Cholera in travellers: a systematic review

Abstract Exposure to cholera is a risk for individuals and groups travelling to endemic areas, and the bacteria can be imported to cholera-free countries by returning travellers. This systematic review of the literature describes the circumstances in which cholera infection can occur in travellers and considers the possible value of the cholera vaccine for prevention in travellers. PubMed and EMBASE were searched for case reports of cholera or diarrhoea among travellers, with date limits of 1 January 1990–30 April 2018. Search results were screened to exclude the following articles: diarrhoea not caused by cholera, cholera in animals, intentional cholera infection in humans, non-English articles and publications on epidemics that did not report clinical details of individual cases and publications of cases pre-dating 1990. Articles were reviewed through descriptive analytic methods and information summarized. We identified 156 cases of cholera imported as a consequence of travel, and these were reviewed for type of traveller, source country, serogroup of cholera, treatment and outcomes. The case reports retrieved in the search did not report consistent levels of detail, making it difficult to synthesize data across reports and draw firm conclusions from the data. This clinical review sheds light on the paucity of actionable published data regarding the risk of cholera in travellers and identifies a number of gaps that should drive additional effort. Further information is needed to better inform evidence-based disease prevention strategies, including vaccination for travellers visiting areas of cholera risk. Modifications to current vaccination recommendations to include or exclude current or additional traveller populations may be considered as additional risk data become available. The protocol for this systematic review is registered with PROSPERO (registration number: 122797).

Download Full-text

Prevalence of Mycoplasma genitalium by anatomical site in men who have sex with men: a systematic review and meta-analysis

Sexually Transmitted Infections ◽

10.1136/sextrans-2019-054310 ◽

2020 ◽

Vol 96 (8) ◽

pp. 563-570

Author(s):

Rosie L Latimer ◽

Hannah S Shilling ◽

Lenka A Vodstrcil ◽

Dorothy A Machalek ◽

Christopher K Fairley ◽

...

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Mycoplasma Genitalium ◽

Nucleic Acid Amplification ◽

Hiv Positive ◽

Published Data ◽

Anatomical Site ◽

Ovid Medline ◽

Registration Number ◽

Sex With Men

ObjectiveTo systematically review and appraise published data, to determine the prevalence of Mycoplasma genitalium (MG) in men who have sex with men (MSM) tested at each anatomical site, that is, at the urethra, rectum and/or pharynx.DesignSystematic review and meta-analysis.Data sourcesOvid Medline, PubMed, Embase were searched for articles from 1st January 1981 (the year MG was first identified) to 1st June 2018.Review methodsStudies were eligible for inclusion if they reported MG prevalence in MSM tested at the urethra, rectum and/or pharynx, in at least 50 MSM, using nucleic acid amplification testing. Data were extracted by anatomical site, symptom and HIV status. Summary estimates (95% CIs) were calculated using random-effects meta-analysis. Subgroup analyses were performed to assess heterogeneity between studies.ResultsForty-six studies met inclusion criteria, with 34 reporting estimates of MG prevalence at the urethra (13 753 samples), 25 at the rectum (8629 samples) and 7 at the pharynx (1871 samples). MG prevalence was 5.0% (95% CI 3.5 to 6.8; I2=94.0) at the urethra; 6.2% (95% CI 4.6 to 8.1; I2=88.1) at the rectum and 1.0% (95% CI 0.0 to 5.1; I2=96.0) at the pharynx. The prevalence of MG was significantly higher at urethral and rectal sites in symptomatic versus asymptomatic MSM (7.1% vs 2.2%, p<0.001; and 16.1% vs 7.5%, p=0.039, respectively). MG prevalence at the urethra was significantly higher in HIV-positive compared with HIV-negative MSM (7.0% vs 3.4%, p=0.006).ConclusionMG was common in MSM, particularly at urethral and rectal sites (5% to 6%). MG was more commonly detected in symptomatic men at both sites, and more common in HIV-positive men at the urethra. MG was uncommonly detected in the pharynx. Site-specific estimates are similar to those for chlamydia and will be helpful in informing testing practices in MSM.PROSPERO registration numberCRD42017058326.

