scholarly journals Recurrence of cervical artery dissection: protocol for a systematic review

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e037124
Author(s):  
Elizabeth Lounsbury ◽  
Brian Dewar ◽  
Alexandra Davis ◽  
Dean A Fergusson ◽  
Dar Dowlatshahi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Vertebral Artery Dissection ◽  
Primary Data ◽  
Artery Dissection ◽  
Cervical Artery Dissection ◽  
Cochrane Central Register ◽  
Minor Trauma ◽  
Central Register ◽  
Cervical Artery ◽  
Registration Number

IntroductionCervical artery dissection, including carotid and vertebral artery dissection, is an important cause of stroke in the young. Risk of developing cervical artery dissection has been associated with physical activity in various forms and has been presumed to be related to minor trauma and mechanical stretching of the cervical arteries. This systematic review will aim to synthesise data on the risk of recurrent cervical artery dissection after an initial dissection. This information may be applied to further understand the natural history of this disease, and potentially to help direct evidence-based discussions on safe return to activity after dissection.Methods and analysisA broad search of multiple electronic databases (Medline, Embase, Cochrane Central Register of Controlled Trials and Web of Science) will be conducted to identify studies published as of 13 November 2019, examining all-comers with cervical artery dissection observed over time. Studies will be screened by two independent reviewers in a two-level process to determine eligibility for inclusion. Data will be pooled from eligible articles and the main outcome of recurrent cervical artery dissection at 5 years will be determined using quantitative analysis.Ethics and disseminationEthics approval is not necessary as no primary data are being collected. The information will be disseminated in the form of a systematic review article which will be submitted to a peer-reviewed medical journal.PROSPERO registration numberCRD42020166105.

scholarly journals Fluid resuscitation in paediatric burns: how do we get it right? A systematic review of the evidence

2018 ◽  
Vol 104 (3) ◽  
pp. 280-285 ◽  
Author(s):  
Christopher Stutchfield ◽  
Anna Davies ◽  
Amber Young
Keyword(s):  
Systematic Review ◽  
Fluid Resuscitation ◽  
Primary Data ◽  
Controlled Trials ◽  
Burn Shock ◽  
Cochrane Central Register ◽  
Study Protocols ◽  
Central Register ◽  
Affect Patient Outcome ◽  
Randomised Controlled

BackgroundOptimal fluid resuscitation in children with major burns is crucial to prevent or minimise burn shock and prevent complications of over-resuscitation.ObjectivesTo identify studies using endpoints to guide fluid resuscitation in children with burns, review the range of reported endpoint targets and assess whether there is evidence that targeted endpoints impact on outcome.DesignSystematic review.MethodsMedline, Embase, Cinahl and the Cochrane Central Register of Controlled Trials databases were searched with no restrictions on study design or date. Search terms combined burns, fluid resuscitation, endpoints, goal-directed therapy and related synonyms. Studies reporting primary data regarding children with burns (<16 years) and targeting fluid resuscitation endpoints were included. Data were extracted using a proforma and the results were narratively reviewed.ResultsFollowing screening of 777 unique references, 7 studies fulfilled the inclusion criteria. Four studies were exclusively paediatric. Six studies used urine output (UO) as the primary endpoint. Of these, one set a minimum UO threshold, while the remainder targeted a range from 0.5–1.0 mL/kg/hour to 2–3 mL/kg/hour. No studies compared different UO targets. Heterogeneous study protocols and outcomes precluded comparison between the UO targets. One study targeted invasive haemodynamic variables, but this did not significantly affect patient outcome.ConclusionsFew studies have researched resuscitation endpoints for children with burns. Those that have done so have investigated heterogeneous endpoints and endpoint targets. There is a need for future randomised controlled trials to identify optimal endpoints with which to target fluid resuscitation in children with burns.

scholarly journals Local anaesthetics combined with vasoconstrictors in patients with cardiovascular disease undergoing dental procedures: systematic review and meta-analysis protocol

BMJ Open ◽  
2017 ◽  
Vol 7 (11) ◽  
pp. e014611 ◽  
Author(s):  
Caio Chaves Guimaraes ◽  
Rogério Heládio Lopes Motta ◽  
Cristiane de Cássia Bergamaschi ◽  
Jimmy de Oliveira Araújo ◽  
Natalia Karol de Andrade ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cardiovascular Disease ◽  
Data Extraction ◽  
Meta Analysis ◽  
Local Anaesthetics ◽  
Cochrane Central Register ◽  
Assessment Development ◽  
Dental Procedures ◽  
Central Register ◽  
Registration Number

