Immunonutrition for traumatic brain injury in children and adolescents: protocol for a systematic review and meta-analysis

IntroductionTraumatic brain injury (TBI) is the leading cause of paediatric trauma death and disability worldwide. The ‘Guidelines for the Management of Severe Traumatic Brain Injury (Fourth Edition)’ recommend that nutritional goals should be achieved within 5–7 days of injury. Immune-enhancing nutrition or immunonutrition, referring to the addition of specialised nutrients, including glutamine, alanine, omega-3 fatty acids and nucleotides, to standard nutrition formulas, may improve surgical outcomes in the perioperative period. However, the role of immune-enhancing nutritional supplements for patients with paediatric TBI remains unclear. We will conduct a systematic review to determine the efficacy and safety of immunonutrition for patients with paediatric TBI and provide evidence for clinical decision-making.Methods and analysisStudies reporting immune-enhancing nutrition treatments for patients with paediatric TBI will be included. Outcomes of interest include the length of hospital stay, wound infections, all-cause mortality, non-wound infection, including pneumonia, urinary tract infection and bacteraemia, and the reports adverse events. Duration of follow-up has no restriction. Primary studies consisting of randomised controlled trials (RCTs) and non-RCTs will be eligible for this review, and only studies published in English will be included. We will search the Medline, Embase and Cochrane Library databases from their inception dates to January 2020. We will also search clinicaltrials.gov and the WHO International Clinical Trials Registry Platform for additional information. Two reviewers will independently select studies and extract data. Risk-of-bias will be assessed with tools based on the Cochrane risk-of-bias criteria and Newcastle-Ottawa Quality Assessment Scale. A meta-analysis will be used to pool data when there are sufﬁcient studies with homogeneity. Heterogeneity of the estimates across studies will be assessed; if necessary, a subgroup analysis will be performed to explore the source of heterogeneity. The Grades of Recommendation, Assessment, Development and Evaluation method will be applied to assess the level of evidence obtained from this systematic review.Ethics and disseminationThe proposed systematic review and meta-analysis will be based on published data, and thus ethical approval is not required. The results of this review will be published.PROSPERO registration numberCRD42020154814.

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Risk of venous thromboembolism in patients undergoing gastric cancer surgery: protocol for a systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2019-033267 ◽

2020 ◽

Vol 10 (1) ◽

pp. e033267

Author(s):

Dengfeng Wang ◽

Yang Yu ◽

Pengxian Tao ◽

Dan Wang ◽

Yajing Chen ◽

...

Keyword(s):

Gastric Cancer ◽

Systematic Review ◽

Venous Thromboembolism ◽

Evaluation Method ◽

Clinical Decision Making ◽

Meta Analysis ◽

Cancer Surgery ◽

Published Data ◽

Gastric Cancer Surgery ◽

Positive Prevention

IntroductionVenous thromboembolism (VTE) is a serious life-threatening complication in patients with gastric cancer. Abnormal coagulation function and tumour-related treatment may contribute to the occurrence of VTE. Many guidelines considered that surgical treatment would put patients with cancer at high risk of VTE, so positive prevention is needed. However, there are no studies that have systematically reviewed the postoperative risk and distribution of VTE in patients with gastric cancer. We thus conduct this systematic review to determine the risk of VTE in patients with gastric cancer undergoing surgery and provide some evidence for clinical decision-making.Methods and analysisStudies reporting the incidence of VTE after gastric cancer surgery will be included. Primary studies of randomised controlled trials, cohort studies, population-based surveys and cross-sectional studies are eligible for this review and only studies published in Chinese and English will be included. We will search the Medline, Embase, Web of Science, CBM, CNKI and Wanfang data from their inception to November 2019. Two reviewers will independently select studies and extract data. The quality of each included study will be assessed with tools corresponding to their study design. Meta-analysis will be used to pool the incidence data from included studies. Heterogeneity of the estimates across studies will be assessed, if necessary, a subgroup analysis will be performed to explore the source of heterogeneity. The Grades of Recommendation, Assessment, Development and Evaluation method is applied to assess the level of evidence obtained from this systematic review.Ethics and disseminationThis proposed systematic review and meta-analysis is based on published data, and thus ethical approval is not required. The results of this review will be sought for publication.PROSPERO registration numberCRD42019144562