Download Full-text

Association between financial links to indoor tanning industry and conclusions of published studies on indoor tanning: systematic review

BMJ ◽

10.1136/bmj.m7 ◽

2020 ◽

pp. m7 ◽

Cited By ~ 1

Author(s):

Lola Adekunle ◽

Rebecca Chen ◽

Lily Morrison ◽

Meghan Halley ◽

Victor Eng ◽

...

Keyword(s):

Systematic Review ◽

Systematic Reviews ◽

Science Studies ◽

Case Reports ◽

Indoor Tanning ◽

Original Research ◽

Industry Funding ◽

Study Selection ◽

English Articles ◽

Tanning Industry

Abstract Objective To assess whether an association exists between financial links to the indoor tanning industry and conclusions of indoor tanning literature. Design Systematic review. Data sources PubMed, Embase, and Web of Science, up to 15 February 2019. Study selection criteria Articles discussing indoor tanning and health were eligible for inclusion, with no article type restrictions (original research, systematic reviews, review articles, case reports, editorials, commentaries, and letters were all eligible). Basic science studies, articles describing only indoor tanning prevalence, non-English articles, and articles without full text available were excluded. Results 691 articles were included in analysis, including empiric articles (eg, original articles or systematic reviews) (357/691; 51.7%) and non-empiric articles letters (eg, commentaries, letters, or editorials) (334/691; 48.3%). Overall, 7.2% (50/691) of articles had financial links to the indoor tanning industry; 10.7% (74/691) articles favored indoor tanning, 3.9% (27/691) were neutral, and 85.4% (590/691) were critical of indoor tanning. Among the articles without industry funding, 4.4% (27/620) favored indoor tanning, 3.5% (22/620) were neutral, and 92.1% (571/620) were critical of indoor tanning. Among the articles with financial links to the indoor tanning industry, 78% (39/50) favored indoor tanning, 10% (5/50) were neutral, and 12% (6/50) were critical of indoor tanning. Support from the indoor tanning industry was significantly associated with favoring indoor tanning (risk ratio 14.3, 95% confidence interval 10.0 to 20.4). Conclusions Although most articles in the indoor tanning literature are independent of industry funding, articles with financial links to the indoor tanning industry are more likely to favor indoor tanning. Public health practitioners and researchers need to be aware of and account for industry funding when interpreting the evidence related to indoor tanning. Systematic review registration PROSPERO CRD42019123617.

Download Full-text

Dantrolene in the treatment of MDMA-related hyperpyrexia: a systematic review

CJEM ◽

10.1017/s1481803500012598 ◽

2010 ◽

Vol 12 (05) ◽

pp. 435-442 ◽

Cited By ~ 38

Author(s):

Brian E. Grunau ◽

Matthew O. Wiens ◽

Jeffrey R. Brubacher

Keyword(s):

Systematic Review ◽

Clinical Decision Making ◽

Case Reports ◽

Data Extraction ◽

Patient Characteristics ◽

Clinical Decision ◽

Poison Control ◽

Published Data ◽

Published Evidence

ABSTRACTObjective:The use of dantrolene in the treatment of hyperpyrexia related to MDMA (3,4-methylenedioxymethamphetamine) is controversial, with little data available to guide clinical decision-making. Although the treatment is recommended by several poison control centres, published data are primarily in the form of case reports and animal and in vitro experiments. We conducted a systematic review to investigate the published evidence regarding the safety and benefits of dantrolene for MDMA-related hyperpyrexia in humans.Data sources:A systematic search of Embase and MEDLINE was conducted from the earliest possible date to November 2008.Study selection:All human trials and case reports of MDMA-related hyperpyrexia were considered.Data extraction:Data were abstracted systematically and characteristics including use of dantrolene, adverse reactions attributed to dantrolene, peak temperature, complications from MDMA-related hyperpyrexia and survival were recorded.Data synthesis:Our search yielded 668 articles of which 53, reporting 71 cases of MDMA-induced hyperpyrexia, met our inclusion criteria. No clinical trials, randomized controlled trials, observational studies or meta-analyses were identified. Dantrolene was used in 26 cases. Patient characteristics were similar in the dantrolene and no dantrolene groups. The proportion of survivors was higher in the dantrolene group (21/26) than in the no dantrolene group (25/45). This difference was especially pronounced in those with extreme (≥ 42°C) and severe (≥ 40°C) fever, with a survival rate of 8 of 13 and 10 of 10, respectively, in the dantrolene group compared with 0 of 4 and 15 of 27 in the no dantrolene group. There were no reports of adverse events attributable to dantrolene with the exception of a possible association with an episode of transient hypoglycemia.Conclusion:Our systematic review suggests that dantrolene is safe for patients with MDMA-related hyperpyrexia. Dantrolene may also be associated with improved survival and reduced complications, especially in patients with extreme (≥ 42°C) or severe (≥ 40°C) hyperpyrexia, although this conclusion must be interpreted with caution given the risk of reporting or publication bias.

