Zeitpunkt der Entfernung des Wundverbands bei primär heilenden chirurgischen Wunden: Eine Meta-Analyse

Pflege ◽  
2013 ◽  
Vol 26 (4) ◽  
pp. 255-269
Author(s):  
Doris Eberhardt ◽  
Almuth Berg ◽  
Steffen Fleischer ◽  
Gero Langer
Keyword(s):  
Cochrane Collaboration ◽  
Postoperative Versorgung

Die Entstehung einer chirurgischen Wundinfektion soll unter anderem durch eine sachgerechte postoperative Versorgung der Wunde verhindert werden. Gerade die Dauer der Wundabdeckung wird derzeit jedoch unterschiedlich gehandhabt und empfohlen. Ziel der systematischen Übersichtsarbeit war es deshalb, die Bedeutung des Zeitpunkts der Entfernung des Wundverbands bei primär heilenden chirurgischen Wunden für die Entstehung einer Wundinfektion zu bewerten. Die Literaturrecherche erfolgte im August 2011 in den Datenbanken MEDLINE, EMBASE, CINAHL, Cochrane – CENTRAL sowie in weiteren Quellen durch Handsuche. Es wurden alle randomisierten kontrollierten Studien eingeschlossen, in denen die generelle Abdeckung und Nichtabdeckung der Wunde sowie unterschiedliche Zeitpunkte der Entfernung des Wundverbands miteinander verglichen wurden. Die Erstellung der systematischen Übersichtsarbeit und Meta-Analyse erfolgte nach den Empfehlungen der Cochrane Collaboration. Acht Studien mit insgesamt 2097 Teilnehmenden wurden in die Meta-Analyse eingeschlossen, wobei alle Studien ein unklares oder hohes Bias-Risiko aufwiesen. Die Meta-Analyse erbrachte keinen Hinweis darauf, dass durch eine frühzeitige Entfernung des Wundverbands im Gegensatz zur späten Entfernung die Entstehung von Wundinfektionen beziehungsweise -komplikationen bei primär heilenden chirurgischen Wunden begünstigt wird: Risikodifferenz (RD) – 0,01; 95 %-Konfidenzintervall (CI) – 0,03; 0,01. Aufgrund der methodischen Limitationen der Studien sind jedoch weitere aussagekräftige Primärstudien zur Sicherung der Ergebnisse notwendig.

Delay Discounting in Impulsive Behavior

2019 ◽  
Vol 24 (4) ◽  
pp. 312-321 ◽  
Author(s):  
Diana Moreira ◽  
Fernando Barbosa
Keyword(s):  
Delay Discounting ◽  
Human Subjects ◽  
Empirical Studies ◽  
Cochrane Collaboration ◽  
Initial Assessment ◽  
Impulsive Behavior ◽  
Manual Search ◽  
Study Results ◽  
Depth Analysis ◽  
The Future

Abstract. Delay discounting (DD) is the process of devaluing results that happen in the future. With this review, we intend to identify specificities in the processes of DD in impulsive behavior. Studies were retrieved from multiple literature databases, through rigorous criteria (we included systematic reviews and empirical studies with adult human subjects), following the procedures of the Cochrane Collaboration initiative. Of the 174 documents obtained, 19 were considered eligible for inclusion and were retained for in-depth analysis. In addition, 13 studies from the manual search were included. Thus, a total of 32 studies were selected for review. The objectives/hypotheses, results, and the main conclusion(s) were extracted from each study. Results show that people with pronounced traits of impulsivity discount rewards more markedly, that is, they prefer immediate rewards, though of less value, or postponed losses, even though they worsen in the future. Taken together, the existing data suggest the importance of inserting DD as a tool for initial assessment in conjunction with measures of addiction and stress level, as well as the consideration of new therapies.

