Potential risks of rare serious adverse effects related to long‐term use of bisphosphonates: An overview of systematic reviews

Background. Breech presentation at the time of delivery is 3.8–4%. Fetuses that maintain a noncephalic presentation beyond 32 weeks will have a lower probability of spontaneous version before labor. Given the increasing interest in exploring the use of complementary medicine during pregnancy and childbirth, the moxibustion technique, a type of traditional Chinese medicine, could be another option to try turning a breech baby into a cephalic presentation. Objectives. To review the evidence from systematic reviews (SR) on the efficacy and safety of acupuncture and moxibustion in pregnant women with noncephalic presentation. Main Results. Our SR synthesizes the results from five clinical trials on pregnant women with a singleton noncephalic presentation. There is evidence that moxibustion reduces the number of noncephalic presentations at the time of birth compared with no treatment. The adverse effects that acupuncture and moxibustion can cause seem to be irrelevant. Most SRs agree that there are no adverse effects directly related to acupuncture and moxibustion. Conclusions. Even though the results obtained are positive and the five reviews conclude that moxibustion reduces the number of noncephalic presentations at birth (alone or combined with postural techniques or acupuncture), there is considerable heterogeneity between them. Better methodologically designed studies are required in the future to reaffirm this conclusion.

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Vocational interventions to help adults with long-term health conditions or disabilities gain and maintain paid work: an overview of systematic reviews

BMJ Open ◽

10.1136/bmjopen-2021-049522 ◽

2021 ◽

Vol 11 (12) ◽

pp. e049522

Author(s):

William Mark Magnus Levack ◽

Joanna Kirstin Fadyl

Keyword(s):

Mental Health ◽

Systematic Reviews ◽

Health Conditions ◽

Paid Work ◽

High Quality ◽

Mental Health Conditions ◽

Moderate Quality ◽

Overview Of Systematic Reviews ◽

Quality Evidence

ObjectiveTo conduct an overview of systematic reviews to examine the effectiveness of vocational interventions to help adults with long-term health conditions or disability gain and maintain new paid work and to analyse the spread and quality of evidence in this area.MethodsWe pre-published our protocol in PROSPERO (CRD42019132448). We searched Cochrane Database of Systematic Reviews, MEDLINE, EMBASE, PsycINFO, AMED, CINAHL, Proquest Dissertations and Theses database, NICE and Business Source Complete from inception to 21 August 2020. We included any systematic reviews of clinical trials on vocational interventions for adults with long-term health conditions or disability who were not in work or had recently gained work. We excluded reviews of vocational interventions for employed people on sick leave. Two researchers identified, critically appraised,using A MeaSurement Tool to Assess systematic Reviews (AMSTAR) 2, and extracted data from included reviews. We used Grading of Recommendations Assessment, Development and Evaluation to evaluate strength of evidence underpinning overview findings.ResultsWe identified 26 reviews (5 high-quality and 21 critically low to moderate quality) that focused on vocational interventions for acquired brain injury, autism, intellectual disability, multiple sclerosis, mental health conditions, spinal cord injury and general disability populations. We identified moderate quality evidence that people with moderate to severe mental health conditions who participate in supported employment, particularly individual placement and support, are more likely to gain competitive employment compared with people who receive traditional vocational services (risk ratio 2.07; 95% CI 1.82 to 2.35; 27 studies, 6651 participants). We found only very low-quality to low-quality evidence on vocational intervention for people with any other health condition. We found little to no data on employer or employee satisfaction with work outcomes or the cost effectiveness of interventions.ConclusionGiven the importance placed on work opportunities for people with long-term health conditions or disability, there is urgent need for more high-quality research on vocational interventions for this population.Prospero registration numberCRD42019132448.

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Vitamin D Supplementation for the Prevention of Falls and Fractures in Residents of Long-Term Care Facilities: A 2021 Update

Canadian Journal of Health Technologies ◽

10.51731/cjht.2021.111 ◽

2021 ◽

Vol 1 (7) ◽

Author(s):

Srabani Banerjee ◽

Holly Gunn ◽

Carolyn Spry

Keyword(s):

Vitamin D ◽

Elderly Patients ◽

Systematic Reviews ◽

Long Term Care ◽

Vitamin D Supplementation ◽

Term Care ◽

Care Facilities ◽

Overview Of Systematic Reviews ◽

Evidence Based Guidelines

The relevant publications identified comprised 1 overview of systematic reviews and 2 systematic reviews. There is a suggestion that for seniors living in long-term care facilities, compared to control, vitamin D supplementation, with or without calcium, may reduce the rate of falls and fractures; however, the reductions were not always statistically significant. There were no statistically significant differences in the number of seniors who fell with vitamin D supplementation, with or without calcium, compared with control groups. Findings need to be interpreted with caution, considering the limitations such as primary studies of variable quality (critically low to moderate) and lack of clarity with respect to the type of long-term care setting. No cost-effectiveness studies regarding vitamin D supplementation for the prevention of falls and fractures in elderly patients residing in long-term care facilities were identified. No evidence-based guidelines regarding vitamin D supplementation for the prevention of falls and fractures in elderly patients residing in long-term care facilities were identified.

