RARE-62. VISUAL FUNCTION IN CHILDREN WITH CRANIOPHARYNGIOMA AT DIAGNOSIS: A SYSTEMATIC REVIEW

Abstract Childhood craniopharyngioma is a rare and slow growing brain tumour, often located in the sellar and suprasellar region. It commonly manifests with visual impairment, increased intracranial pressure and hypothalamic and/or pituitary deficiencies. Visual impairment in childhood adversely affects a child’s daily functioning and quality of life. We systematically reviewed the literature to provide an extensive overview of the visual function in children with craniopharyngioma at diagnosis in order to estimate the diversity, magnitude and relevance of the problem of visual impairment. Of the 543 potentially relevant articles, 84 studies met our inclusion criteria. Visual impairment at diagnosis was reported in 1041 of 2071 children (50.3%), decreased visual acuity was reported in 546 of 1321 children (41.3%) and visual field defects were reported in 426 of 1111 children (38.3%). Other ophthalmological findings described were fundoscopic (32.5%) and orthoptic abnormalities (12.5%). Variations in ophthalmological testing methods and ophthalmological definitions precluded a meta-analysis. The results of this review confirm the importance of ophthalmological examination in children with craniopharyngioma at diagnosis in order to detect visual impairment and provide adequate support. Future studies should focus on long-term visual follow-up of childhood craniopharyngioma in response to different treatment strategies to provide insight in risks and ways to prevent further loss of vision.

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Internet and Computer-Based Cognitive Behavioral Therapy for Anxiety and Depression in Adolescents and Young Adults: Systematic Review and Meta-Analysis

Journal of Medical Internet Research ◽

10.2196/17831 ◽

2020 ◽

Vol 22 (9) ◽

pp. e17831

Author(s):

Carolien Christ ◽

Maria JE Schouten ◽

Matthijs Blankers ◽

Digna JF van Schaik ◽

Aartjan TF Beekman ◽

...

Keyword(s):

Young Adults ◽

Depressive Symptoms ◽

Active Treatment ◽

Meta Analysis ◽

Anxiety Symptoms ◽

Adolescents And Young Adults ◽

Long Term Follow Up

Background Anxiety and depressive disorders are prevalent in adolescents and young adults. However, most young people with mental health problems do not receive treatment. Computerized cognitive behavior therapy (cCBT) may provide an accessible alternative to face-to-face treatment, but the evidence base in young people is limited. Objective The objective was to perform an up-to-date comprehensive systematic review and meta-analysis of the effectiveness of cCBT in treating anxiety and depression in adolescents and young adults compared with active treatment and passive controls. We aimed to examine posttreatment and follow-up effects and explore the moderators of treatment effects. Methods We conducted systematic searches in the following six electronic databases: PubMed, EMBASE, PsycINFO, CINAHL, Web of Science, and Cochrane Central Register of Controlled Trials. We included randomized controlled trials comparing cCBT with any control group in adolescents or young adults (age 12-25 years) with anxiety or depressive symptoms. The quality of included studies was assessed using the Cochrane risk-of-bias tool for randomized trials, version 2.0. Overall quality of evidence for each outcome was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Posttreatment means and SDs were compared between intervention and control groups, and pooled effect sizes (Hedges g) were calculated. Random-effects meta-analyses were conducted using Comprehensive Meta-Analysis software. Subgroup analyses and meta-regression analyses were conducted to explore whether age, guidance level, and adherence rate were associated with treatment outcome. Results The search identified 7670 papers, of which 24 studies met the inclusion criteria. Most included studies (22/24) had a high risk of bias owing to self-report measures and/or inappropriate handling of missing data. Compared with passive controls, cCBT yielded small to medium posttreatment pooled effect sizes regarding depressive symptoms (g=0.51, 95% CI 0.30-0.72, number needed to treat [NNT]=3.55) and anxiety symptoms (g=0.44, 95% CI 0.23-0.65, NNT=4.10). cCBT yielded effects similar to those of active treatment controls regarding anxiety symptoms (g=0.04, 95% CI −0.23 to 0.31). For depressive symptoms, the nonsignificant pooled effect size favored active treatment controls (g=−0.70, 95% CI −1.51 to 0.11, P=.09), but heterogeneity was very high (I2=90.63%). No moderators of treatment effects were identified. At long-term follow-up, cCBT yielded a small pooled effect size regarding depressive symptoms compared with passive controls (g=0.27, 95% CI 0.09-0.45, NNT=6.58). No other follow-up effects were found; however, power was limited owing to the small number of studies. Conclusions cCBT is beneficial for reducing posttreatment anxiety and depressive symptoms in adolescents and young adults compared with passive controls. Compared with active treatment controls, cCBT yielded similar effects regarding anxiety symptoms. Regarding depressive symptoms, however, the results remain unclear. More high-quality research involving active controls and long-term follow-up assessments is needed in this population. Trial Registration PROSPERO CRD42019119725; https://tinyurl.com/y5acfgd9.