Download Full-text

Global epidemiology of acute generalised peritonitis: a protocol for a systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2019-034326 ◽

2020 ◽

Vol 10 (1) ◽

pp. e034326

Author(s):

Joel Noutakdie Tochie ◽

Ndip Valirie Agbor ◽

Tianyi Tianyi Frank Leonel ◽

Aime Mbonda ◽

Desmond Aji Abang ◽

...

Keyword(s):

Systematic Review ◽

Case Fatality Rate ◽

Data Extraction ◽

Meta Analysis ◽

Case Fatality ◽

Published Data ◽

Fatality Rate ◽

Global Epidemiology ◽

Ethical Approval ◽

Registration Number

IntroductionGlobally, acute generalised peritonitis (AGP) is a common medical and surgical emergency which is a major contributor to non-trauma deaths despite improvements in diagnosis and surgical and intensive care management. In order to determine the global burden of AGP, geared at tailoring key interventions to curb its morbidity and mortality, we proposed this first ever systematic review and meta-analysis to estimate the contemporary prevalence, and to determine the most frequent AGP and the case fatality rate of AGP, at the global scene.Methods and analysisWe intend to searchAfricanJournalsOnline, Americana em Ciências da Saúde, Citation index, EMBASE, Global Index Medicus, Literatura Latino Africa Index Medicus, Medline and Scientific Electronic Library Online databases from 1 January 2009 to 31 July 2019 to identify studies that reported the prevalence, types of AGP, and case fatality rate of AGP in the global population without any language restrictions. Study selection, data extraction and risk of bias assessment will be conducted independently at each level by a pair of independent investigators. Random-effects meta-analysis will be used to pool studies judged to be clinically homogeneous. The presence of heterogeneity will be evaluated using the χ² test on Cochrane’s Q statistic and quantified with the I² statistics. Publication bias will be evaluated statistically and visually using the Egger’s test and funnel plots, respectively. Findings will be reported and compared by countries, WHO regions and globally.Ethics and disseminationSince this study will be based on published data, it does will not require an ethical approval. The findings will be published in a scientific peer-reviewed journal. They will also be presented at scientific conferences and to relevant public health actors.PROSPERO registration numberCRD42019143331.

Download Full-text

Technology-assisted depression screening tools for patients with cancer: a systematic review protocol

BMJ Open ◽

10.1136/bmjopen-2020-041878 ◽

2021 ◽

Vol 11 (3) ◽

pp. e041878

Author(s):

Maria Isabel Lazaro-Escudero ◽

Camila Alanna Burgos-Cardona ◽

Karina Acevedo-Fernández ◽

Eida Maria Castro-Figueroa

Keyword(s):

