into two intervals, before 1 January 2014 (period I, n = 189 patients) and after 1 January 2014 (period II, n = 68 patients), when the trauma center was established and a formal management protocol was followed for patients with blunt traumatic splenic injuries. Results: The proportion of emergency operations performed for patients with more serious (grades 3–5) splenic injuries was lower in period II than in period I (29% vs 22%, respectively, p < 0.001) whereas the rate of angioembolization was higher (89% vs 39.0%, respectively, p < 0.001). The time to intervention, irrespective of whether emergency operation or angioembolization was performed, was shorter in period II than in period I (312.8 min vs 129 min, respectively, p = 0.001). A greater proportion of patients was managed non-operatively in period II (78% vs 71%), and the non-operative management success rate was higher in period II than it was in period I (100% vs 83%; p = 0.014). Similarly, the splenic salvage rate was higher in period II (78% vs 59%, p = 0.03). Conclusion: After establishing a regional trauma center and introducing a protocol for the management of blunt splenic injuries, the rates of non-operative management and splenic salvage improved significantly. The reasons for this may be multifactorial, being related to the early involvement of a trauma surgeon, expansion of angiographic facilities and resources, and the introduction and application of a protocol for managing blunt splenic injury.

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