233 POSTOPERATIVE DELIRIUM AFTER OESOPHAGECTOMY FOR CANCER: HOW CAN WE PREVENT AND MANAGE IT?

2020 ◽  
Vol 33 (Supplement_1) ◽  
Author(s):  
A Rita ◽  
E Pinto ◽  
L Pomba ◽  
F Tolin ◽  
G Mattara ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Literature Search ◽  
Healing Process ◽  
Cochrane Library ◽  
Psychiatric Disease ◽  
High Morbidity ◽  
Systematic Literature Search ◽  
Inclusion Criteria ◽  
Duration Of Surgery

Abstract   Oesophagectomy is associated with high morbidity. One of the postoperative complication observed after esophageal resection is Post Operative Delirium (POD), a psychiatric disease caused by major surgical stress and pharmacological treatments. POD can jeopardize patient healing-process since patients are not collaborative to perioperative care but also because they can harm themselves. Thus the aim of this systematic review was to identify POD factors and its effective management in patients undergone oesophagectomy for oesophageal/oesophagogastric-junction cancer. Methods A comprehensive systematic literature search was conducted using PubMed, Cochrane Library, Scopus, psycINFO and psycARTICLES in order to identify all articles published until January 2020. The following combinations of terms were used for the search strategy: neoplasm; esophagus; gastro-esophageal junction; oesophagectomy; delirium. The following inclusion criteria were set: full article published in English; patients with esophageal cancer undergone oesophagectomy; POD observed. Two researchers independently selected studies matching the inclusion criteria. Duplicate studies, non-relevant topic, data from abstracts or unpublished were excluded. Any disagreements between the researchers’ evaluation concerning inclusion of studies were resolved by consensus. Results Of 235 studies yielded by systematic literature search, 21 met inclusion criteria. POD incidence was observed between 3 and 38% of patients and was precursor of other complications in 1/3 of POD patients. Preoperative risk factors were older age, cerebrovascular disease and pulmonary disfunction. Anxiety and depression resulted predisposing factors. Perioperative risk factors were duration of surgery, ICU length of stay, colloids infusion and blood transfusion. Open-surgery seemed to influence POD more than minimally-invasive and robotic surgery. Interventions identified to treat POD were pharmacological (prophylactic haloperidol, insomnia treatment) and behavioral (patient reorientation by family involvement, bright-light therapy, early mobilization). Conclusion This systematic review identified preoperative, intraoperative and postoperative risk factors of POD after oesophagectomy. No standardized prevention nor treatment of POD was identified. POD impacts patients’ ability in perceiving postoperative symptoms. The difficulty in communicating with health professionals may lead to delay the diagnosis of others complications and prolong hospital stay. Therefore further trials are required to assess efficacy of different POD treatments aimed to enhance postoperative management.

scholarly journals Sinus Floor Augmentation—Associated Surgical Ciliated Cysts: Case Series and a Systematic Review of the Literature

2021 ◽  
Vol 11 (4) ◽  
pp. 1903
Author(s):  
Adrian Kahn ◽  
Shlomo Matalon ◽  
Rahaf Bassam Salem ◽  
Lazar Kats ◽  
Liat Chaushu ◽  
...  
Keyword(s):  
Systematic Review ◽  
Microscopic Examination ◽  
Literature Search ◽  
Case Series ◽  
Systematic Literature Search ◽  
Review Of The Literature ◽  
Inclusion Criteria ◽  
Sinus Floor Augmentation ◽  
Sinus Floor

This study aimed to characterize the demographic and clinical features of underreported surgical ciliated cysts developing after sinus floor augmentation, based on a series of cases from our files and a systematic review of the literature. A series of five cases (four patients) of microscopically confirmed surgical ciliated cysts following sinus floor augmentation procedures from our files are described. A systematic literature search (1991–2020) with strict clinical-, radiological- and microscopic-based exclusion and inclusion criteria was performed to detect additional similar cases. The systematic review revealed only five cases that fulfilled the inclusion criteria. Altogether, surgical ciliated cysts associated with sinus floor augmentation have been rarely reported in the literature, and have not been characterized either demographically or clinically. Graft materials were diverse, implants were placed simultaneously, or up to two years post-augmentation. The associated surgical ciliated cysts developed between 0.5 and 10 years post-augmentation. Although limited in its extent, this study is the first series to characterize possible underreported sequelae of surgical ciliated cysts associated with sinus floor augmentation. It emphasizes the need for long post-operative follow-up and confirmation of lesion by microscopic examination.