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Psychometric Properties of the Croatian Version of the 25-item National Eye Institute Visual Function Questionnaire (NEI VFQ-25)

10.21203/rs.3.rs-415530/v1 ◽

2021 ◽

Author(s):

Dina Lešin Gaćina ◽

Bernarda Škegro ◽

Sonja Jandroković ◽

Ivan Škegro ◽

Iva Bešlić ◽

...

Keyword(s):

Quality Of Life ◽

Visual Impairment ◽

Psychometric Properties ◽

Visual Function ◽

Discriminant Validity ◽

Ophthalmological Examination ◽

Sf 36 ◽

Related Quality ◽

Visual Function Questionnaire

Abstract Purpose: The purpose of study was to translate, adapt and validate the Croatian version of the 25-item National Eye Institute Visual Function Questionnaire (NEI VFQ-25) in participants with visual impairment. This study also aims at evaluating the relationship between visual impairment and health-related quality of life (HRQoL).Methods: The prospective observational study was conducted at the University Hospital Centre Zagreb, Department of Ophthalmology. The sample consisted of 175 patients with four chronic ocular diseases: cataract, glaucoma, diabetic retinopathy and age-related macular degeneration (ARMD). The translation of the NEI VFQ-25 to Croatian was conducted following the standardized procedure. All participants underwent an ophthalmological examination and completed the NEI VFQ-25 and the Medical Outcomes Study Short Form-36 Questionnaire (SF-36). In order to assess the psychometric properties of the NEI VFQ-25 we calculated Cronbach's α coefficient, intraclass correlation coefficient (ICC), convergent and discriminant validity, as well as criterion and concurrent validity.Results: Results show high internal consistency (Cronbach α range 0.739-0.932) and high test-retest reliability (ICC 0.876-0.975) for all subscales. None of the items had failed either convergent or discriminant validity. Moderate to high Spearman's rho coefficients of correlations were found between best corrected visual acuity and 8 subscales in the NEI VFQ-25 (0.430<ρ<0.631). Moderate correlations were found between comparable domains in the NEI VFQ-25 and in the SF-36 questionnaire (p<0.01).Conclusion: The Croatian version of the NEI VFQ-25 has very good psychometric properties and can be a useful instrument for assessing vision-related quality of life in Croatian population with chronic ophthalmic diseases. The trial registration number: DRKS-ID DRKS00016751Date of registration in DRKS: 2019/02/15

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Post-covid syndrome: a review of pathophysiology, neuropsychiatric manifestations and treatment perspectives

Neurology neuropsychiatry Psychosomatics ◽

10.14412/2074-2711-2021-3-93-98 ◽

2021 ◽

Vol 13 (3) ◽

pp. 93-98

Author(s):

D. R. Khasanova ◽

Yu. V. Zhitkova ◽

G. R. Vaskaeva

Keyword(s):

Work Performance ◽

Treatment Strategies ◽

Rehabilitation Programs ◽

Long Time ◽

Neuropsychiatric Manifestations ◽

Promising Treatment ◽

Significant Disease

In the context of the COVID-19 pandemic, healthcare is faced with several new problems, one of which is a post-covid syndrome. Symptoms in many COVID-19 survivors can persist for a long time, significantly affecting the quality of life and work performance. All of the above makes post-covid syndrome a socially significant disease, requires dynamic follow-up of such patients, and rehabilitation programs development. We are currently at the stage of accumulating knowledge about the SARS-CoV-2 pathophysiology and morphogenesis and its long-term consequences. This article discusses neuropsychiatric aspects of the post-covid syndrome: pathogenetic hypotheses, clinical features, and potentially promising treatment strategies.