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Adverse effects of herbal medicines: an overview of systematic reviews

Clinical Medicine ◽

10.7861/clinmedicine.13-1-7 ◽

2013 ◽

Vol 13 (1) ◽

pp. 7-12 ◽

Cited By ~ 90

Author(s):

Paul Posadzki ◽

Leala K Watson ◽

Edzard Ernst

Keyword(s):

Adverse Effects ◽

Systematic Reviews ◽

Herbal Medicines ◽

Overview Of Systematic Reviews

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Prognostic Factors for Persistent Symptoms in Adults With Mild Traumatic Brain Injury: Protocol for an Overview of Systematic Reviews

10.21203/rs.3.rs-72770/v1 ◽

2020 ◽

Author(s):

Julien Déry ◽

Élaine De Guise ◽

Marie-Eve Lamontagne

Keyword(s):

Traumatic Brain Injury ◽

Prognostic Factors ◽

Brain Injury ◽

Mild Traumatic Brain Injury ◽

Systematic Reviews ◽

Clinical Decision Making ◽

Public Health Problem ◽

Persistent Symptoms ◽

Overview Of Systematic Reviews

Abstract Background: Mild traumatic brain injury (mTBI) is an increasing public health problem, and persistent symptoms following mTBI have several functional consequences. Understanding the prognosis of a condition is an important component of clinical decision-making and can help to guide prevention of long-term disabilities and to intervene with mTBI patients. Prognosis of chronic symptoms in mTBI has stimulated several empirical primary research papers and many systematic reviews. We aim to integrate these heterogenous factors into a model in order to have a better understanding of such prognostic factors on the development of chronic symptoms.Methods: We will conduct an overview of systematic reviews following steps described in the Cochrane Handbook. We will search for systematic reviews in databases using a search strategy to include articles that review evidence about prognosis of persistent symptoms after an mTBI in the adult population. Two reviewers will independently screen all references and then select eligible reviews based on eligibility criteria. Any disagreements will be discussed by the two reviewers and if consensus is not reached, we will consult a third reviewer. A data extraction grid will be used to extract relevant information. The risk of bias included will be rated using ROBIS tool. Data will be synthesized into a comprehensive conceptual map in order to have a better understanding of the predictor factors that could impact the recovery after mTBI.Discussion: Results will help multiple stakeholders, such as clinicians and rehabilitation program managers, to understand the prognosis of long-term consequences following an mTBI. It could guide stakeholders to recognize predisposing, precipitating, and perpetuating factors of their patients and to invest their time and resources on patients needing the most.Systematic review registration: PROSPERO CRD42020176676

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The effects of interventions preventing self-harm and suicide in children and adolescents: an overview of systematic reviews

F1000Research ◽

10.12688/f1000research.19506.1 ◽

2019 ◽

Vol 8 ◽

pp. 890 ◽

Cited By ~ 3

Author(s):

Ida Sund Morken ◽

Astrid Dahlgren ◽

Ingeborg Lunde ◽

Siri Toven

Keyword(s):

