High-level Systematic Review Assesses Hearing Aid Effectiveness

BACKGROUND: People living with Parkinson’s disease (PD) are less active than healthy individuals. Ehealth is an emerging concept in healthcare which presents opportunities to promote physical activity (PA) in people with PD. The aim of this systematic review was to explore the effectiveness of ehealth in the promotion of PA in people living with PD. METHODS: Suitable articles were searched for using EMBASE, PsychInfo, Web of Science and OVID Medline databases using a combination of keywords and medical subject headings. Articles were included if they described an ehealth intervention designed to promote PA in people living with PD. Two reviewers screened studies for suitability and extracted data. Risk of bias was assessed using the Cochrane risk of bias 2 tool and the Downs and Black risk of bias checklist. Due to the heterogeneity of studies, a narrative synthesis of study interventions and results was completed rather than a quantitative analysis. RESULTS: 1449 articles were screened. Four studies met the eligibility criteria which included 652 participants. Web and mobile applications were used to design the PA interventions. PA levels were measured using self-reported questionnaires, Fitbits, activity monitors and accelerometers. Three of the studies reported improvements in aspects of PA. However, this was not consistently reported in all study participants. No adverse effects, a high level of enjoyment and a relatively low attrition rate (∼12.5%) were reported. CONCLUSION: Ehealth is a safe and feasible intervention to promote PA in this population. It is unclear whether ehealth is effective at promoting PA in people with PD. Keywords:

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P6: ANTIPLATELET AND ANTICOAGULANT USE IN RANDOMISED TRIALS OF PATIENTS UNDERGOING ENDOVASCULAR INTERVENTION FOR PERIPHERAL ARTERIAL DISEASE: SYSTEMATIC REVIEW

British Journal of Surgery ◽

10.1093/bjs/znab117.091 ◽

2021 ◽

Vol 108 (Supplement_1) ◽

Author(s):

MI Qureshi ◽

HL Li ◽

GK Ambler ◽

KHF Wong ◽

S Dawson ◽

...

Keyword(s):

Systematic Review ◽

Peripheral Arterial Disease ◽

Antiplatelet Therapy ◽

Dual Antiplatelet Therapy ◽

Arterial Intervention ◽

Arterial Disease ◽

Endovascular Intervention ◽

Randomised Trials ◽

Peripheral Arterial ◽

High Level

Abstract Introduction Guideline recommendations for antithrombotic (antiplatelet and anticoagulant) therapy during and after endovascular intervention are patchy and conflicted, in part due to a lack of evidence. The aim of this systematic review was to examine the antithrombotic specifications in randomised trials for peripheral arterial endovascular intervention. Method This review was conducted according to PRISMA guidelines. Randomised trials including participants with peripheral arterial disease undergoing endovascular arterial intervention were included. Trial methods were assessed to determine whether an antithrombotic protocol had been specified, its completeness, and the agent(s) prescribed. Antithrombotic protocols were classed as periprocedural (preceding/during intervention), immediate postprocedural (up to 14 days following intervention) and maintenance postprocedural (therapy continuing beyond 14 days). Trials were stratified according to type of intervention. Result Ninety-four trials were included. Only 29% of trials had complete periprocedural antithrombotic protocols, and 34% had complete post-procedural protocols. In total, 64 different periprocedural protocols, and 51 separate postprocedural protocols were specified. Antiplatelet monotherapy and unfractionated heparin were the most common choices of regimen in the periprocedural setting, and dual antiplatelet therapy (55%) was most commonly utilised postprocedure. There is an increasing tendency to use dual antiplatelet therapy with time or for drug-coated technologies. Conclusion Randomised trials comparing different types of peripheral endovascular arterial intervention have a high level of heterogeneity in their antithrombotic regimens, and there has been an increasing tendency to use dual antiplatelet therapy over time. Antiplatelet regimes need to be standardised in trials comparing endovascular technologies. Take-home message To determine the benefits of any endovascular intervention within a randomised trial, antithrombotic regimens should be standardised to prevent confounding. This systematic review demonstrates a high level of heterogeneity of antithrombotic prescribing in randomised trials of endovascular intervention, and an increasing tendency to utilise dual antiplatelet therapy, despite a lack of evidence of benefit, but an increased risk of harm.