Medikamentöse Schmerztherapie bei degenerativen Gelenkerkrankungen

2012 ◽  
Vol 32 (01) ◽  
pp. 18-23 ◽  
Author(s):  
E. Schneider
Keyword(s):  
Cochrane Collaboration ◽  
Nichtsteroidale Antirheumatika ◽  
Medikamentöse Behandlung ◽  
Medikamentöse Schmerztherapie

ZusammenfassungUnter den Leitsymptomen bei degenerativen Gelenkerkrankungen ist es in der Regel der Schmerz, der Patienten zum Arzt führt. In dieser Arbeit wird dargestellt, welche Rolle die medikamentöse Behandlung im Gesamtkontext aller Behandlungsmöglichkeiten (konservativ und operativ) spielt. Dazu werden nationale und internationale hochrangige Leitlinien analysiert. Ergänzt werden diese Daten durch die Ergebnisse umfassender Metaanalysen (Cochrane Collaboration u. a.). Aus den Resultaten ergeben sich Hinweise auf Effektivität und Sicherheit der untersuchten Präparate, die Auswirkungen auf die nationalen und supranationalen Zulassungsmodalitäten haben. Besondere Bedeutung haben nichtsteroidale Antirheumatika (NSAR), deren Wirkungsprinzip entweder die selektive oder auch die nichtselektive Hemmung der Zyklooxygenase-2 ist. Sie kommen (in der Literatur übereinstimmend eingeschätzt) insbesondere dann zum Einsatz, wenn bei den Arthrosen entzündliche Prozesse (Aktivierung) vorliegen. Dabei ist vor allem auf gastrointestinale, kardiovaskuläre und renale Komplikationen zu achten.

scholarly journals Impact of Vibration on the Levels of Biomarkers: A Systematic Review

2021 ◽  
pp. 030157422110195
Author(s):  
Ashish Agrawal ◽  
TM Chou
Keyword(s):  
Systematic Review ◽  
Web Of Science ◽  
Tooth Movement ◽  
Orthodontic Tooth Movement ◽  
Cochrane Collaboration ◽  
Risk Of Bias ◽  
Cochrane Library ◽  
Inclusion Criteria ◽  
Electronic Search ◽  
Proquest Dissertation

Introduction: The objective of this systematic review is to assess the effect of vibrational force on biomarkers for orthodontic tooth movement. Methods: An electronic search was conducted for relevant studies (up to December 31, 2020) on the following databases: Pubmed, Google scholar, Web of Science, Cochrane Library, Wiley Library, and ProQuest Dissertation Abstracts and Thesis database. Hand searching of selected orthodontic journals was also undertaken. The selected studies were assessed for the risk of bias in Cochrane collaboration risk of bias tool. The “traffic plot” and “weighted plot” risk of bias distribution are designed in the RoB 2 tool. The 2 authors extracted the data and analyzed it. Results: Six studies fulfilled the inclusion criteria. The risks of biases were high for 4, low and some concern for other 2 studies. The biomarkers, medium, device, frequency and duration of device, as well as other data were extracted. The outcomes of the studies were found to be heterogenous. Conclusion: One study showed highly statistically significant levels of IL-1 beta with <.001. Rate of tooth movement was correlated with levels of released biomarkers under the influence of vibrational force in 3 studies, but it was found to be significant only in 1 study. It was further observed that vibration does not have any significant reduction in pain and discomfort.

scholarly journals The effect of dietary phytochemicals on nuclear factor erythroid 2-related factor 2 (Nrf2) activation: a systematic review of human intervention trials

2021 ◽  
Author(s):  
Tom Clifford ◽  
Jarred P. Acton ◽  
Stuart P. Cocksedge ◽  
Kelly A. Bowden Davies ◽  
Stephen J. Bailey
Keyword(s):  
Systematic Review ◽  
Assessment Tool ◽  
Cochrane Collaboration ◽  
Risk Of Bias ◽  
Related Factor ◽  
Human Intervention ◽  
Nrf2 Activation ◽  
Dietary Phytochemicals ◽  
Intervention Trials