Children And Adolescents ◽

Systematic Reviews ◽

Suicide Attempts ◽

Health Providers ◽

Long Term Effects ◽

Community Based Interventions ◽

Overview Of Systematic Reviews ◽

Self Harm ◽

Suicide Clusters

Background: Self-harm and suicide in children and adolescents are of serious consequence and increase during the adolescent years. Consequently, there is need for interventions that prevent such behaviour. The objective of this paper: to evaluate the effects of interventions preventing self-harm and suicide in children and adolescents in an overview of systematic reviews. Methods: We conducted a review of systematic reviews (OoO). We included reviews evaluating any preventive or therapeutic intervention. The quality of the included reviews was assessed independently, and data was extracted by two reviewers. We report the review findings descriptively. The certainty of the evidence was assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE). Results: Moderate certainty evidence suggests that school-based interventions prevent suicidal ideation and attempts short term, and possibly with long term effects on suicide attempts. The effects of community-based interventions following suicide clusters and local suicide plans are uncertain, as are the benefits and harms of screening young people for suicide risk. The effects of most interventions targeting children and adolescents with known self-harm are uncertain. However, low certainty evidence suggests that dialectical behavioural therapy and developmental group therapy are equally as effective on repetition of self-harm as enhanced treatment as usual. Conclusions: Research on several recommended practices, such as local suicide plans, prevention of suicide clusters and approaches to risk assessment, is lacking. When implemented, these interventions should be closely evaluated. There also is need for more research on treatment for repeated self-harm, including long term follow-up, and in general: possible harmful effects. Policy makers and health providers should consider evidence from population-based studies and adults in preventing self-harm and suicide in children and adolescents. Also, approaches showing promise in treatment of conditions associated with self-harm and/or suicidality, such as depression and psychosis, should be considered. PROSPERO registration: CRD42019117942 08/02/19.

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Massage Therapy in Infants and Children under 5 Years of Age: Protocol for an Overview of Systematic Reviews and A Systematic Review

10.21203/rs.3.rs-59513/v1 ◽

2020 ◽

Author(s):

Shucheng CHEN ◽

Juan Yu ◽

Sam Chun-Sum Yuen ◽

Jason Chun-Sing Lam ◽

Lorna Kwai-Ping Suen ◽

...

Keyword(s):

Systematic Review ◽

Adverse Effects ◽

Systematic Reviews ◽

Treatment Effects ◽

Massage Therapy ◽

Infants And Children ◽

Current Evidence ◽

Overview Of Systematic Reviews ◽

In Infants And Children

Abstract Introduction: Massage is a popularly used complementary and alternative therapy. Previous randomised controlled trials have examined the effects of massage on children, and several systematic reviews have been conducted to synthesise these data. This study aims to assess and summarise the current evidence from published systematic reviews of controlled clinical trials on the practice of paediatric massage, specifically in infants and children aged < 5 years. Methods and analysis: This protocol was developed based on the Cochrane Handbook of Systematic Reviews of Interventions and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols. The online databases MEDLINE, Embase, Health Technology Assessment Database, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, Allied and Complementary Medicine, China National Knowledge Infrastructure, and Wanfang Data will be searched from the inception to June 2020 for evidence of the treatment effects. We will include systematic reviews of randomised control trials in infants and children aged < 5 years. Two reviewers will independently screen the articles for inclusion as per the eligibility criteria. They will extract information from the included studies and assess the methodological quality of the included studies. In addition, a systematic review of the adverse effects of massage on infants and children aged < 5 years will be included in this overview. We will present the treatment effects and adverse effects narratively. The pooled effect estimates for meta-analysed outcomes from the included studies will be extracted when possible. Additionally, we will generate a figure to show the recommendation level of massage therapy for each condition included according to the evidence quality of the studies included in the systematic reviews.Discussion: This overview of systematic reviews will summarise the current evidence on massage, specifically for infants and children aged < 5 years. We will comprehensively present the positive effects and adverse effects of this intervention.Trial registration number: CRD42020186003

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Current evidence for prenatal and postnatal corticosteroids in preterm infants

Archives of Disease in Childhood - Fetal and Neonatal Edition ◽

10.1136/archdischild-2020-319706 ◽

2021 ◽

pp. fetalneonatal-2020-319706

Author(s):

Eric S Shinwell ◽

Polina Gurevitz ◽

Igor Portnov

Keyword(s):

Adverse Effects ◽

Inhaled Corticosteroids ◽

Standard Of Care ◽

Current Evidence ◽

Antenatal Corticosteroids ◽

Term Outcome ◽

Long Term Outcome ◽

Beneficial Effects ◽

Potential Risks

Antenatal corticosteroids undoubtedly save many lives and improve the quality of many others. However, the currently accepted dosage schedule has been in place since 1972, and recent studies have suggested that beneficial effects may be seen with less. Most but not all studies of long-term outcome show no adverse effects. The use of antenatal corticosteroids in women with COVID-19 raises important questions regarding potential risks and benefits. However, currently, most authorities recommend continuing according to published guidelines. With regard to postnatal corticosteroids, alternatives to systemic dexamethasone, the somewhat tainted standard of care, show promise in preventing bronchopulmonary dysplasia without adverse effects. Systemic hydrocortisone and inhaled corticosteroids are of note. The mixture of surfactant and corticosteroids deserves particular attention in the coming years.

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Effectiveness of mobile applications in diabetic patients’ healthy lifestyles: review of systematic reviews.