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Clinical presentation of strokes confined to the insula: a systematic review of literature

Neurological Sciences ◽

10.1007/s10072-021-05109-1 ◽

2021 ◽

Author(s):

Vincenzo Di Stefano ◽

Maria Vittoria De Angelis ◽

Chiara Montemitro ◽

Mirella Russo ◽

Claudia Carrarini ◽

...

Keyword(s):

Systematic Review ◽

Clinical Presentation ◽

Insular Cortex ◽

Affective Processing ◽

Appropriate Treatment ◽

Insula Cortex ◽

Atypical Presentations ◽

High Level ◽

To Receive ◽

Insular Region

Abstract Background and purpose The insular cortex serves a wide variety of functions in humans, ranging from sensory and affective processing to high-level cognition. Hence, insular dysfunction may result in several different presentations. Ischemic strokes limited to the insular territory are rare and deserve a better characterization, to be quickly recognized and to receive the appropriate treatment (e.g. thrombolysis). Methods We reviewed studies on patients with a first-ever acute stroke restricted to the insula. We searched in the Medline database the keywords “insular stroke” and “insular infarction”, to identify previously published cases. Afterwards, the results were divided depending on the specific insular region affected by the stroke: anterior insular cortex (AIC), posterior insular cortex (PIC) or total insula cortex (TIC). Finally, a review of the clinical correlates associated with each region was performed. Results We identified 25 reports including a total of 49 patients (59.7 ± 15.5 years, 48% male) from systematic review of the literature. The most common clinical phenotypes were motor and somatosensory deficits, dysarthria, aphasia and a vestibular-like syndrome. Atypical presentations were also common and included dysphagia, awareness deficits, gustatory disturbances, dysautonomia, neuropsychiatric or auditory disturbances and headache. Conclusions The clinical presentation of insular strokes is heterogeneous; however, an insular stroke should be suspected when vestibular-like, somatosensory, speech or language disturbances are combined in the same patient. Further studies are needed to improve our understanding of more atypical presentations.

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The risk of venous thromboembolism and physical activity level, especially high level: a systematic review

Journal of Thrombosis and Thrombolysis ◽

10.1007/s11239-020-02372-5 ◽

2021 ◽

Author(s):

H. Danin-Mankowitz ◽

A. Ugarph-Morawski ◽

F. Braunschweig ◽

P. Wändell

Keyword(s):

Physical Activity ◽

Systematic Review ◽

Venous Thromboembolism ◽

Activity Level ◽

Case Control Studies ◽

The Third ◽

Area Of Interest ◽

High Level ◽

The Relationship

AbstractVenous thromboembolism (VTE) is the third most common cause of cardiovascular disease. Connection between high level of physical activity (PA) and the onset of VTE is unknown. We searched the literature on the possible association between PA level, especially high levels, and the risk of VTE. A systematic review was carried out to identify relevant articles on the relation between PA level and VTE. The initial search was conducted together with the Karolinska Institutet University Library in February 2018, with follow-up searches after that. In total, 4383 records were found and then screened for exclusion of duplicates and articles outside the area of interest. In total, 16 articles with data on 3 or more levels of PA were included. Of these, 12 were cohort and 4 were case-control studies. Totally 13 studies aimed at investigating VTE cases primarily, while three studies had other primary outcomes. Of the 16 studies, five found a U-shaped association between PA level and VTE risk, although non-significant in three of them. Two articles described an association between a more intense physical activity and a higher risk of VTE, which was significant in one. Nine studies found associations between increasing PA levels and a decreasing VTE risk. Available literature provides diverging results as to the association between high levels of PA and the risk of venous thromboembolism, but with several studies showing an association. Further research is warranted to clarify the relationship between high level PA and VTE.