scholarly journals Prediction of mortality in adult patients with sepsis using six biomarkers: a systematic review and meta-analysis

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Andreas Pregernig ◽  
Mattia Müller ◽  
Ulrike Held ◽  
Beatrice Beck-Schimmer
Keyword(s):  
Systematic Review ◽  
Literature Search ◽  
Meta Analysis ◽  
Advanced Glycation Endproducts ◽  
Adult Patients ◽  
Cochrane Library ◽  
Systematic Literature Search ◽  
Prognostic Information ◽  
Prediction Of Mortality ◽  
Mean Differences

Abstract Background Angiopoietin-1 (Ang-1) and 2 (Ang-2), high mobility group box 1 (HMGB1), soluble receptor for advanced glycation endproducts (sRAGE), soluble triggering receptor expressed on myeloid cells 1 (sTREM1), and soluble urokinase-type plasminogen activator receptor (suPAR) have shown promising results for predicting all-cause mortality in critical care patients. The aim of our systematic review and meta-analysis was to assess the prognostic value of these biomarkers for mortality in adult patients with sepsis. Methods A systematic literature search of the MEDLINE, PubMed, EMBASE, and Cochrane Library databases, for articles in English published from 01.01.1990 onwards, was conducted. The systematic review focused exclusively on observational studies of adult patients with sepsis, any randomized trials were excluded. For the meta-analysis, only studies which provide biomarker concentrations within 24 h of admission in sepsis survivors and nonsurvivors were included. Results are presented as pooled mean differences (MD) between nonsurvivors and survivors with 95% confidence interval for each of the six biomarkers. Studies not included in the quantitative analysis were narratively summarized. The risk of bias was assessed in all included studies using the Quality in Prognosis Studies (QUIPS) tool. Results The systematic literature search retrieved 2285 articles. In total, we included 44 studies in the qualitative analysis, of which 28 were included in the meta-analysis. The pooled mean differences in biomarker concentration (nonsurvivors − survivors), measured at onset of sepsis, are listed as follows: (1) Ang-1: − 2.9 ng/ml (95% CI − 4.1 to − 1.7, p < 0.01); (2) Ang-2: 4.9 ng/ml (95% CI 2.6 to 7.1, p < 0.01); (3) HMGB1: 1.2 ng/ml (95% CI 0.0 to 2.4, p = 0.05); (4) sRAGE: 1003 pg/ml (95% CI 628 to 1377, p < 0.01); (5) sTREM-1: 87 pg/ml (95% CI 2 to 171, p = 0.04); (6) suPAR: 5.2 ng/ml (95% CI 4.5 to 6.0, p < 0.01). Conclusions Ang-1, Ang-2, and suPAR provide beneficial prognostic information about mortality in adult patients with sepsis. The further development of standardized assays and the assessment of their performance when included in panels with other biomarkers may be recommended. Trial registration This study was recorded on PROSPERO, prospective register of systematic reviews, under the registration ID: CRD42018081226

Risk Factors in Burning Mouth Syndrome among Older Adults

2021 ◽  
Vol 15 (8) ◽  
pp. 2060-2063
Author(s):  
Muhammad Shoaib Yousaf ◽  
Muhammad Anwaar Alam ◽  
Mustafa Qadeer ◽  
Fareed Ahmad ◽  
Rabia Huma Riaz ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Elderly People ◽  
Data Extraction ◽  
Burning Mouth Syndrome ◽  
Cochrane Library ◽  
Psychiatric Disease ◽  
Female Population ◽  
Aged People ◽  
Burning Mouth