IntroductionThe use of vasoconstrictors combined with local anaesthetics (LAs) in dentistry for patients with cardiovascular disease (CVD) is still controversial in the scientific literature. It raises concerns regarding the possibility of transient episodes, triggering negative cardiovascular outcomes.Method/designTrials eligible for our systematic review will enrol patients with CVD who have undergone dental treatments carried out with the use of LAs by comparing two arms: LAs with vasoconstrictors and LAs without vasoconstrictors. The research will be conducted in the electronic databases, namely Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, Healthstar (via Ovid), Cumulative Index to Nursing and Allied Health Literature and Web of Science, from their inception to December 2017, without any restrictions in terms of language and status of publication. A team of reviewers will independently assess titles, abstracts and complete text to determine eligibility. For eligible studies, the same reviewers will perform data extraction and evaluate the risk of bias in the selected articles. The selected outcomes comprise death, mortality by a specific cause, stroke, acute myocardial infarction, hospitalisation, pain, bleeding, arrhythmias, ischaemic episodes, anxiety, adverse effects, changes in blood pressure, changes in heart rate, anxiety and results obtained via oximetry. Whenever possible, we will conduct a meta-analysis to establish the effects of LAs with and without vasoconstrictors in the patients with CVD, and the overall quality of evidence for each outcome will be determined using the Grading of Recommendations Assessment, Development and Evaluation classification system.Ethics and disseminationEthics committee approval was not necessary because this is a protocol of systematic review. This systematic review will be submitted for presentation at conferences and for publication in a peer-reviewed journal. Our review will assess the risks of cardiovascular events when using LAs with and without vasoconstrictors in patients with CVD, focusing on important clinical outcomes.PROSPERO registration numberCRD42016045421.

scholarly journals Weaning and Extubation Assisted with Conversational Hypnosis : A Systematic Review

2021 ◽  
Author(s):  
Johan Wormser ◽  
Christophe Romanet ◽  
Aurel Bellaïche ◽  
François Philippart
Keyword(s):  
Systematic Review ◽  
Oxygen Saturation ◽  
Web Of Science ◽  
Case Series ◽  
Anxiety Reduction ◽  
Cochrane Central Register ◽  
Central Register ◽  
Registration Number ◽  
The One ◽  
Present Systematic Review

Abstract Background : Patients admitted in intensive care units often receive mechanical ventilation. Prior to extubation, weaning process could be a major cause of dyspnea and anxiety in awake intubated patients. Hypnosis is commonly used to manage anxiety and pain. Our hypothesis is that hypnosis would decrease stress during the weaning and extubation process. Methods: This systematic review follows PRISMA Guidelines and was registered in PROSPERO (CRD42020171445). Web of Science, MEDLINE and Cochrane Central Register of Controlled Trials databases were searched until 11 March 2020. We included all interventional trials assessing hypnotherapy for intubated patients whom were undergoing weaning or extubation. Two of the authors independently screened studies, extracted data and assessed risk of bias from identified trials. Results: One study fulfilled our selection. This case series included 2 patients. Eleven sessions were completed. Dyspnea was not assessed/reported. Hypnotherapy decreased anxiety during the weaning process from a median of 1 point (Interquartile Range: 1.0-2.5). Increase in oxygen saturation is also reported. There was no evidence of neither an anxiety reduction or an oxygen saturation improvement. This is due to the scarcity of publication and the methodological design of the one selected study. Conclusions: We cannot conclude whether or not hypnosis could be recommended in the weaning process of intubated patients. Further studies are needed to assess hypnosis effects. Registration: The present systematic review was registered in the International prospective register of systematic reviews (PROSPERO) under registration number CRD42020171445.

scholarly journals Prevalence of Cervical Artery Dissection among Hospitalized Patients with Stroke by Age in a Nationally Representative Sample from the United States

Neurology ◽  
2021 ◽  
pp. 10.1212/WNL.0000000000011420
Author(s):  
Yahya B. Atalay ◽  
Pirouz Piran ◽  
Abhinaba Chatterjee ◽  
Santosh Murthy ◽  
Babak B. Navi ◽  
...  
Keyword(s):  
United States ◽  
Ischemic Stroke ◽  
Representative Sample ◽  
Age Groups ◽  
Vertebral Artery Dissection ◽  
The United States ◽  
Artery Dissection ◽  
Cervical Artery Dissection ◽  
Cervical Artery ◽  
Nationally Representative