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Global prevalence of persistent neuromuscular symptoms and the possible pathomechanisms in COVID-19 recovered individuals: A systematic review and meta-analysis

Narra J ◽

10.52225/narra.v1i3.48 ◽

2021 ◽

Vol 1 (3) ◽

Author(s):

Jhonny K. Fajar ◽

Muhammad Ilmawan ◽

Sukamto Mamada ◽

Endang Mutiawati ◽

Milda Husnah ◽

...

Keyword(s):

Joint Pain ◽

Meta Analysis ◽

Study Characteristics ◽

Newcastle Ottawa Scale ◽

Severe Infections ◽

Prolonged Fatigue ◽

Ottawa Scale

This study was conducted to determine the prevalence of prolonged neuromuscular symptoms, including fatigue, anosmia, headache, myalgia, and joint pain in COVID-19 survivors hospitalized with mild, moderate, or severe infections worldwide. The search was conducted up to January 30th, 2021 using three databases (PubMed, Scopus, and Web of Science) to identify potentially eligible studies. Data on study characteristics, follow-up characteristics, and severity of COVID-19 during hospitalization were collected in accordance with PRISMA guidelines. The Newcastle-Ottawa scale was used to assess the quality of relevant articles. The estimated prevalence of specific prolonged neuromuscular symptoms and the association between COVID-19 severity and occurrence of prolonged neuromuscular symptoms was analyzed wherever appropriate. Database search yielded 4,050 articles and 22 articles were included for meta-analysis. The estimated prevalence of prolonged fatigue was recorded in 21.2% (95%CI: 11.9%–34.8%) of 3,730 COVID-19 survivors. Persistent anosmia was recorded in 239 of 2,600 COVID-19 survivors (9.7%, 95%CI: 6.1%–15.2%). In 84 out of 2,412 COVID-19 survivors (8.9%, 95%CI: 3.2%–22.6%), prolonged headache was observed. A total of 53 out of 1,125 COVID-19 patients (5.6%, 95%CI: 2.1%–14.2%) complained of persistent myalgia even after being discharged from the hospital. The prevalence of prolonged joint pain was in 15.4% (95%CI: 8.2%–27.2%) of subjects. Due to data scarcity on COVID-19 severity and prolonged neuromuscular symptoms, association analysis could not be conducted. Widespread concern regarding long-term impacts of COVID-19 was raised after several studies reported prolonged symptoms in COVID-19 survivors. Numerous theories have been proposed to address this concern; however, as the research on this pandemic is still ongoing, no explanation is definitive yet. Therefore, follow-up studies in COVID-19 survivors after recovery from COVID-19 are warranted to determine the pathogenesis of prolonged symptoms. PROSPERO registration: CRD42021242332.

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Internet and Computer-Based Cognitive Behavioral Therapy for Anxiety and Depression in Adolescents and Young Adults: Systematic Review and Meta-Analysis (Preprint)

10.2196/preprints.17831 ◽

2020 ◽

Author(s):

Carolien Christ ◽

Maria JE Schouten ◽

Matthijs Blankers ◽

Digna JF van Schaik ◽

Aartjan TF Beekman ◽

...

Keyword(s):