Systematic Review ◽

Data Extraction ◽

Meta Analysis ◽

Screening Tools ◽

Depression Screening ◽

Published Data ◽

Final Decision ◽

Patients With Cancer ◽

Use Of Technology ◽

Registration Number

IntroductionAmong patients with cancer, depression is still under-detected. The use of technology-assisted screening tools is rising; however, little is known about the uptake of these devices as depression screening tools among patients with cancer.Methods and analysisA systematic review will be conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P). The review is registered with PROSPERO and any adjustments to the protocol will be traced. The aims of this systematic review are to (1) identify the most common and feasible depression screening information technology (IT) delivery models among patients with cancer, (2) identify the most common depression screening instrument used in IT devices and (3) describe the published technology-assisted depression screening tools for patients with cancer. PubMed, EBSCOhost and Google Scholar databases will be used. PICO (Patient/Population, Intervention, Comparison, Outcomes) guidelines will inform the inclusion criteria. Two researchers will independently review titles and abstracts, followed by full article review and data extraction. In the case of a disagreement, a third reviewer will make the final decision. Title/abstract screening will be conducted using a screening tool prepared by the researchers. Articles will be included for review if: (1) the study includes patients with cancer, cancer survivors and/or patients on remission, (2) depression is screened using technology and (3) technology-assisted depression screening effectiveness, efficacy, feasibility and/or acceptance is addressed. The quality of the articles will be assessed using the Methodological Index For Non-Randomised Studies (MINORS, maximum score 24) through independent coding of reviewers.Ethics and disseminationThis research is exempt from ethics approval given that this is a protocol for a systematic review, which uses published data. Findings from this review will be disseminated through peer-reviewed publications and scientific conferences.Systematic review registrationPROSPERO registration number CRD42019121048.

Download Full-text

Conundrum of re-positives COVID-19 cases: A Systematic review of Case reports and Case series

10.1101/2020.12.10.20223990 ◽

2020 ◽

Author(s):

Arun Kumar Yadav ◽

Subhadeep Ghosh ◽

Sudhir Dubey

Keyword(s):

Systematic Review ◽

Animal Studies ◽

English Language ◽

Case Reports ◽

Case Series ◽

Contact Tracing ◽

First Episode ◽

Rt Pcr ◽

Registration Number ◽

Age Range

AbstractIntroductionThere have been case reports and case series published for RT PCR positive COVID - 19 cases that became RT PCR negative but subsequently became RT PCR positive after a symptom free interval following a negative RT PCR test. These cases may include re-positive, reactivated and re-infection cases. Hence, the systematic review to summarize and synthesize evidence from all available case series and case reports published was undertaken.MethodologyThe systematic review of case series and case reports was registered with Prospero with registration number CRD42020210446. PRISMA guidelines were followed for conducting the systematic review. Studies published in English language only were considered for the Systematic Review. Inclusion criteria for studies included case reports and case series which have documented cases of positive RT-PCR after a period of improvement or negative RT PCR. Reviews, opinions and animal studies were excluded. Case reports which described clinical presentation or manifestations of COVID-19 cases were also excluded from the studies. Methodological quality was assessed using modified Murad scale.ResultsA total of 30 case reports/case series were included in the study, wherein a total of 219 cases were included. In re-positive cases, the age range varied from 10 months to 91 years. The pooled proportion using random effects was 12% with 95% CI from 09% to 15%. Among the re-positives, a total of 57 cases (26%) of the cases had co-morbidities. A total of 51 (23.3%) and 17 (7.8%) re-positive cases had been treated with antivirals and corticosteroids respectively. Among the symptomatic cases, the disease severity was lesser as compared to the initial episode of illness. Only a few studies have confirmed the presence of antibodies after the first episode. The few studies that had done contact tracing of re-positives did not find any positive cases among those in contact with re-positives.ConclusionThis systematic review presents the review of all the case reports and case series on recurrence of COVID 19 disease. Although limited evidence has been generated due to paucity of such studies and shortcomings in the study designs of case reports and case-series, nonetheless, the evidence generated can still be used in making clinical decisions and framing policy guidelines

Download Full-text

What are the risk factors for injuries and injury prevention strategies for skiers and snowboarders in terrain parks and half-pipes? A systematic review

British Journal of Sports Medicine ◽

10.1136/bjsports-2018-099166 ◽

2018 ◽

Vol 53 (1) ◽

pp. 19-24 ◽

Cited By ~ 6

Author(s):

Olivier Audet ◽

Brent E Hagel ◽

Albertro Nettel-Aguirre ◽

Tatum Mitra ◽

Carolyn A Emery ◽

...