AbstractWe conducted a systematic review of human trials examining the effects of dietary phytochemicals on Nrf2 activation. In accordance with the PRISMA guidelines, Medline, Embase and CAB abstracts were searched for articles from inception until March 2020. Studies in adult humans that measured Nrf2 activation (gene or protein expression changes) following ingestion of a phytochemical, either alone or in combination were included. The study was pre-registered on the Prospero database (Registration Number: CRD42020176121). Twenty-nine full-texts were retrieved and reviewed for analysis; of these, eighteen were included in the systematic review. Most of the included participants were healthy, obese or type 2 diabetics. Study quality was assessed using the Cochrane Collaboration Risk of Bias Assessment tool. Twelve different compounds were examined in the included studies: curcumin, resveratrol and sulforaphane were the most common (n = 3 each). Approximately half of the studies reported increases in Nrf2 activation (n = 10); however, many were of poor quality and had an unclear or high risk of bias. There is currently limited evidence that phytochemicals activate Nrf2 in humans. Well controlled human intervention trials are needed to corroborate the findings from in vitro and animal studies.

scholarly journals Do we need to improve the reporting of evidence in tendinopathy management? A critical appraisal of systematic reviews with recommendations on strength of evidence assessment

2021 ◽  
Vol 7 (1) ◽  
pp. e000920
Author(s):  
Dimitris Challoumas ◽  
Neal L Millar
Keyword(s):  
Systematic Reviews ◽  
Assessment Tool ◽  
Data Extraction ◽  
Cochrane Collaboration ◽  
Mean Difference ◽  
Strength Of Evidence ◽  
The Mean ◽  
Randomised Controlled ◽  
Meta Analyses ◽  
The Cochrane Collaboration

ObjectiveTo critically appraise the quality of published systematic reviews (SRs) of randomised controlled trials (RCTs) in tendinopathy with regard to handling and reporting of results with special emphasis on strength of evidence assessment.Data sourcesMedline from inception to June 2020.Study eligibilityAll SRs of RCTs assessing the effectiveness of any intervention(s) on any location of tendinopathy.Data extraction and synthesisIncluded SRs were appraised with the use of a 12-item tool devised by the authors arising from the Preferred Reporting Items in Systematic Reviews and Meta-Analyses statement and other relevant guidance. Subgroup analyses were performed based on impact factor (IF) of publishing journals and date of publication.ResultsA total of 57 SRs were included published in 38 journals between 2006 and 2020. The most commonly used risk-of-bias (RoB) assessment tool and strength of evidence assessment tool were the Cochrane Collaboration RoB tool and the Cochrane Collaboration Back Review Group tool, respectively. The mean score on the appraisal tool was 46.5% (range 0%–100%). SRs published in higher IF journals (>4.7) were associated with a higher mean score than those in lower IF journals (mean difference 26.4%±8.8%, p=0.004). The mean score of the 10 most recently published SRs was similar to that of the first 10 published SRs (mean difference 8.3%±13.7%, p=0.54). Only 23 SRs (40%) used the results of their RoB assessment in data synthesis and more than half (n=30; 50%) did not assess the strength of evidence of their results. Only 12 SRs (21%) assessed their strength of evidence appropriately.ConclusionsIn light of the poor presentation of evidence identified by our review, we provide recommendations to increase transparency and reproducibility in future SRs.

scholarly journals Treatment for mitochondrial diseases

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Tongling Liufu ◽  
Zhaoxia Wang
Keyword(s):  
Clinical Trials ◽  
Nuclear Dna ◽  
Mitochondrial Diseases ◽  
Cochrane Collaboration ◽  
Potential Bias ◽  
Leber Hereditary Optic Neuropathy ◽  
Pharmacological Agents ◽  
Unpublished Studies ◽  
New Treatment ◽  
Allotopic Expression