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A Systematic Review of Research on Questioning as a High-level Cognitive Strategy

English Language Teaching ◽

10.5539/elt.v8n10p76 ◽

2015 ◽

Vol 8 (10) ◽

Cited By ~ 4

Author(s):

Mohammad Davoudi ◽

Narges Amel Sadeghi

Keyword(s):

Systematic Review ◽

Cognitive Strategy ◽

High Level

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Longitudinal Study of Hearing Aid Effectiveness. I

Journal of Speech Language and Hearing Research ◽

10.1044/jshr.3604.808 ◽

1993 ◽

Vol 36 (4) ◽

pp. 808-819 ◽

Cited By ~ 30

Author(s):

Ruth A. Bender ◽

Diane P. Niebuhr ◽

Janet P. Getta ◽

Charles V. Anderson

Keyword(s):

Hearing Loss ◽

Longitudinal Study ◽

Nonsense Syllable ◽

Hearing Aid ◽

Aid Effectiveness ◽

Training Effect ◽

Speech Perception In Noise ◽

Objective Tests ◽

Recognition Testing

This report is the first of two detailing a longitudinal follow-up of hearing aid users. Sixty-five subjects were followed for 12 months post-hearing aid fitting. Objective tests included insertion gain, the Speech Perception in Noise (SPIN) test (Kalikow, Stevens & Elliott, 1977; Bilger, Neutzel, Rabinowitz, & Rzeczkowski, 1984) and the Nonsense Syllable Test (NST) (Levitt & Resnick, 1978) presented in quiet and noise backgrounds. Initially each subject’s hearing aid was fit to the revised National Acoustic Laboratories prescriptive formula (NAL-R) (Byrne & Dillon, 1986) using insertion gain measures. Use gain, measured at 6 and 12 months post-fitting, indicated that subjects generally used those prescribed values, except for subjects in the steeply sloping configuration subgroup. The NST and SPIN tests were administered at the fitting and at 1, 3, 6, and 12 months post-fitting. No change in performance, or training effect, was found for the group or for factors of experience, degree of hearing loss, configuration of hearing loss, use time, or circuit type. Failure to demonstrate a training effect may be attributed, in part, to the fact that initial speech recognition testing was done with the hearing aid volume set at the prescribed values. None of the circuits used showed performance superiority, except when comparing scores for the NST obtained in a quiet background to those obtained in a background of speech-weighted noise. In that comparison, the users of adaptive filter circuits exhibited less deterioration of performance in a noise background.

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The Association Between Dental Anxiety And Psychiatric Disorders And Symptoms: A Systematic Review

Clinical Practice and Epidemiology in Mental Health ◽

10.2174/1745017901814010207 ◽

2018 ◽

Vol 14 (1) ◽

pp. 207-222 ◽

Cited By ~ 3

Author(s):

Harri Halonen ◽

Jenna Nissinen ◽

Heli Lehtiniemi ◽

Tuula Salo ◽

Pirkko Riipinen ◽

...

Keyword(s):

Systematic Review ◽

Psychiatric Disorders ◽

Web Of Science ◽

Dental Anxiety ◽

Data Sources ◽

Inclusion Criteria ◽

Clinical Interviews ◽

Specific Phobias ◽

Axis I ◽

High Level

Background:A growing amount of evidence suggests that dental anxiety is associated with other psychiatric disorders and symptoms. A systematic review was conducted to critically evaluate the studies of comorbidity of dental anxiety with other specific phobias and other Axis I psychiatric disorders.Objective:The aim of the review was to explore how dental anxiety is associated with other psychiatric disorders and to estimate the level of comorbid symptoms in dental anxiety patients.Methods:The review was conducted and reported in accordance with the MOOSE statement. Data sources included PubMed, PsycInfo, Web of Science and Scopus.Results:The search produced 631 hits, of which 16 unique records fulfilled the inclusion criteria. The number of eligible papers was low. Study populations were heterogeneous including 6,486 participants, and a total of 25 tests and in few cases clinical interviews were used in the evaluation processes. The results enhanced the idea about the comorbidity between dental anxiety and other psychiatric disorders. The effect was found strong in several studies.Conclusion:Patients with a high level of dental anxiety are more prone to have a high level of comorbid phobias, depression, mood disorders and other psychiatric disorders and symptoms.

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Factors and Strategies for Post-Vertebroplasty Residual Pain from Thoracolumbar Osteoporotic Vertebral Compression Fractures (OVCF): a systematic review.