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Mannitol cannot reduce the mortality on acute severe traumatic brain injury (TBI) patients: a meta–analyses and systematic review

Burns & Trauma ◽

10.1186/s41038-015-0006-8 ◽

2015 ◽

Vol 3 ◽

pp. 1-8 ◽

Cited By ~ 3

Author(s):

Kai Wang ◽

Mingwei Sun ◽

Hua Jiang ◽

Xiao-ping Cao ◽

Jun Zeng

Keyword(s):

Systematic Review ◽

Traumatic Brain Injury ◽

Brain Injury ◽

Severe Traumatic Brain Injury ◽

Brain Injuries ◽

Meta Analysis ◽

Outcome Data ◽

Control Treatment ◽

Current Evidence ◽

Cochrane Library

Abstract Background We aimed to systematically review the efficacy of mannitol (MTL) on patients with acute severe traumatic brain injury (TBI). Methods Databases such as PubMed (US National Library of Medicine), CENTRAL (The Cochrane Library 2014, Issue 3), ISI (Web of Science: Science Citation Index Expanded), Chinese Biomedicine Database (CBM), and China Knowledge Resource Integrated Database (CNKI) have been searched for relevant studies published between 1 January 2003 and 1 October 2014. We have established inclusion and exclusion criteria to identify RCTs, which were suitable to be enrolled in the systematic review. The comparison group could be hypertonic saline (HS), hydroxyethyl starch, or others. The quality assessment was based on the Cochrane Handbook for Systematic Reviews of Interventions Version 5.0.1 and modified Jadad score scale. The major outcome was mortality, followed by the secondary outcomes such as neurological outcome, days on intensive care unit (ICU), and ventilator day. In addition, intracranial pressure (ICP), cerebral perfusion pressure (CPP), and mean arterial pressure (MAP) were used as the surrogate endpoints. Data synthesis and meta-analysis was conducted by using R (version 3.7-0.). Results When 176 potential relevant literatures and abstracts have been screened, four RCTs met all the inclusion criteria and were enrolled for the meta-analysis. Amongst all the enrolled studies, two trials have provided the primary outcome data. There was no heterogeneity between two studies (I2 = 0 %) and a fixed model was used for meta-analysis (n = 53), pooled result indicated that the mortality was similar in mannitol intervention and control treatment, OR = 0.80, 95 % CI [0.27, 2.37], P = 0.38. We found that both mannitol and HS were efficient in decreasing the ICP. Furthermore, the effect of the HS on the ICP appeared to be more effective in the patients with diffuse brain injuries than mannitol did. Conclusions As a conclusion, the mannitol therapy cannot reduce the mortality risk of acute severe traumatic brain injury. Current evidence does not support the mannitol as an effective treatment of acute severe traumatic brain injury. The well-designed randomized controlled trials are in urgent need to demonstrate the adoption of mannitol to acute severe traumatic brain injury.

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LO93: Prognostic value of S-100B protein for prediction of post-concussion symptoms following a mild traumatic brain injury: systematic review and meta-analysis

CJEM ◽

10.1017/cem.2017.155 ◽

2017 ◽

Vol 19 (S1) ◽

pp. S60

Author(s):

E. Mercier ◽

P. Tardif ◽

P. Cameron ◽

B. Batomen Kuimi ◽

M. Émond ◽

...

Keyword(s):

