Comparison of the use of lung ultrasound and chest radiography in the diagnosis of rib fractures: a systematic review

2018 ◽  
Vol 36 (3) ◽  
pp. 185-190 ◽  
Author(s):  
Ceri Battle ◽  
Simon Hayward ◽  
Sabine Eggert ◽  
Phillip Adrian Evans
Keyword(s):  
Systematic Review ◽  
Quality Assessment ◽  
Chest Wall ◽  
Chest Radiograph ◽  
Chest Radiography ◽  
Lung Ultrasound ◽  
Grey Literature ◽  
Rib Fractures ◽  
Chest Wall Trauma ◽  
Study Results

IntroductionIt is well-recognised that the detection of rib fractures is unreliable using chest radiograph. The aim of this systematic review was to investigate whether the use of lung ultrasound is superior in accuracy to chest radiography, in the diagnosis of rib fractures following blunt chest wall trauma.MethodsThe search filter was used for international online electronic databases including MEDLINE, EMBASE, Cochrane and ScienceDirect, with no imposed time or language limitations. Grey literature was searched. Two review authors completed study selection, data extraction and data synthesis/analysis process. Quality assessment using the Quality Assessment of Diagnostic Accuracy Studies Tool (QUADAS-2) was completed.Results13 studies were included. Overall, study results demonstrated that the use of lung ultrasound in the diagnosis of rib fractures in blunt chest wall trauma patients appears superior compared with chest radiograph. All studies were small, single centre and considered to be at risk of bias on quality assessment. Meta-analysis was not possible due to high levels of heterogeneity, lack of appropriate reference standard and poor study quality.DiscussionThe results demonstrate that lung ultrasound may be superior to chest radiography, but the low quality of the studies means that no definitive statement can be made.

scholarly journals Efficacy of intercostal cryoneurolysis as an analgesic adjunct for chest wall pain after surgery or trauma: systematic review

2021 ◽  
Vol 6 (1) ◽  
pp. e000690
Author(s):  
Peter I Cha ◽  
Jung Gi Min ◽  
Advait Patil ◽  
Jeff Choi ◽  
Nishita N Kothary ◽  
...  
Keyword(s):  
Systematic Review ◽  
Chest Wall ◽  
Rib Fractures ◽  
Hospital Length Of Stay ◽  
Cochrane Library ◽  
Trauma Patients ◽  
Qualitative Synthesis ◽  
Thoracic Pain ◽  
Level Of Evidence ◽  
Chest Wall Trauma

BackgroundThere is a critical need for non-narcotic analgesic adjuncts in the treatment of thoracic pain. We evaluated the efficacy of intercostal cryoneurolysis as an analgesic adjunct for chest wall pain, specifically addressing the applicability of intercostal cryoneurolysis for pain control after chest wall trauma.MethodsA systematic review was performed through searches of PubMed, EMBASE, and the Cochrane Library. We included studies involving patients of all ages that evaluated the efficacy of intercostal cryoneurolysis as a pain adjunct for chest wall pathology. Quantitative and qualitative synthesis was performed.ResultsTwenty-three studies including 570 patients undergoing cryoneurolysis met eligibility criteria for quantitative analysis. Five subgroups of patients treated with intercostal cryoneurolysis were identified: pectus excavatum (nine studies); thoracotomy (eight studies); post-thoracotomy pain syndrome (three studies); malignant chest wall pain (two studies); and traumatic rib fractures (one study). There is overall low-quality evidence supporting intercostal cryoneurolysis as an analgesic adjunct for chest wall pain. A majority of studies demonstrated decreased inpatient narcotic use with intercostal cryoneurolysis compared with conventional pain modalities. Intercostal cryoneurolysis may also lead to decreased hospital length of stay. The procedure did not definitively increase operative time, and risk of complications was low.ConclusionsGiven the favorable risk-to-benefit profile, both percutaneous and thoracoscopic intercostal cryoneurolysis may serve as a worthwhile analgesic adjunct in trauma patients with rib fractures who have failed conventional medical management. However, further prospective studies are needed to improve quality of evidence.Level of evidenceLevel IV systematic reviews and meta-analyses.

scholarly journals P054: Interventions aimed at improvement in emergency department related transitions in care for adult patients with atrial fibrillation and flutter: a systematic review