10.21203/rs.3.rs-162171/v1 ◽

2021 ◽

Author(s):

Binbin Tang ◽

Kang Liu ◽

Lianguo Wu ◽

Xiaolin Shi

Keyword(s):

Systematic Review ◽

Bone Cement ◽

Vertebral Compression Fractures ◽

Osteoporotic Vertebral Compression Fractures ◽

Related Factors ◽

Residual Pain ◽

Compression Fractures ◽

Short Period ◽

Cement Distribution ◽

High Level

Abstract Purpose Insignificant pain relief (IPR) in short period after vertebroplasty is common, which often disturb doctors and affect patients Therefore, we reviewed systematically relative articles and attempted to get meaningful evidence on factors and strategies for IPR.Methods PubMed, Web of Science, Embase, CNKI, WanFang, and VIP were searched for literatures treating the osteoporotic vertebral compression fractures (OVCFs) with vertebroplasty and assessing the clinical efficacy.Results 817 references were electronically retrieved, 81 full-text papers were screened and 41 studies were included. Twenty-two trials presented factors on IPR, mainly including bone cement related, operation related and patient-related factors. Nineteen studies showed strategies on residual pain, including improving osteoporosis, reforming surgical operation and add other therapies. 16 prospective, 20 retrospective and 5 meta-analyses consisted the systematic review. The date from included studies point to different results, with less risk of bias, were needed to clarify the factors and strategies for residual pain.Conclusions Bone cement distribution and operation error are highly related to the post-vertebroplasty residual pain. Many therapeutic methods could improve pain and rehabilitate function but lacking more high-level evidence due to the insufficient trails.

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Post-natalizumab disease reactivation in multiple sclerosis: systematic review and meta-analysis

Therapeutic Advances in Neurological Disorders ◽

10.1177/1756286419837809 ◽

2019 ◽

Vol 12 ◽

pp. 175628641983780 ◽

Cited By ~ 9

Author(s):

Luca Prosperini ◽

Revere P. Kinkel ◽

Augusto A. Miravalle ◽

Pietro Iaffaldano ◽

Simone Fantaccini

Keyword(s):

Multiple Sclerosis ◽

Systematic Review ◽

Disease Activity ◽

Meta Analysis ◽

Random Effect ◽

Patient Characteristics ◽

Increased Risk ◽

Disease Reactivation ◽

Definition Of ◽

High Level

Background: Natalizumab (NTZ) is sometimes discontinued in patients with multiple sclerosis, mainly due to concerns about the risk of progressive multifocal leukoencephalopathy. However, NTZ interruption may result in recrudescence of disease activity. Objective: The objective of this study was to summarize the available evidence about NTZ discontinuation and to identify which patients will experience post-NTZ disease reactivation through meta-analysis of existing literature data. Methods: PubMed was searched for articles reporting the effects of NTZ withdrawal in adult patients (⩾18 years) with relapsing–remitting multiple sclerosis (RRMS). Definition of disease activity following NTZ discontinuation, proportion of patients who experienced post-NTZ disease reactivation, and timing to NTZ discontinuation to disease reactivation were systematically reviewed. A generic inverse variance with random effect was used to calculate the weighted effect of patients’ clinical characteristics on the risk of post-NTZ disease reactivation, defined as the occurrence of at least one relapse. Results: The original search identified 205 publications. Thirty-five articles were included in the systematic review. We found a high level of heterogeneity across studies in terms of sample size (10 to 1866 patients), baseline patient characteristics, follow up (1–24 months), outcome measures (clinical and/or radiological), and definition of post-NTZ disease reactivation or rebound. Clinical relapses were observed in 9–80% of patients and peaked at 4–7 months, whereas radiological disease activity was observed in 7–87% of patients starting at 6 weeks following NTZ discontinuation. The meta-analysis of six articles, yielding a total of 1183 patients, revealed that younger age, higher number of relapses and gadolinium-enhanced lesions before treatment start, and fewer NTZ infusions were associated with increased risk for post-NTZ disease reactivation ( p ⩽ 0.05). Conclusions: Results from the present review and meta-analysis can help to profile patients who are at greater risk of post-NTZ disease reactivation. However, potential reporting bias and variability in selected studies should be taken into account when interpreting our data.

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