Systematic Review ◽

Traumatic Brain Injury ◽

Brain Injury ◽

Serum Level ◽

Mild Traumatic Brain Injury ◽

Prognostic Value ◽

Search Strategy ◽

Meta Analysis ◽

Risk Of Bias ◽

Protein Serum

Introduction: Mild traumatic brain injury (mTBI) is a major cause of morbidity but there are no validated tools to help clinicians predict post-concussion symptoms. This systematic review and meta-analysis aimed to determine the prognostic value of S-100B protein to predict post-concussion symptoms following a mTBI in adults. Methods: The protocol of this systematic review was registered with the PROSPERO database (CRD42016032578). A search strategy was performed on seven databases (CINAHL, Cochrane CENTRAL, EMBASE, MEDLINE, Web of Knowledge, PyscBITE, PsycINFO) from their inception to October 2016. Studies evaluating the association between S-100B protein level and post-concussion symptoms assessed at least seven days after the mTBI were eligible. Individual patient data were requested. Studies eligibility assessment, data extraction and risk of bias assessment were performed independently by two researchers. Analyses were done following the meta-analysis using individual participant data or summary aggregate data guidelines from the Cochrane Methodology Review Group. Results: Outcomes were dichotomised as persistent (≥3 months) or early (≥7 days <3 months). Our search strategy yielded 23,298 citations of which 29 studies presenting between seven and 223 patients (n=2505) were included. Post-concussion syndrome (PCS) (16 studies), neuropsychological symptoms (9 studies) and health-related quality of life (4 studies) were the most frequently presented outcomes. The S-100B protein serum level of patients with no PCS was similar to that of patients experiencing persistent PCS (mean difference 0.00 [-0.05, 0.04]) or early PCS (mean difference 0.03 [-0.02, 0.08]). The odds of having persistent PCS (OR 0.56 (95% CI: 0.29-1.10) or early PCS (OR 1.67 (95% CI: 0.98-2.85) in patients with an elevated S-100B protein serum level was not significantly different from that of patients with normal values. No meta-analysis was performed for other outcomes than PCS due to heterogeneity and small samples. Studies’ overall risk of bias was considered moderate. Conclusion: Results suggest that the prognostic value of S-100B protein serum level to predict persistent and early post-concussion symptoms is limited. Variability in injury to S-100B protein sample time and outcomes assessed could potentially explain the lack of association and needs further evaluation.

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Effect of music intervention on mental health in patients with diabetes mellitus: protocol for a systematic review and meta-analysis of randomizsed controlled trials

BMJ Open ◽

10.1136/bmjopen-2019-036268 ◽

2020 ◽

Vol 10 (8) ◽

pp. e036268

Author(s):

Lin-yue Zhou ◽

Yuan Zhang ◽

Yuan Tian ◽

Xiaoxu Fu ◽

Li-zhen Wang ◽

...

Keyword(s):

Systematic Review ◽

Mental Disorders ◽

Meta Analysis ◽

Risk Of Bias ◽

Cochrane Library ◽

Secondary Outcome ◽

Published Data ◽

Controlled Trials ◽

Music Intervention ◽

Patients With Diabetes

IntroductionAbout 463 million adults aged 20–79 have diabetes globally. Mental disorders often exist in patients with diabetes as comorbidities, which can lead to aggravation of the diseases, increased difficulties in treatment, as well as elevated mortality rates. Music intervention has been applied in the treatment of comorbidities for 12 years now, but there are still no recommendations due to the lack of evidence. Thus, a meta-analysis is necessary to evaluate the effect of music intervention in treating mental disorders of patients with diabetes.Methods and analysisWe will search the following nine online electronic databases from their inception until March 2020: PubMed, Web of Science, Embase, EBSCO, Cochrane Library, Chinese National Knowledge Infrastructure, Wanfang Database, Chinese Scientific Journal Database (VIP) and Chinese Biomedical and Medical Database. We also plan to search other relevant resources, including grey literature and the reference lists of relevant publications. Only randomised controlled trials of music intervention to treat depression or anxiety in patients with diabetes will be involved. The primary outcomes include the depression score and anxiety score measured on certain scales, and the secondary outcome is safety. Data extraction will be independently implemented by two researchers. The risk of bias will be evaluated through the Cochrane Collaboration’s Risk of Bias tool. Eventually, all the data will be analysed via the Review Manager V.5.3 software.Ethics and disseminationThis meta-analysis will provide information about applying music intervention to treat depression or anxiety in patients with diabetes. No ethical approval is required because this meta-analysis is based on published data. The results of this systematic review will be published in a peer-reviewed journal.PROSPERO registration numberCRD42019146439

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Effect of acupuncture treatment on cognitive impairment after traumatic brain injury in adults: A systematic review protocol

10.37766/inplasy2021.11.0113 ◽

2021 ◽

Author(s):

Na LI ◽

◽

Xia AI ◽

Xinrong Guo ◽

Juan Liu ◽

...