CJEM ◽  
2018 ◽  
Vol 20 (S1) ◽  
pp. S76-S76
Author(s):  
J. Gilbertson ◽  
R. Moghrabi ◽  
S.W. Kirkland ◽  
K. Tate ◽  
W. Sevcik ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Systematic Review ◽  
Cohort Study ◽  
Quality Assessment ◽  
Clinical Pathways ◽  
Grey Literature ◽  
Electrical Cardioversion ◽  
Adult Patients ◽  
Hospital Length Of Stay ◽  
Transitions In Care

Introduction: Introduction: Transitions in care (TiC) interventions have been proposed to improve the management and outcomes of patients in emergency departments (ED). The objective of this review was to examine the effectiveness of ED-based TiC interventions to improve outcomes for adult patients presenting to an ED with acute atrial fibrillation or flutter (AFF). Methods: Methods: A comprehensive search of eight electronic databases and various grey literature sources was conducted. Comparative studies assessing the effectiveness of interventions to improve TiC for patients presenting to the ED with acute AFF were eligible. Two independent reviewers completed study selection, quality assessment, and data extraction. When applicable, relative risks (RR) with 95% confidence intervals (CIs) were calculated using a random effects model and heterogeneity was reported among studies using I-square (I2) statistics. Results: Results: From 744 citations, seven studies were included, consisting of three randomized controlled trials (RCT), three before-after (B/A) studies, and one cohort study. Study quality ranged from unclear to low for the RCTs according to the risk of bias tool, moderate in the BA trials according to the BA quality assessment tool, and high quality of the cohort study according to the Newcastle Ottawa scale. The majority of interventions were set within-ED (n=5), including three clinical pathways/management guidelines and two within-ED observation units. Post-ED interventions (n=2) included patient education and general practitioner referral. Four studies reported a decreased overall hospital length of stay (LoS) for AFF patients undergoing TiC interventions compared to control, ranging from 26.4 to 53 hours; however, incomplete and non-standardized outcome reporting precluded meta-analysis. An increase in conversion to normal sinus rhythm among TiC intervention patients was noted, which may be related to increased utilization of electrical cardioversion among the RCTs (RR=2.16; 95% CI: 1.42, 3.30; I2=%), B/A studies (RR=2.69, 95% CI: 2.17, 3.33), and cohort study (RR=1.39; 95% CI: 1.24, 1.56). Conclusion: Conclusions: Within-ED TiC interventions may reduce hospital LoS and increase use of electrical cardioversion. However, no clear recommendations to implement such interventions in EDs can be generated from this systematic review and more efforts are required to improve TiC for patients with AFF.

scholarly journals Gingival crevicular fluid alkaline phosphatase activity as growth marker: A systematic review

2021 ◽  
Vol 0 ◽  
pp. 1-8
Author(s):  
Siddharth Sonwane ◽  
Wasundhara Bhad
Keyword(s):  
Systematic Review ◽  
Alkaline Phosphatase ◽  
Quality Assessment ◽  
Gingival Crevicular Fluid ◽  
Skeletal Maturity ◽  
Grey Literature ◽  
Google Scholar ◽  
Cross Sectional ◽  
Alp Activity ◽  
Crevicular Fluid

Background: This review synthesizes the available evidence about the individual skeletal maturity with biological maturity indicators and compares it with the levels of gingival crevicular fluid (GCF) alkaline phosphatase (ALP) activity in growing children. Aims: This systematic review aimed to clarify the question: Is GCF ALP a reliable biomarker to assess skeletal maturity during growth? Objectives: The objective of this systematic review is to collect, compile, and review the existing evidence on the levels of GCF ALP activity in growing children and comparing its reliability with contemporary growth indicators. Materials and Methods: A literature appraisal executed using Entres PubMed, www.ncbi.nim.nih.gov, Scupose, Hinary, Ebsco, Embass, Cochrane; Google Scholar Electronic database search engines were used. The MeSH term used “growth markers in gingival crevicular fluid” or “growth markers in growing children.” Studies published till October, 2020, were included in this study. Data Extraction and Quality Assessment: The data have extracted from the selected articles based on year of publication, study design, age of subjects, instruments used, and author’s conclusions. The quality assessment was executed using BIOCROSS Scale. This scale is exclusive for cross-sectional studies with biomarkers. Results: Literature search identified 731 records from electronic databases and from the partial grey literature (Google scholar) search. Finally, six articles fulfilled eligibility criteria included in the review. Conclusions: All the six studies concluded that GCF ALP activity is a reliable method in determining a skeletal maturity indicator in growing children.