Background of the study: A chronic and untraceable condition of pain is burning mouth syndrome (BMS) and is commonly observed in middle-aged and elderly people of both the genders. Many psychiatric disease that include anxiety levels, personality disorders and depressions are caused by oral problems i.e dysgeusia, burning mouth, oral malodour and dry mouth. Objective: This study aimed investigation of factors of risk associated with BMS in elderly people of both the genders. Design: It was a systematic review. Material and Methods: Inclusion and exclusion criteria were used and studies published from 2008 till date of review were included in the systematic review. For gathering relevant studies, some key words were used to find already published material i.e “elder, older, burning mouth syndrome / BMS, oral health problems, and elderly people”. Moreover, for enhancing relevancy and appropriateness, Boolean operators like AND, OR, double quotations, asterisk etc. were used. Popular and good reputed databases with peer-reviewed articles and journals were used that included PubMed health, Google scholar, EBSCO host, CINAHL, Embase and Cochrane Library. A table comprising of columns like study title, name of author, sample size, research objective, limitations and key findings was prepared for data extraction. Results: Based on moderate or strong quality, thirteen studies relevant to the objective were shortlisted. These studies had highlighted BMS as risk factor. It was held that female population is more affected by BMS in comparison with males and its prevalence is high in elderly aged people i.e. above 55-years age. Conclusion: From findings of the review, it is established that in older population numerous risk factors of BMS are dental procedures, increased age, lacking therapeutic treatments, lack of knowledge besides poor knowledge and practices of medical staff and poor care being given to older age people especially in post-menopausal stage in women. Keywords: Burning mouth syndrome, WHO, global population, post-menopause.

scholarly journals Obesity and periodontitis: systematic review and meta-analysis

2014 ◽  
Vol 19 (6) ◽  
pp. 1763-1772 ◽  
Author(s):  
Patrícia Garcia de Moura-Grec ◽  
Juliane Avansini Marsicano ◽  
Cristiane Alves Paz de Carvalho ◽  
Silvia Helena de Carvalho Sales-Peres
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Body Mass Index ◽  
Literature Search ◽  
Search Strategy ◽  
Meta Analysis ◽  
Inclusion Criteria ◽  
Paired Samples ◽  
Literature Search Strategy ◽  
Selection Of

The scope of this study was to conduct a systematic review of the studies on the association between obesity and periodontitis. The methods applied included a literature search strategy and selection of studies using inclusion and exclusion in accordance with the criteria for characteristics of the studies and meta-analysis. The research was conducted in the PubMed, Embase and Lilacs databases through 2010. Selected papers were on studies on humans investigating whether or not obesity is a risk factor for periodontitis. Of the 822 studies identified, 31 studies met the inclusion criteria and were included in this meta-analysis. The risk of periodontitis was associated with obesity (or had a tendency for this) in 25 studies, though it was not associated in 6 studies. The meta-analysis showed a significant association with obesity and periodontitis (OR = 1.30 [95% Confidence Interval (CI), 1.25 - 1.35]) and with mean Body Mass Index (BMI) and periodontal disease (mean difference = 2.75). Obesity was associated with periodontitis, however the risk factors that aggravate these diseases should be better clarified to elucidate the direction of this association. Working with paired samples and avoiding confusion factors may contribute to homogeneity between the studies.

scholarly journals A Systematic review on aligning efficiency of superelastic NITI: in comparison with conventional NITI and multistranded stainless steel archwires

2017 ◽  
Vol 5 (1) ◽  
pp. 39
Author(s):  
Deepa Kumaran ◽  
Shantha Sundari ◽  
Shyamala Chandrasekhar
Keyword(s):  
Systematic Review ◽  
Stainless Steel ◽  
Orthodontic Treatment ◽  
Literature Search ◽  
Nickel Titanium ◽  
Systematic Literature Search ◽  
Inclusion Criteria ◽  
Initial Alignment ◽  
Steel Wires ◽  
In The Beginning