Keyword(s):

Systematic Review ◽

Traumatic Brain Injury ◽

Cognitive Impairment ◽

Brain Injury ◽

Meta Analysis ◽

Scientific Journal ◽

Relevant Literature ◽

Biomedical Literature ◽

Cochrane Library ◽

China National Knowledge Infrastructure

Review question / Objective: Are acupuncture more effective than control interventions (i.e. treatment as sham acupuncture or placebo) in the treatment of motor and cognitive impairment after traumatic brain injury in adults? Information sources: search database:The following electronic databases will be searched for relevant literature: the Cochrane Library, MEDLINE, EMBASE, Web of Science, Springer, the Chinese Science Citation Database (CSCD), China National Knowledge Infrastructure (CNKI), the Chinese Biomedical Literature Database (CBM),Wanfang, and. the Chinese Scientific Journal Database (VIP). Time limit: the searches will be conducted from the inception of each database to November 30, 2021. Protocol of Systematic review and Meta analysis of acupuncture in the treatment of cognitive impairment after traumatic brain injury and the included literatures were all RCTS with English and Chinese on language.

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Hangeshashinto for preventing oral mucositis in patients receiving cancer treatment: protocol for a systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2020-047627 ◽

2021 ◽

Vol 11 (5) ◽

pp. e047627

Author(s):

Yu-Ting Wang ◽

Yifeng Ren ◽

Chong Xiao ◽

Hong Liu ◽

Xi Fu ◽

...

Keyword(s):

Systematic Review ◽

Cancer Treatment ◽

Oral Mucositis ◽

Clinical Decision Making ◽

Grey Literature ◽

Treatment Protocol ◽

Risk Of Bias ◽

Cochrane Library ◽

Published Data ◽

Statistical Heterogeneity

IntroductionHangeshashinto has been employed for oral mucositis prevention in patients receiving cancer treatment, but the evidence has not been sufficiently robust to guide clinical decision-making. This study will therefore be undertaken to assess the effectiveness of Hangeshashinto for preventing oral mucositis in patients with cancer who are receiving treatment.Methods and analysisThe databases will include PubMed, Embase, the Cochrane Library, Chinese databases and Japanese databases. The literature will be searched from the databases’ inception until May 2021. Other sources, such as potential grey literature, reference lists from included studies and relevant systematic reviews and conference papers, will also be searched. The primary outcome is the incidence of mucositis of any severity, and the secondary outcomes are interruptions to cancer treatment, oral pain and nutritional status. The risk of bias of eligible studies will be assessed using the Cochrane Collaboration’s ‘risk of bias’ tool. Both the Q test and I2 statistic will be performed to assess statistical heterogeneity. If I2 >50%, sensitivity and subgroup analysis will be conducted. The quality of evidence will be rated according to the Grading of Recommendations, Assessment, Development and Evaluation approach. Egger’s test will be used to assess reporting bias.Ethics and disseminationThis systematic review will evaluate only published data; therefore, ethical approval is not required.PROSPERO registration numberCRD42020216145.

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Integrated management of type 2 diabetes and gestational diabetes within multi-morbidity conditions in Africa: a systematic review protocol

BMJ Open ◽

10.1136/bmjopen-2018-023684 ◽

2019 ◽

Vol 9 (3) ◽

pp. e023684

Author(s):

Jean Claude Mutabazi ◽

Mahmoud M Werfalli ◽

Angeli Rawat ◽

Ezekiel Musa ◽

Shane A Norris ◽

...

Keyword(s):