scholarly journals Surgical management of rib fractures in chest wall trauma

2020 ◽  
Vol 6 ◽  
pp. 7-7
Author(s):  
Fabrizio Minervini ◽  
Peter B. Kestenholz ◽  
Pietro Bertoglio ◽  
Marco Scarci ◽  
Gregor J. Kocher
Keyword(s):  
Chest Wall ◽  
Surgical Management ◽  
Rib Fractures ◽  
Chest Wall Trauma

scholarly journals Mechanical Outcomes, Microleakage, and Marginal Accuracy at the Implant-Abutment Interface of Original versus Nonoriginal Implant Abutments: A Systematic Review of In Vitro Studies

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Marco Tallarico ◽  
Joseph Fiorellini ◽  
Yasushi Nakajima ◽  
Yuki Omori ◽  
Iida Takahisa ◽  
...  
Keyword(s):  
Systematic Review ◽  
Quality Assessment ◽  
Grey Literature ◽  
Third Party ◽  
Inclusion Criteria ◽  
Pubmed Database ◽  
Implant Abutments ◽  
Implant Abutment

Purpose. Instead of original abutments, compatible abutments are often selected for financial reasons. The present study aimed to evaluate mechanical outcomes, microleakage, and marginal accuracy at the implant-abutment interface of original versus nonoriginal implant abutments. Study Selection. Search strategy encompassed literature from 1967 up to March 2017 to identify relevant studies meeting the inclusion criteria. The following electronic databases were consulted: PubMed database of the U.S. National Library of Medicine, Embase (Excerpta Medica dataBASE), and the Grey Literature Database (New York Academy of Medicine Grey Literature Report). Quality assessment of the full-text articles selected was performed. Abutments were classified in original (produced by the same implant manufacturer), nonoriginal certified (produced by a third-party milling center, certified by implant companies), and nonoriginal compatible (produced by a third-party milling center for similar connections). Results. A total of 16 articles fulfilled inclusion criteria and quality assessment and were selected for the qualitative analysis. All of the included studies were in vitro research with high or moderate risk of bias and reported data from 653 implant abutments. Original and nonoriginal certified abutments showed better results in terms of mechanical outcomes, microleakage, and marginal accuracy compared to nonoriginal compatible abutments. Conclusions. Following the clear warnings coming from the present systematic review, clinical suggestions regarding the effect of a nonoriginal abutment can be drawn. However, in vivo, long-term, randomized controlled trials are needed to provide definitive clinical conclusion about the long-term clinical outcomes of original and nonoriginal abutments.

scholarly journals D.09 Pharmacological therapy for the prevention and management of cardiomyopathy in Duchenne muscular dystrophy: a systematic review

2016 ◽  
Vol 43 (S2) ◽  
pp. S15-S15
Author(s):  
B El-Aloul ◽  
R Rodrigues ◽  
L Altamirano-Diaz ◽  
M Malvankar ◽  
C Nguyen ◽  
...  
Keyword(s):  
Systematic Review ◽  
Duchenne Muscular Dystrophy ◽  
Muscular Dystrophy ◽  
Quality Assessment ◽  
Systolic Function ◽  
Angiotensin Receptor Blockers ◽  
Grey Literature ◽  
Left Ventricular ◽  
Optimal Timing ◽  
Aldosterone Antagonists

Background: Improved respiratory care of Duchenne muscular dystrophy (DMD) patients has unmasked cardiomyopathy as a major source of morbidity and mortality. There is currently no consensus regarding the management of DMD-associated cardiomyopathy (DMD-CM). The objective of this systematic review was to evaluate the efficacy of pharmacological therapies for prevention and management of DMD-CM, and determine the optimal timing to commence these interventions. Methods: A systematic search was conducted in October 2015 and updated in January 2016 using MEDLINE, EMBASE and CINAHL databases and 9 grey literature sources for studies evaluating the use of angiotensin-converting enzyme inhibitors (ACEi), angiotensin receptor blockers (ARB), beta-blockers (BB) or aldosterone antagonists (AA) in DMD patients. References of retrieved records were searched. Quality assessment was conducted using the Downs and Black Quality Assessment Checklist. PRISMA reporting guidelines were used. Results: The 11 included studies were of low methodological quality. However, the use of an ACEi, ARB, BB and AA tended to improve or preserve left ventricular systolic function and delay the progression of cardiomyopathy. Conclusions: While there is evidence supporting the use of heart failure medication in patients with DMD-CM, data regarding these interventions for delaying the onset of DMD-CM and when to initiate therapy is lacking.