Background: The initial leveling and aligning phase of orthodontic treatment involve the use of nickel titanium wires. The nickel titanium wires exhibit unique properties like shape memory and superelasticity. In the beginning, conventional nitinol wires were used, which lacked the superelastic property. Nowadays, superelastic nickel titanium wires are being used commonly. This systematic review aims to evaluate the efficiency of Superelastic NITi in the initial alignment of orthodontic treatment in comparison with conventional NiTi and multistranded stainless steel archwires by measuring the amount of decrowding and the time taken for decrowding.Method: A systematic literature search was performed on Pubmed, Cochrane, Google scholar & Lilacs.Result: Thirty four studies were identified by the search and ten studies satisfied the inclusion criteria and one study was excluded after abstract reading. Finally nine articles were included for quality assessment.Conclusion: This systematic review concluded that there was no significant differences in the aligning efficiency of superelastic NiTi in comparison with conventional NiTi and multistranded stainless steel wires. 

Biologic therapy for Behçet’s uveitis: a systematic review

2019 ◽  
Vol 104 (8) ◽  
pp. 1045-1051 ◽  
Author(s):  
Perpetual Uke ◽  
Rachel Gorodkin ◽  
Nicholas Beare
Keyword(s):  
Randomised Controlled Trials ◽  
Literature Search ◽  
Biologic Therapy ◽  
Evidence Base ◽  
Cochrane Library ◽  
Systematic Literature Search ◽  
Inclusion Criteria ◽  
Behçet’S Uveitis ◽  
Randomised Controlled ◽  
Adequate Evidence

BackgroundBiologics are increasingly used in management of Behçet’s Disease (BD) including ocular BD, but the evidence base is limited, mostly from studies of uveitis and BD manifestations.ObjectiveTo review the evidence base for biologics in the treatment of ocular BD.MethodsSystematic literature search was made using exploded key words—Behçet’s, ocular, biologics in MEDLINE, Cochrane library, Database of Abstracts Reviews and Effects, Clinical Trials.gov, Science Direct and Google Scholar. There was no limitation on region, language or date (Search updated 16th October 2018). Literature retrieval was restricted to randomised controlled trials (RCTs) of biologics.ResultsOf 237 papers retrieved, eight met the inclusion criteria. RCTs on interferon alpha 2a (INF-α 2a), adalimumab, secukinumab, gevokizumab, rituximab and daclizumab were retrieved (two for adalimumab and gevokizumab). The outcome measures were not met for secukinumab, daclizumab and gevokizumab. Rituximab and INF-α 2a showed promising preliminary results but sufficiently powered RCTs are needed to provide adequate evidence of efficacy. The RCTs on adalimumab did not evaluate efficacy for BD uveitis specifically, hence are of limited value for this review.ConclusionSome biologics show promise in treating BD uveitis, but more RCTs are needed for firm conclusions about efficacy. A phase IV study or, registry of adalimumab could provide data on its efficacy in BD uveitis compared to other forms.

scholarly journals Augmented reality in medical education: a systematic review

2019 ◽  
Author(s):  
Kevin S Tang ◽  
Derrick L Cheng ◽  
Eric Mi ◽  
Paul B Greenberg
Keyword(s):  
Systematic Review ◽  
Medical Education ◽  
Augmented Reality ◽  
Literature Search ◽  
Medical Training ◽  
Experimental Studies ◽  
Cochrane Library ◽  
Inclusion Criteria ◽  
Potential Applications

Introduction The field of augmented reality (AR) is rapidly growing with many new potential applications in medical education. This systematic review aims to investigate the current state of augmented reality applications (ARAs) as teaching tools in the healthcare field. Methods A literature search was conducted using PubMed, Embase, Web of Science, Cochrane Library, and Google Scholar. This review followed PRISMA guidelines and included publications from January 1, 2000 to June 18, 2018. Inclusion criteria were experimental studies evaluating ARAs implemented in healthcare education published in English. The quality of each study was assessed using GRADE criteria. Five stages of validity were also evaluated for each ARA. Results We identified 100,807 articles in the initial literature search; 36 met inclusion criteria for final review and were categorized into three categories: Surgery (23), Anatomy (9), and Classroom (4). The overall quality of the studies was poor. No ARAs were validated at all five levels. Conclusion While AR technology is growing at a rapid rate, the current quality and breadth of AR research in medical training is insufficient to recommend the adoption into educational curricula. More coordinated and comprehensive research is needed to define the role of AR technology in medical education. 