Young Adults ◽

Depressive Symptoms ◽

Active Treatment ◽

Meta Analysis ◽

Anxiety Symptoms ◽

Adolescents And Young Adults ◽

Long Term Follow Up

BACKGROUND Anxiety and depressive disorders are prevalent in adolescents and young adults. However, most young people with mental health problems do not receive treatment. Computerized cognitive behavior therapy (cCBT) may provide an accessible alternative to face-to-face treatment, but the evidence base in young people is limited. OBJECTIVE The objective was to perform an up-to-date comprehensive systematic review and meta-analysis of the effectiveness of cCBT in treating anxiety and depression in adolescents and young adults compared with active treatment and passive controls. We aimed to examine posttreatment and follow-up effects and explore the moderators of treatment effects. METHODS We conducted systematic searches in the following six electronic databases: PubMed, EMBASE, PsycINFO, CINAHL, Web of Science, and Cochrane Central Register of Controlled Trials. We included randomized controlled trials comparing cCBT with any control group in adolescents or young adults (age 12-25 years) with anxiety or depressive symptoms. The quality of included studies was assessed using the Cochrane risk-of-bias tool for randomized trials, version 2.0. Overall quality of evidence for each outcome was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Posttreatment means and SDs were compared between intervention and control groups, and pooled effect sizes (Hedges g) were calculated. Random-effects meta-analyses were conducted using Comprehensive Meta-Analysis software. Subgroup analyses and meta-regression analyses were conducted to explore whether age, guidance level, and adherence rate were associated with treatment outcome. RESULTS The search identified 7670 papers, of which 24 studies met the inclusion criteria. Most included studies (22/24) had a high risk of bias owing to self-report measures and/or inappropriate handling of missing data. Compared with passive controls, cCBT yielded small to medium posttreatment pooled effect sizes regarding depressive symptoms (g=0.51, 95% CI 0.30-0.72, number needed to treat [NNT]=3.55) and anxiety symptoms (g=0.44, 95% CI 0.23-0.65, NNT=4.10). cCBT yielded effects similar to those of active treatment controls regarding anxiety symptoms (g=0.04, 95% CI −0.23 to 0.31). For depressive symptoms, the nonsignificant pooled effect size favored active treatment controls (g=−0.70, 95% CI −1.51 to 0.11, P=.09), but heterogeneity was very high (I2=90.63%). No moderators of treatment effects were identified. At long-term follow-up, cCBT yielded a small pooled effect size regarding depressive symptoms compared with passive controls (g=0.27, 95% CI 0.09-0.45, NNT=6.58). No other follow-up effects were found; however, power was limited owing to the small number of studies. CONCLUSIONS cCBT is beneficial for reducing posttreatment anxiety and depressive symptoms in adolescents and young adults compared with passive controls. Compared with active treatment controls, cCBT yielded similar effects regarding anxiety symptoms. Regarding depressive symptoms, however, the results remain unclear. More high-quality research involving active controls and long-term follow-up assessments is needed in this population. CLINICALTRIAL PROSPERO CRD42019119725; https://tinyurl.com/y5acfgd9.

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660 Trapeziectomy Versus Joint Replacement for First Carpometacarpal (CMC-1) Joint Osteoarthritis: A Systematic Review and Meta-Analysis

British Journal of Surgery ◽

10.1093/bjs/znab259.1003 ◽

2021 ◽

Vol 108 (Supplement_6) ◽

Author(s):

S Raj ◽

R Clay ◽

S Ramji ◽

R Shaunak ◽

A Dadrewalla ◽

...

Keyword(s):

Systematic Review ◽

Joint Replacement ◽

Revision Surgery ◽

Meta Analysis ◽

Long Term Follow Up ◽

Vas Scores ◽

Surgery Rates

Abstract Aim The challenge of managing first carpometacarpal (CMC-1) joint osteoarthritis is the lack of guidance on which surgical intervention is superior. This systematic review and meta-analysis compares joint replacement (JR) and trapeziectomy techniques to provide an update. Method In August 2020, MEDLINE, Embase and Web of Science were searched for eligible studies that compared these two techniques for the treatment of CMC-1 joint osteoarthritis (PROSPERO registration ID: CRD42020189728). Primary outcomes included the Disabilities of the Arm, Shoulder and Hand (DASH), QuickDASH and pain visual analogue scale (VAS) scores. Secondary outcomes, such as total complication, dislocation, and revision surgery rates, were also measured. Results From 1909 studies identified, 14 studies (1005 patients) were eligible. Our meta-analysis found that post-operative QuickDASH score was lower for patients in the JR group, indicating decreased disability following this technique (5 studies, p = 0.0002). However, pain VAS scores were similar between the two groups (5 studies, p = 0.22). Interestingly, JR techniques had significantly greater odds of overall complications (12 studies; OR 2.27; 95% CI 1.17-4.40, p = 0.02) and significantly greater odds of revision surgery (9 studies; OR 5.14; 95% CI 2.06-12.81, p = 0.0004). Conclusions Overall, based on low to moderate quality evidence, we found that JR treatments may result in better function with less disability with comparable pain (VAS) scores; however, JR has greater odds of complications and greater odds of requiring revision surgery. More robust RCTs that compare JR and TRAP with standardised outcome measures and long-term follow-up would add to the overall quality of evidence.