10.21203/rs.3.rs-115192/v1 ◽

2020 ◽

Author(s):

Francisco Jesús Represas Carrera ◽

Ángel Alfredo Martínez Ques ◽

Ana Clavería Fontán

Keyword(s):

Diabetes Mellitus ◽

Adverse Effects ◽

Systematic Reviews ◽

Mobile Applications ◽

Control Group ◽

Diabetic Patients ◽

Healthy Lifestyles ◽

Major Public Health Problem

Abstract Background: Diabetes mellitus (DM) is currently a major public health problem worldwide. It is traditionally approached by a clinical inpatient relationship between patients and healthcare professionals. However, the rise in of the use of new technologies, particularly mobile applications, is revolutionizing the traditional healthcare model with the introduction of telehealthcare.Objective: (1) Examine the mobile applications that address lifestyles to improve the metabolic control of adult patients with Diabetes Mellitus. (2) Describe the characteristics of the used mobile applications, identify the healthy lifestyles they target, and describe any of their adverse effects.Methods: Review of systematic reviews following Cochrane Collaboration and Joanna Briggs Institute guidelines. We included studies that used any mobile application to help patients improve DM self-management by focusing on healthy lifestyles. Studies needed to include a control group receiving regular care without using mobile devices. In May 2018, Medline, Embase, Cochrane, LILACS, PsychINFO, Cinahl and Science Direct were searched, updated in May 2019. The methodological quality of the studies was assessed by the Amstar-2 tool.Results: Seven systematic reviews of 798 articles were initially selected for the analysis. Interventions lasted 1-12 months. Twenty-three different mobile applications were identified. They were all related to eating and physical activity. Significant changes were found in HbA1c values, body weight and BMI, but no clear improvement was observed in others like lipid profile, quality of life or blood pressure. No significant adverse effects were identified.Conclusions: Clearly evidence appeared for using mobile applications to improve glycemic control in diabetic patients in the short term, but not for long-term benefits. Thus carrying out further studies is necessary to learn about the long-term effectiveness of mobile applications to promote DM patients’ healthy lifestyles. PROSPERO Register: CRD42019133685

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Massage therapy in infants and children under 5 years of age: protocol for an overview of systematic reviews

Systematic Reviews ◽

10.1186/s13643-021-01681-x ◽

2021 ◽

Vol 10 (1) ◽

Author(s):

Shu-Cheng Chen ◽

Juan Yu ◽

Sam Chun-Sum Yuen ◽

Jason Chun-Sing Lam ◽

Lorna Kwai-Ping Suen ◽

...

Keyword(s):

Adverse Effects ◽

Systematic Reviews ◽

Methodological Quality ◽

Massage Therapy ◽

Infants And Children ◽

Current Evidence ◽

Psychological Outcome ◽

Overview Of Systematic Reviews ◽

In Infants And Children

Abstract Introduction Massage is a popularly used complementary and alternative therapy. Previous randomised controlled trials have examined the effects of massage on children, and several systematic reviews have been conducted to synthesise these data. This study aims to assess and summarise the current evidence from published systematic reviews of controlled clinical trials on the practice of paediatric massage, specifically in infants and children aged < 5 years. Methods The online databases MEDLINE, Embase, Health Technology Assessment Database, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, Allied and Complementary Medicine, China National Knowledge Infrastructure and Wanfang Data will be searched from the inception onwards for evidence of the treatment effects. We will include systematic reviews of randomised control trials evaluating the effects and safety of massage therapy in infants and children aged < 5 years. The primary outcomes will be any physical or psychological outcome, and adverse effects on children. Secondary outcomes will include any physical or psychological outcome on caregivers. Two reviewers will independently screen the articles for inclusion as per the eligibility criteria. They will extract information from the included studies and assess the methodological quality of the included studies. A table will be used to summarise of information of the included studies, which includes the basic information, method and findings. The methodological quality of the included systematic reviews will be assessed by A Measurement Tool to Assess Systematic Reviews version 2 (AMSTAR 2). Extracted data from the included studies will be collected and presented using narrative approach. The pooled effect estimates for meta-analysed outcomes will be extracted when possible. If there is a discrepancy in results of two or more reviews on the same topic, then the causes of such discrepancy will be further explored. Discussion This overview of systematic reviews will summarise the current evidence on massage, specifically for infants and children aged < 5 years. We will comprehensively present the positive effects and adverse effects of this intervention. Findings from this overview will be published in a peer-reviewed journal. Systematic review registration CRD42020186003.

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