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Injury Prevention ◽

Meta Analysis ◽

Original Data ◽

Current Evidence ◽

Prevention Strategies ◽

Eligibility Criteria ◽

Severe Injuries ◽

Registration Number

ObjectiveTo synthesise the current evidence regarding the risk factors, the injury prevention strategies and the profile of injured skiers and snowboarders in terrain parks (TPs) and half-pipes (HPs).DesignSystematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines.Data sourcesLiterature searches from six electronic databases and manual searches were performed.Eligibility criteria for selecting studiesInclusion criteria were: (1) publication based on original data; (2) injuries sustained in TPs or HPs; (3) recreational skiing or snowboarding injuries; (4) observational or experimental study design with a comparison group.ResultsNo study explored the risk factors in HPs or the prevention strategies in TPs or HPs. From the literature retrieved, there is strong evidence that skiing or snowboarding in a TP is a risk factor for head, neck, back and severe injuries. Two papers assessed the risk factors for injuries in TPs, mainly demonstrating that features promoting aerial manoeuvres or a large drop to the ground were associated with higher feature-specific injury rates. The profile of injured skiers and snowboarders in TPs described in the literature suggested some evidence of associations between factors including activity, sex, skill level, helmet use, age and TP injuries.Summary/conclusionsThis systematic review demonstrates the need for studies identifying the risk factors for injuries to skiers and snowboarders and on interventions to reduce the risk of injury in TPs and HPs. Studies addressing the issue of TP design should be considered.PROSPERO registration numberCRD42016045206.

Download Full-text

Effectiveness, Uses and Safety of Granulocyte Colony Stimulating Factor biosimilars: a protocol for systematic review and meta-analysis

10.21203/rs.3.rs-195467/v1 ◽

2021 ◽

Author(s):

Chi-kadibia Theophilus Ukoma ◽

Emmanuel Okechukwu Nna ◽

Helen Chioma Okoye ◽

Augustine Nwakuche Duru ◽

Samuel Osobuchi Ngene ◽

...

Keyword(s):

Systematic Review ◽

English Language ◽

Reference Product ◽

Meta Analysis ◽

Severe Neutropenia ◽

Cochrane Library ◽

Published Data ◽

Mesh Terms ◽

Statistical Heterogeneity ◽

Registration Number

Abstract Background Granulocyte Colony-stimulating factors (G-CSF) biosimilars are recombinant biologics that are similar to a reference product, neupogen, a 175 amino acid recombinant human G-CSF. Characteristically, biosimilars are produced from living cells as high molecular weight, heterogenous compounds that are highly immunogenic. They are primarily used to treat febrile and severe neutropenia in oncology patients as well as mobilize peripheral stem cells in transplant donors. However, as biosimilars are produced by biological processes rather than chemical synthesis, their comparable effectiveness and safety are very paramount to clinical uses. We aimed to produce a protocol for consistent and accurate systematic review and meta-analysis of G-CSF biosimilars.Methods We developed a search strategy using MeSH terms, key words and entry terms to search 9 databases: PubMed, AJOL, Embase, Google Scholar, Scopus, Cochrane Library, CINAHL, Web of Science and ResearchGate. Only randomized controlled trials retreivable in the English language will be included in this study. The primary measurable outcomes in this study are uses, effectiveness and safety of G-CSF biosimilars. Identified primary studies will be screened, deduplicated and selected based on study design, inclusion/exclusion criteria and outcome measures using DistillerSR software. Studies will be assessed for methodological, clinical and statistical heterogeneity. Extractable data items for effectiveness measure are: i) proportion of patients with 50% increase in absolute neutrophil count within 3–7 days; ii) resolution of fever within 3–7 days, iii) resolution of intra-oral mucosa ulcers within 7–10 days and iv) resoluton of difficulty in swallowing within 7–10 days. Measures of safety are i) proportion of patients with immunologic reactions, ii) any other documented adverse events. Quality scores and risk of bias for individual studies will be reported. Funnel Plots will be used for assessing publication bias in selected studies. Effect size, variance, SE and % CI and heterogeneity tests will be reported on forest plots using the CMA software version 3. Subgroup analysis and meta-regression will also be included using secondary outcomes as moderators and explanatory variables. The systematic review and meta-analysis will be reported according to PRISMA 2015 Statement.Discussion Ethical approval will not be required since this study will be based on published data. G-CSF biosimilars will be compared with the reference product, neupogen (filgrastin). The uses, effectiveness and safety of the biosimilars will be discussed. The study will also examine short and long acting biosimilars and compare their overall effectiveness. The strength of evidence from this study will be assessed using the NIH Quality assessment for systematic review and meta-analysis.Trial Registration Number The study is registered with PROSPERO, with registration number CRD42021232375