Systematic Review ◽

Type 2 Diabetes ◽

Gestational Diabetes ◽

Integrated Management ◽

Meta Analysis ◽

Cochrane Collaboration ◽

Risk Of Bias ◽

Cochrane Library ◽

Published Data

IntroductionMulti-morbidity, defined as the co-existence of more than one chronic condition in one person, has been increasing due to comorbid non-communicable and infectious chronic diseases (CNCICDs). Type 2 diabetes (T2D) and gestational diabetes mellitus (GDM) incidences within the CNCICDs conditions are increasing and overwhelming already weak and under-resourced healthcare systems in Africa. There is then an urgent need for the integrated management of CNCICDs. We aim to review the integrated management of T2D and GDM within multi-morbidity conditions in Africa.MethodsStudies that have assessed the integrated management of T2D and GDM within multi-morbidity conditions in Africa will be considered based on the Population, Intervention, Comparator and Outcome method: population (adult diagnosed with T2D and GDM, who also have other diseases, non-communicable diseases (NCDs) and infectious, in public primary and secondary healthcare facilities in Africa); Intervention (integrated management of T2D and GDM, also suffering from other diseases in Africa), Comparator (Unintegrated management of T2D and GDM in Africa) and Outcomes (integrated management of T2D and GDM in Africa). The following databases Cochrane Library, MEDLINE, PubMed and SCOPUS, the WHO International Clinical Trials Registry Platform, among others will be searched. Two reviewers (JCM and MW) will independently screen, select eligible studies and extract data. Discrepancies will be resolved by consensus or by a discussion with the third author (AR). Quality of included studies will be assessed using both the newly developed tool, ‘the Cochrane Collaboration Risk of Bias Tool’ and ‘Risk Of Bias In Non-randomised Studies - of Interventions (ROBINS-I)”. A narrative synthesis of extracted data and meta-analysis, if necessary will be conducted and then reported according to the preferred reporting items for systematic review and meta-analysis.Ethics consideration and disseminationBy only using the published data, there is no ethics approval required for this study. This systematic review will be included in JCM’s PhD thesis and its findings will also be disseminated through peer-reviewed publication and conference presentation.PROSPERO registration numberCRD42016046630.

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Non-pharmacological interventions for treating sexual dysfunction in postpartum women: a systematic review protocol

BMJ Open ◽

10.1136/bmjopen-2018-028660 ◽

2019 ◽

Vol 9 (9) ◽

pp. e028660

Author(s):

Michelly Nóbrega Monteiro ◽

Kleyton Santos Medeiros ◽

Iaponira Vidal ◽

Ivete Matias ◽

Ricardo Ney Cobucci ◽

...

Keyword(s):

Systematic Review ◽

Sexual Dysfunction ◽

Meta Analysis ◽

Risk Of Bias ◽

Sexual Problems ◽

Cochrane Library ◽

Published Data ◽

Postpartum Women ◽

Cochrane Central Register ◽

Pharmacological Interventions

IntroductionSexual dysfunction in the postpartum period is a very common and relevant clinical problem, which has a significant adverse impact on the health of women. We aim to analyse the efficacy and safety of non-pharmacological interventions for treating sexual dysfunction in postpartum women. Our review aims to provide accurate data for effective policy-making and improve our understanding of the treatment of postpartum sexual dysfunction with non-pharmacological therapies.Methods and analysisThe Cochrane Central Register of Controlled Trials in The Cochrane Library, clinicaltrials.gov, Medline/PubMed, CINAHL (Cumulative Index to Nursing and Allied Health Literature), LILACS (Literatura Latino-americana e do Caribe em Ciências da Saúde) and Embase will be used to search for articles dated from database inception to July 2019. Randomised controlled clinical trials and large prospective cohorts with control groups using non-pharmacological treatments for sexual dysfunction in postpartum women will be included. Sexual problems are directly linked to sexual dysfunction; thus, the primary outcome will be the absolute number or percentage of sexual issues in each treatment group. The secondary outcomes will be assessed by decreased sexual problems, such as lack of lubrication, decreased libido and difficulty reaching orgasm. Three reviewers will independently select trials and extract data from the original publications. The citations will be screened independently by reviewers in duplicate. The risk of bias of the included studies will be assessed according to the Cochrane risk of bias tool. Data synthesis will be performed using Review Manager (RevMan) software V.5.2.3. In the event that a meta-analysis is possible, we will assess the heterogeneity across the studies by computing the I2statistic.Ethics and disseminationAs the design of this study includes a review of published data, the need to obtain ethical approval was waived by our institutional review committee. We intend to publish the findings of this systematic review in a peer-reviewed journal.PROSPERO registration numberCRD42018103077.