scholarly journals Physical comorbidity and use of healthcare services in people with schizophrenia: protocol for a systematic review

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e053324
Author(s):  
Mercè Salvador Robert ◽  
Alejandro Porras-Segovia ◽  
Inmaculada Peñuelas-Calvo ◽  
Enrique Baca-Garcia
Keyword(s):  
Systematic Review ◽  
Literature Search ◽  
Web Of Science ◽  
Research Question ◽  
Healthcare Services ◽  
Cochrane Library ◽  
Systematic Literature Search ◽  
Registration Number ◽  
Unhealthy Diet ◽  
Psychiatric Population

IntroductionPeople with schizophrenia die about 15–20 years earlier than the general population. A constellation of factors contributes to this gap in life expectancy: side effects of psychotropic drugs, unhealthy lifestyles (inactivity, unhealthy diet) and inequality in the provision of healthcare services. This is a topic of main importance, which requires constant update and synthesis of the literature. The aim of this review is to explore the evidence of physical comorbidity and use of healthcare services in people with schizophrenia.Methods and analysisWe will conduct a systematic literature search in the databases PubMed/MEDLINE, EMBASE, Scopus, Web of Science, PsycINFO and Cochrane Library, Proquest Health Research Premium Collection, in order to identify studies that answer to our research question: Are patients with schizophrenia different from the non-psychiatric population in terms of physical comorbidity and use of healthcare services? Two authors will independently review the studies and extract the data.Ethics and disseminationThis study does not include human or animal subjects. Thus, ethics considerations are not applicable. Dissemination plans include publications in peer-reviewed journals and discussion of results in psychiatric congresses.PROSPERO registration numberCRD42020139972.

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.

Wrist Arthrolysis: A Systematic Review of Open and Arthroscopic Techniques

2021 ◽  
Author(s):  
Marco Guidi ◽  
Riccardo Luchetti ◽  
Inga Besmens ◽  
Esin Rothenfluh ◽  
Maurizio Calcagni
Keyword(s):  
Systematic Review ◽  
Literature Search ◽  
Systematic Literature Search ◽  
Viable Option ◽  
Level Of Evidence ◽  
Open Arthrolysis ◽  
Arthroscopic Arthrolysis ◽  
Radiocarpal Joint ◽  
Post Traumatic ◽  
Wrist Stiffness

Abstract Background Wrist arthrolysis is a viable option in wrist stiffness and can be performed via open or arthroscopic techniques. Purpose The aim of the study is to describe and evaluate the available techniques of open and arthroscopic arthrolysis of the radiocarpal joint and the distal radio ulnar joint (DRUJ) in posttraumatic wrist stiffness. Methods A systematic literature search was performed in PubMed to identify studies reporting on open and arthroscopic wrist arthrolysis. Key words included “open wrist arthrolysis,” “arthroscopic wrist arthrolysis,” “post-traumatic wrist stiffness,” and “DRUJ arthrolysis.” Data were extracted independently by a pair of reviewers. Results Overall, 637 studies were identified; 13 additional articles were found through previous publications (total 650 articles). A total of 612 records resulted after duplicates was removed. Fourteen studies were selected and only eight respected the inclusions criteria. One study focused on volar open arthrolysis and four studies on arthroscopic arthrolysis of the radiocarpal joint; two studies reported on open arthrolysis and two studies on arthroscopic DRUJ arthrolysis. Range of motion following open and arthroscopic wrist arthrolysis improved in all studies. Conclusion Both arthroscopic and open arthrolysis can lead to similar and satisfactory results in radiocarpal joint and DRUJ stiffness.. Level of Evidence This is a level 3a study.

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