Download Full-text

Delirium Research in India: A Systematic Review

Journal of Neurosciences in Rural Practice ◽

10.1055/s-0041-1725211 ◽

2021 ◽

Vol 12 (02) ◽

pp. 236-266

Author(s):

Sandeep Grover ◽

Sanjana Kathiravan ◽

Devakshi Dua

Keyword(s):

Systematic Review ◽

Research Output ◽

Case Reports ◽

Delirium Tremens ◽

Psychiatric Diagnoses ◽

Prevention Strategies ◽

Pharmacological Interventions ◽

Symptom Profile ◽

Indian Context ◽

Comprehensive Search

AbstractDelirium is the most common psychiatric diagnoses encountered in patients with various medical-surgical illnesses, in all the treatment set-ups, with relatively higher incidence and prevalence in the intensive care units. As delirium is encountered in multiple specialties, it is important to understand the research on this diagnosis. This study aims to assess the research output involving patients of delirium from India. A comprehensive search was undertaken using Medline (PubMed) and other databases. Search words included were “delirium,” “delirious,” “delirium tremens” AND “India.” No filters were used. Internet and hand searches yielded 305 articles. Out of these articles, 151 had the terms “delirium,” “delirious,” “delirium tremens” in the title and these were included for the review. Additionally, 14 articles were included for the review, although these did not have these terms in the title, but delirium was one of the major outcome parameters in these studies. Majority of the papers were original articles (n = 81), and these were followed by, case reports (n = 58), review articles (n = 10), letter to the editor (not as case reports but as a communication; n = 13), editorials (n = 2) and one clinical practice guideline. Most of the original papers have either focused on epidemiology (incidence, prevalence, outcome, etc.), symptom profile, with occasional studies focusing on effectiveness of various pharmacological interventions. There is a dearth of research in the field of delirium from India. There is a lack of studies on biomarkers, evaluation of nonpharmacological interventions, and evaluation of prevention strategies. It is the need of the hour to carry out more studies to further our understanding of delirium in the Indian context.

Download Full-text

Prior surgical uterine evacuation of pregnancy and infertility: protocol for systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2019-034837 ◽

2020 ◽

Vol 10 (7) ◽

pp. e034837

Author(s):

Pengcheng Tu ◽

Kaiyan Pei

Keyword(s):

Systematic Review ◽

Data Extraction ◽

Meta Analysis ◽

Published Data ◽

Inverse Variance ◽

Increased Risk ◽

Registration Number ◽

Meta Analyses ◽

Classification Tool ◽

Dissemination Of Results

IntroductionPrior surgical uterine evacuation is associated with an increased risk of infertility. However, findings are inconsistent, highlighting the need for a clear consensus on the effect of prior surgical uterine evacuation on the risk of infertility. Therefore, the aim of this systematic review and meta-analysis is to summarise the available evidence examining the association between prior surgical uterine evacuation and the risk of infertility.Methods and analysisA systematic search of electronic databases (ie, PubMed, Scopus, ClinicalTrials.gov, EMBASE and ScienceDirect) will be conducted since their inception until October 2019 with no limit for language using a detailed prespecified search strategy. Both the authors will independently screen titles and abstracts and select full-text articles, perform data extraction and appraise the quality of included studies using a bias classification tool. Meta-analyses will be performed to calculate the overall pooled estimates using the generic inverse variance method. This systematic review and meta-analysis will follow the Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) guidelines.Ethics and disseminationGiven that this is a protocol based on published data, there is no requirement for ethics approval. It is anticipated that the dissemination of results will be reported according to the PRISMA statement. The results will be published in peer-reviewed journals and presented at scientific conferences.PROSPERO registration numberCRD42019117266.

Download Full-text