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Network Meta‐Analysis Comparing the Outcomes of Treatments for Intermittent Claudication Tested in Randomized Controlled Trials

Journal of the American Heart Association ◽

10.1161/jaha.120.019672 ◽

2021 ◽

Vol 10 (9) ◽

Author(s):

Shivshankar Thanigaimani ◽

James Phie ◽

Chinmay Sharma ◽

Shannon Wong ◽

Muhammad Ibrahim ◽

...

Keyword(s):

Intermittent Claudication ◽

Exercise Therapy ◽

Meta Analysis ◽

Risk Of Bias ◽

Home Exercise ◽

Controlled Trials ◽

Randomized Controlled

Background No network meta‐analysis has considered the relative efficacy of cilostazol, home exercise therapy, supervised exercise therapy (SET), endovascular revascularization (ER), and ER plus SET (ER+SET) in improving maximum walking distance (MWD) over short‐ (<1 year), moderate‐ (1 to <2 years), and long‐term (≥2 years) follow‐up in people with intermittent claudication. Methods and Results A systematic literature search was performed to identify randomized controlled trials testing 1 or more of these 5 treatments according to Preferred Reporting Items for Systematic Review and Meta‐Analysis guidelines. The primary outcome was improvement in MWD assessed by a standardized treadmill test. Secondary outcomes were adverse events and health‐related quality of life. Network meta‐analysis was performed using the gemtc R statistical package. The Cochrane collaborative tool was used to assess risk of bias. Forty‐six trials involving 4256 patients were included. At short‐term follow‐up, home exercise therapy (mean difference [MD], 89.4 m; 95% credible interval [CrI], 20.9–157.7), SET (MD, 186.8 m; 95% CrI, 136.4–237.6), and ER+SET (MD, 326.3 m; 95% CrI, 222.6–430.6), but not ER (MD, 82.5 m; 95% CrI, −2.4 to 168.2) and cilostazol (MD, 71.1 m; 95% CrI, −24.6 to 167.9), significantly improved MWD (in meters) compared with controls. At moderate‐term follow‐up, SET (MD, 201.1; 95% CrI, 89.8–318.3) and ER+SET (MD, 368.5; 95% CrI, 195.3–546.9), but not home exercise therapy (MD, 99.4; 95% CrI, −174.0 to 374.9) or ER (MD, 84.2; 95% CrI, −35.3 to 206.4), significantly improved MWD (in meters) compared to controls. At long‐term follow‐up, none of the tested treatments significantly improved MWD compared to controls. Adverse events and quality of life were reported inconsistently and could not be meta‐analyzed. Risk of bias was low, moderate, and high in 4, 24, and 18 trials respectively. Conclusions This network meta‐analysis suggested that SET and ER+SET are effective at improving MWD over the moderate term (<2 year) but not beyond this. Durable treatments for intermittent claudication are needed.

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The Prevalence of Suicidal Ideation after the Earthquake: A Systematic Review and Meta-Analysis

Iranian Journal of Public Health ◽

10.18502/ijph.v49i12.4815 ◽

2020 ◽

Author(s):

Katayoun JAHANGIRI ◽

Kosar YOUSEFI ◽

Aliashraf MOZAFARI ◽

Ali SAHEBI

Keyword(s):