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Effectiveness of non-pharmacological interventions for reducing postpartum fatigue: a systematic review protocol

BMJ Open ◽

10.1136/bmjopen-2021-051136 ◽

2021 ◽

Vol 11 (10) ◽

pp. e051136

Author(s):

Jialu Qian ◽

Shiwen Sun ◽

Lu Liu ◽

Xiaoyan Yu

Keyword(s):

Systematic Review ◽

Randomised Controlled Trials ◽

Meta Analysis ◽

Risk Of Bias ◽

Cochrane Library ◽

Published Data ◽

Controlled Trials ◽

Pharmacological Interventions ◽

Randomised Controlled ◽

Postpartum Fatigue

IntroductionPostpartum fatigue is a common symptom among new mothers after their pregnancy. It has a considerable negative impact on women’s functional and mental status as well as the development of babies. Identifying effective interventions to prevent or reduce postpartum fatigue is meaningful to improve the quality of life and avoid adverse outcomes of this vulnerable population. This systematic review aims to synthesise non-pharmacological evidence and evaluate the effectiveness of interventions for reducing postpartum fatigue among puerperas.Methods and analysisThis review will be conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols. We will systematically search the Cochrane Library, PubMed, Embase, Web of Science, PsycINFO, CINAHL and ProQuest databases to identify clinical trials implementing non-pharmacological interventions conducted during 0–78 weeks postpartum for fatigue reduction. An additional search of OpenGrey will be conducted to identify grey literature. The search will be performed on 30 March 2021 without restrictions on time and language. Two independent reviewers will be responsible for study selection, data extraction and study quality assessment. The Cochrane risk-of-bias tool will be adopted to evaluate the risk biases of the included randomised controlled trials, and the Risk of Bias in Non-randomised Studies of Interventions will be applied to evaluate non-randomised controlled trials. Any disagreements will be referred to a third reviewer to reach a consensus. Findings will be qualitatively synthesised, and a meta-analysis will be conducted for the statistical combination if outcome data are sufficient and available.Ethics and disseminationThis systematic review will not involve the collection of primary data and will be based on published data. Therefore, ethics approval is not required. The final findings will be disseminated through peer-reviewed journals and academic conferences.PROSPERO registration numberCRD42021234869

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Effectiveness and feasibility of telerehabilitation in patients with COVID-19: a protocol for a systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2021-058932 ◽

2022 ◽

Vol 12 (1) ◽

pp. e058932

Author(s):

Abubeker Alebachew Seid ◽

Setognal Birara Aychiluhm ◽

Ahmed Adem Mohammed

Keyword(s):

Quality Of Life ◽

Systematic Review ◽

Meta Analysis ◽

Risk Of Bias ◽

Mean Difference ◽

Cochrane Library ◽

P Value ◽

Published Data ◽

Respiratory Rehabilitation

IntroductionRespiratory rehabilitation is the use of exercise, education, and behavioural interventions to alleviate symptoms and improve quality of life. Recent studies highlight that respiratory rehabilitation is effective and safe for patients with COVID-19. We aim to evaluate the effectiveness and feasibility of respiratory telerehabilitation on patients infected with COVID-19 by conducting a systematic review and meta-analysis.Methods and analysisPubMed, Web of Science, Science Direct, Physiotherapy Evidence Database, Google Scholar and Cochrane Library databases will be searched from inception to the end of November 2021. Randomised controlled trials investigating the effectiveness of telerehabilitation in the management of COVID-19 will be included. The primary outcomes will be functional capacity, cardiopulmonary exercise tests and quality of life. Secondary outcomes will include anxiety/depression level, sleep quality, mortality rate, completion rate, reason for withdrawal, adverse events, service satisfaction, cost-effectiveness and other potential factors. Two reviewers will independently screen and extract data and perform quality assessment of included studies. The Cochrane risk of bias tool will be used to assess risk of bias. Review Manager V.5.4 (Cochrane Collaboration) software will be used for statistical analysis. Heterogeneity will be analysed using I² statistics. Mean difference or standardised mean difference with 95% CI and p value will be used to calculate treatment effect for outcome variables.Ethics and disseminationEthical approval is not required because this systematic review and meta-analysis is based on previously published data. Final result will be published in peer-reviewed journal and presented at relevant conferences and events.PROSPERO registration numberCRD42021287975.

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