Objective:To test the hypothesis that the prevalence of cervical artery dissection remains constant across age groups, we evaluated the relationship between age and cervical artery dissection in patients with stroke using a Nationally Representative Sample from the United States.Methods:We used inpatient claims data included in the 2012-2015 releases of the National Inpatient Sample (NIS). We used validated ICD-9-CM codes to identify adults hospitalized with ischemic stroke and a concomitant diagnosis of carotid- or vertebral-artery dissection. Survey weights provided by the NIS and population estimates from the U.S. census were used to calculate nationally representative estimates. The chi-square test for trend was used to compare the prevalence of concomitant dissection among stroke hospitalizations across patient subgroups defined by age. Poisson regression and the Wald test for trend were used to evaluate whether the prevalence of hospitalizations for stroke and concomitant dissection per million person-years varied by age groups.Results:There were 17,320 (95% confidence interval [CI], 15,614-19,026) hospitalizations involving ischemic stroke and a concomitant dissection. The prevalence of dissection among stroke hospitalizations decreased across 10-year age groups from 7.2% (95% CI, 6.2%-8.1%) among persons younger than age 30 years to 0.2% (95% CI, 0.1%-0.2%) among persons older than age 80 years (P value for trend <0.001). However, the prevalence of hospitalizations for stroke and concomitant dissection increased from 5.4 (95% CI, 4.6-6.2) hospitalizations per million person-years among adults younger than age 30 to 24.4 (95% CI, 21.0-27.9) hospitalizations per million person-years among adults older than age 80 (P value for trend <0.01).Conclusions:In a nationally representative sample, the prevalence of hospitalizations for dissection-related stroke increased with age.

scholarly journals Right versus left thoracic approach oesophagectomy for oesophageal cancer: a systematic review and meta-analysis protocol

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e030157
Author(s):  
Tianci Chai ◽  
Zhimin Shen ◽  
Sui Chen ◽  
Yuhan Lin ◽  
Zhenyang Zhang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Oesophageal Cancer ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Malignant Tumours ◽  
Central Register ◽  
Registration Number ◽  
Thoracic Approach ◽  
Randomised Controlled

IntroductionOesophageal cancer is one of the most common malignant tumours and has been identified as one of the leading causes of cancer death worldwide. Surgery is considered to be the optimal treatment for patients with resectable oesophageal cancer. Oesophagectomy for oesophageal cancer can significantly extend the survival period of patients and provide a potential opportunity for a cure. However, there is still controversy regarding which thoracic approach (right or left) during oesophagectomy for oesophageal cancer can lead to better surgical outcomes globally. This systematic review and meta-analysis will be performed to determine which thoracic approach during oesophagectomy will achieve longer patient survival and will be more beneficial for patients.Methods and analysisWe will search PubMed, Web of Science, Embase, Cancerlit, the Cochrane Central Register of Controlled Trials and Google Scholar databases for relevant clinical trials published in any language before 1 October 2019. Randomised controlled trials (RCTs), quasi-RCTs, propensity score-matched comparative studies and prospective cohort studies of interest, published or unpublished, that meet the inclusion criteria will be included. Subgroup analysis of the type of operation, tumour pathological stage and ethnicity will be performed.PROSPERO registration numberCRD42019124133.Ethics and disseminationBecause this study will be based on published or unpublished records and studies, there is no need for ethics approval. The results of the study will be published in a peer-reviewed journal.

Angiographic frequency of saccular intracranial aneurysms in patients with spontaneous cervical artery dissection

1992 ◽  
Vol 76 (1) ◽  
pp. 62-66 ◽  
Author(s):  
Wouter I. Schievink ◽  
Bahram Mokri ◽  
David G. Piepgras
Keyword(s):  
General Population ◽  
Intracranial Aneurysms ◽  
Vertebral Artery Dissection ◽  
Artery Dissection ◽  
Cervical Artery Dissection ◽  
Angiographic Study ◽  
Content Type ◽  
Cervical Artery ◽  
Male Patients ◽  
Fine Print

✓ The pathogenesis of intracranial aneurysms and spontaneous cervical artery dissection is incompletely understood but a primary arteriopathy, possibly similar in both disorders, may be of importance. To investigate the frequency of intracranial aneurysms in patients with spontaneous cervical artery dissection, the angiograms of 164 patients who were diagnosed at the Mayo Clinic as having spontaneous extracranial carotid or vertebral artery dissection were reviewed. Thirteen intracranial aneurysms were detected in nine (5.5%) of the 164 patients: eight (8.8%) of the 91 female patients and one (1.4%) of the 73 male patients. The frequency of intracranial aneurysms in these patients was significantly higher (p < 0.01) than that observed in a recent angiographic study from the same institution, estimating the frequency of intracranial aneurysms in the general population (1.1%). The significance of these findings is discussed.