AbstractMitochondrial diseases are predominantly caused by mutations of mitochondrial or nuclear DNA, resulting in multisystem defects. Current treatments are largely supportive, and the disorders progress relentlessly. Nutritional supplements, pharmacological agents and physical therapies have been used in different clinical trials, but the efficacy of these interventions need to be further evaluated. Several recent reviews discussed some of the interventions but ignored bias in those trials. This review was conducted to discover new studies and grade the original studies for potential bias with revised Cochrane Collaboration guidelines. We focused on seven published studies and three unpublished studies; eight of these studies showed improvement in outcome measurements. In particular, two of the interventions have been tested in studies with strict design, which we believe deserve further clinical trials with a large sample. Additionally, allotopic expression of the ND4 subunit seemed to be an effective new treatment for patients with Leber hereditary optic neuropathy.

scholarly journals Sensory-Based Priming for Upper Extremity Hemiparesis After Stroke: A Scoping Review

2021 ◽  
pp. 153944922110326
Author(s):  
Mary E. Stoykov ◽  
Courtney Heidle ◽  
Shamshir Kang ◽  
Lisa Lodesky ◽  
Lindsay E. Maccary ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Motor Skills ◽  
Upper Limb ◽  
Scoping Review ◽  
Web Of Science ◽  
Motor Impairment ◽  
Cochrane Collaboration ◽  
Prisma Statement ◽  
Meta Analyses ◽  
The Cochrane Collaboration

Sensory priming is a technique to facilitate neuroplasticity and improve motor skills after injury. Common sensory priming modalities include peripheral nerve stimulation/somatosensory electrical stimulation (PNS/SES), transient functional deafferentation (TFD), and vibration. The aim of this study was to determine whether sensory priming with a motor intervention results in improved upper limb motor impairment or function after stroke. PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science, and EMBASE were the databases used to search the literature in July 2020. This scoping review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and recommendations for the Cochrane collaboration. In total, 30 studies were included in the analysis: three studies examined TFD, 16 examined PNS/SES, 10 studied vibration, and one combined the three stimulation techniques. Most studies reported significant improvements for participants receiving sensory priming. Given the low risk, it may be advantageous to use sensory-based priming prior to or concurrent with upper limb training after stroke.

scholarly journals Effect of Composite Core Materials on Fracture Resistance of Endodontically Treated Teeth: A Systematic Review and Meta-Analysis of In Vitro Studies

Polymers ◽  
2021 ◽  
Vol 13 (14) ◽  
pp. 2251
Author(s):  
Maciej Zarow ◽  
Marzena Dominiak ◽  
Katarzyna Szczeklik ◽  
Louis Hardan ◽  
Rim Bourgi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Fracture Resistance ◽  
Meta Analysis ◽  
Cochrane Collaboration ◽  
Composite Resins ◽  
In Vitro Studies ◽  
Endodontically Treated Teeth ◽  
The Cochrane Collaboration ◽  
Core Materials

Various material properties are involved in the success of endodontically treated restorations. At present, restorative composites are commonly employed as core build-up materials. This study aimed to systematically review the literature to assess the effect of using composite core materials on the in vitro fracture of endodontically treated teeth. Two different reviewers screened the literature, up to June 2021, in five distinct electronic databases: PubMed (MedLine), Scopus, Scielo, ISI Web of Science, and EMBASE. Only in vitro studies reporting the effect of the use of composite core materials on the fracture resistance of endodontically treated teeth were included. A meta-analysis was carried out using a software program (Review Manager v5.4.1; The Cochrane Collaboration, Copenhagen, Denmark). The risk of bias in each study was assessed following the parameters of another systematic review. A total of 5016 relevant papers were retrieved from all databases. After assessing the title and abstract, five publications remained for qualitative analysis. From these, only three studies remained for meta-analysis. The fracture strength of endodontically treated teeth where a core build-up composite was used was statistically significantly higher than the control (p = 0.04). Most of the analyses showed a high heterogenicity. The in vitro evidence suggests that the composite core build-up with higher filler content tended to improve the fracture resistance of the endodontically treated teeth, in comparison with conventional composite resins. This research received no external funding. Considering that this systematic review was only carried out on in vitro papers, registration was not performed. Furthermore, there were no identified clinical studies assessing core build-up materials; therefore, more well-designed research on these materials is needed.

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