Systematic Review ◽

Suicidal Ideation ◽

Suicide Ideation ◽

Meta Analysis ◽

Recovery Phase ◽

Psychological Consequences ◽

Short And Long Term

Background: Disasters have many health consequences such as suicide ideation as one of the relatively common psychological consequences after natural disasters, especially earthquakes. This study aimed to determine the prevalence of post-earthquake suicidal ideation in affected people. Methods: Related keywords of this systematic review and meta-analysis in English and their Persian equivalents were searched in the data resources including Google Scholar, SID, Magiran, Scopus, PubMed, and Web of Science from Jan 2014 to May 2019. The STROBE checklist was used to evaluate the quality of the articles. The I 2 index was used to determine the heterogeneity and the random-effects model was used in meta-analysis. Statistical analysis was conducted in the STATA software version 14. Results: Overall, 14347 subjects including 6662 males and 7715 females with the mean age of 23.88 ± 15.81yr old were assessed. The prevalence of post-earthquake suicidal ideation was 20.34% (95% CI: 13.60-27.08, P<0.001, I2=99.1). The prevalence of suicidal ideation showed a decreasing trend based on the year of the study and the duration of post-earthquake follow-up. Conclusion: Although the prevalence of post-earthquake suicidal ideation showed a decreasing trend, the probability of incidence of these thoughts in the long-term is still noticeable. Therefore, implementing a surveillance system is recommended to monitor the mental health status of earthquakes survivors for the possibility of suicidal thoughts in the short and long term recovery phase.

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LONG-TERM CLINICAL OUTCOMES IN SURVIVORS OF CORONAVIRUS OUTBREAKS AFTER HOSPITALISATION OR ICU ADMISSION: A SYSTEMATIC REVIEW AND META-ANALYSIS OF FOLLOW-UP STUDIES

10.1101/2020.04.16.20067975 ◽

2020 ◽

Cited By ~ 5

Author(s):

Hassaan Ahmed ◽

Kajal Patel ◽

Darren Greenwood ◽

Stephen Halpin ◽

Penny Lewthwaite ◽

...

Keyword(s):

Quality Of Life ◽

Systematic Review ◽

Meta Analysis ◽

Adult Survivors ◽

Icu Admission ◽

Follow Up Studies ◽

Clinical Problems

ABSTRACTObjectiveTo determine the long-term clinical problems in adult survivors of coronavirus (CoV) infection [Coronavirus disease 2019 (COVID-19), Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS)] after hospitalisation or Intensive Care Unit (ICU) admission.DesignSystematic review and meta-analysis of the literature.Data sourcesOvid MEDLINE, EMBASE, CINAHL Plus and PsycINFO were searched using the strategy: (Coronavirus OR Coronavirus Infections OR COVID OR SARS virus OR Severe acute respiratory syndrome OR MERS OR Middle east respiratory syndrome) AND (Follow-up OR Follow-up studies OR Prevalence). Original studies reporting the clinical outcomes of adult survivors of coronavirus outbreaks two months after discharge or three months after admission were included. The quality of the studies was assessed using the Oxford Centre for Evidence-Based Medicine (OCEBM) 2009 Level of Evidence Tool. Meta-analysis was conducted to derive pooled estimates of prevalence and severity for different outcomes at time points up to 6 months follow-up and beyond 6 months follow-up.ResultsThe search yielded 1169 studies of which 28 were included in this review. There were 15 Level 1b, 8 Level 2b, 2 Level 3b and 3 Level 4 studies by OCEBM grading. Pooled analysis of studies revealed that complications commonly observed were impaired diffusing capacity for carbon monoxide (DLCO) [prevalence of 27.26%, 95% CI 14.87 to 44.57] and reduced exercise capacity [(6-minute walking distance (6MWD) mean 461m, 95% CI 449.66 to 472.71] at 6 months with limited improvement beyond 6 months. Coronavirus survivors had considerable prevalence of psychological disorders such as post-traumatic stress disorder (PTSD) [38.80%, CI 30.93 to 47.31], depression [33.20%, CI 19.80 to 50.02] and anxiety [30.04%, CI 10.44 to 61.26) beyond 6 months. These complications were accompanied by low Short Form 36 (SF-36) scores at 6 months and beyond indicating reduced quality of life which is present long-term.ConclusionsThe long term clinical problems in survivors of CoV infections (SARS and MERS) after hospitalisation or Intensive Care Unit (ICU) admission include respiratory dysfunction, reduced exercise capacity, psychological problems such as PTSD, depression and anxiety, and reduced quality of life. Critical care, rehabilitation and mental health services should anticipate a high prevalence of these problems following COVID-19 and ensure their adequate and timely management with the aim of restoring premorbid quality of life.

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