Acute headache and persistent headache attributed to cervical artery dissection: Field testing of ICHD-III beta

Cephalalgia ◽  
2014 ◽  
Vol 34 (9) ◽  
pp. 712-716 ◽  
Author(s):  
Henrik W Schytz ◽  
Messoud Ashina ◽  
Melinda Magyari ◽  
Vibeke A Larsen ◽  
Jes Olesen ◽  
...  
Keyword(s):  
Vertebral Artery Dissection ◽  
Field Testing ◽  
Arterial Dissection ◽  
Artery Dissection ◽  
Cervical Artery Dissection ◽  
Cervical Artery ◽  
Acute Headache ◽  
Persistent Headache ◽  
First Time

The criteria for headache attributed to cervical artery dissection have been changed in the new third edition of the International Classification of Headache Disorders (ICHD-III beta). We have retrospectively investigated 19 patients diagnosed from 2001 to 2006 with cervical artery dissection at onset and followed them up six months after dissection. At dissection onset 17/19 patients were classified as headache probably attributed to vascular disorder at the time of dissection using the ICHD second edition (ICHD-II) criteria. In contrast, 17/19 of patients fulfilled the ICHD-III beta criteria for Headache or facial or neck pain attributed to cervical carotid or vertebral artery dissection or Headache attributed to intracranial arterial dissection. Six months after dissection five of 19 patients still reported persistent headache attributed to dissection. The study demonstrates that the ICHD-III beta criteria for cervical artery dissection are useful for classifying patients at the first encounter. We show for the first time that persistent headache attributed to arterial dissection is frequent.

scholarly journals Migraine, migraine aura, and cervical artery dissection: A systematic review and meta-analysis

Cephalalgia ◽  
2011 ◽  
Vol 31 (8) ◽  
pp. 886-896 ◽  
Author(s):  
Pamela M Rist ◽  
Hans-Christoph Diener ◽  
Tobias Kurth ◽  
Markus Schürks
Keyword(s):  
Systematic Review ◽  
Migraine With Aura ◽  
Meta Analysis ◽  
Current Evidence ◽  
Artery Dissection ◽  
Effect Estimate ◽  
Cervical Artery Dissection ◽  
Migraine Aura ◽  
Increased Risk ◽  
Cervical Artery

Objective: We evaluated the current evidence on the association between migraine, including aura status, and cervical artery dissection. Methods: We performed a systematic review and meta-analysis of studies investigating the association between migraine or migraine subtypes (e.g. migraine with aura) and cervical artery dissection published through October 2010. Results: We identified five case-control studies investigating the association between migraine and cervical artery dissection. In pooled analysis, migraine doubled the risk of cervical artery dissection (pooled odds ratio [OR] = 2.06, 95% confidence interval [CI] 1.33–3.19). All studies allowed evaluation of migraine aura status. While the effect estimate for migraine without aura (pooled OR = 1.94, 95% CI 1.21–3.10) was similar to overall migraine, the association was weaker for migraine with aura (pooled OR = 1.50, 95% CI 0.76–2.96). However, there is no evidence that aura status significantly modifies the association between migraine and cervical artery dissection (meta-regression on aura status p = .58). The risk does not appear to differ between women and men; however, only few studies presented gender-specific data. Heterogeneity among studies was low to moderate. Conclusion: In this meta-analysis migraine is associated with a two-fold increased risk of cervical artery dissection. This risk does not appear to significantly differ by migraine aura status or gender.

scholarly journals Risk factors for community-acquired Escherichia coli bacteraemia: a systematic review protocol

2018 ◽  
Vol 3 ◽  
pp. 117
Author(s):  
Anna Aryee ◽  
Suvi Härmälä ◽  
Laura Shallcross ◽  
Andrew Hayward
Keyword(s):  
Risk Factors ◽  
Escherichia Coli ◽  
Primary Data ◽  
Antibiotic Prescribing ◽  
Cochrane Central Register ◽  
Central Register ◽  
Ethical Approval ◽  
Registration Number ◽  
Review Protocol ◽  
Meta Analyses

Introduction: Rates of community-acquired Escherichia coli bacteraemia (ECB) have been consistently rising. As rates of antimicrobial resistance (AMR), particularly in Gram-negative bacteria, are also increasing, this is of concern both for management of individual patients and healthcare systems. There is currently little data on the risk factors for development of community-acquired ECB: this review aims to identify these risk factors in order to inform community interventions to reduce ECB as well as antibiotic prescribing policy. Methods and analysis: We will search Medline (Ovid), Embase (Ovid), Web of Science/Scopus and the Cochrane Central Register of Controlled Trials for published reports on observational and experimental primary research studies involving patients admitted to hospital with community-acquired ECB. Two reviewers will independently screen the studies for eligibility, perform data collection and assess study quality and risk of bias. Random effects meta-analyses will be performed if appropriate. Ethics and dissemination: No primary data will be collected for this study and so formal ethical approval is not required. We will publish the results of our review in relevant peer-reviewed medical journals, and will also seek to present them at relevant medical conferences. PROSPERO registration number: CRD42018104402

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