scholarly journals Lung ultrasound in the diagnosis and management of acute viral bronchiolitis; a systematic review

2021 ◽  
Author(s):  
Christos Kogias ◽  
Spyridon Prountzos ◽  
Efthymia Alexopoulou ◽  
Konstantinos Douros
Keyword(s):  
Systematic Review ◽  
Chest Radiography ◽  
Viral Infections ◽  
Lung Ultrasound ◽  
Length Of Hospital Stay ◽  
Diagnostic Algorithm ◽  
Main Role ◽  
Eligibility Criteria ◽  
Diagnosis And Management ◽  
Acute Viral Bronchiolitis

Objective: Acute viral bronchiolitis (AVB) is one of the most common viral infections and the most common lower respiratory tract infection in the first year of life. Current guidelines recommend that medical history and physical examination have the main role in the diagnosis of AVB. Lung ultrasound (LUS) has not been included in the diagnostic algorithm so far. The aim of this systematic review is to collect all available studies concerning the role of LUS in the diagnosis and management of AVB. Methods: PubMed - MEDLINE, Scopus and ScienceDirect databases were searched for trials reporting on LUS examination in the diagnosis and management of AVB in paediatric patients. Results: A total of seventeen studies matching our eligibility criteria were analyzed for the purposes of this review and their results were categorized into six major fields each one of them answering to a question. There are several LUS scores that evaluate the severity of sonographic findings in children with AVB. The findings on LUS and chest radiography are comparable and LUS has a significant role in further management of AVB in the Paediatric Emergency Department. LUS score is correlated to the clinical course of AVB and it can predict both the duration of hospitalization and the need for respiratory support. Conclusion: Current literature supports that LUS could have comparable efficiency with chest radiography concerning the diagnosis of AVB and it could predict the length of hospital stay and the need of oxygen supply.

scholarly journals Experiences and perceived health benefits of individuals with a disability participating in sport: A systematic review protocol

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e038214
Author(s):  
Beth Aitchison ◽  
Alison Rushton ◽  
Paul Martin ◽  
Andrew Soundy ◽  
Nicola R Heneghan
Keyword(s):  
Systematic Review ◽  
Quality Assessment ◽  
Sport Participation ◽  
Assessment Tool ◽  
Grey Literature ◽  
Health Benefits ◽  
Sports Participation ◽  
Perceived Health ◽  
Qualitative Studies ◽  
Quantitative Studies

IntroductionSports participation has many physical and mental health benefits for individuals with a disability, including improved functionality and reduced anxiety. Despite this, a large proportion of individuals with a disability are inactive. This review will be the first to synthesise the literature on the experiences and perceived health benefits of sport participation for children, adolescents, adults, elite athletes and veterans with a disability. Investigation of these phenomena will enable an understanding of the positive aspects and benefits of sport participation specific to each population, which may help to improve participation rates and ultimately improve health through promotion of these benefits.MethodsA protocol for systematic review is reported in line with Preferred Reporting Items for Systematic Reviews and Meta-Analysis-P. The phenomena of interest are the experiences and perceived health benefits of individuals with a disability participating in sport. There will be no age limit on participants and all study designs, besides reviews, will be included. Studies in languages other than English will be excluded. Two independent reviewers will conduct the searches, study selection, data collection and quality assessment independently. The online databases MEDLINE, EMBASE, PsychINFO, CINAHL Plus, Web of Science and SportDiscus will be electronically searched from database inception to February 2020. Grey literature will be searched and several sport-related journals will be hand-searched. The Quality Assessment Tool for Studies with Diverse Designs will be used for quality assessment of included studies. Thematic synthesis will be used to analyse the qualitative studies, narrative synthesis will be used to analyse the quantitative studies and the perceived health benefits will be analysed using content analysis. The strength of the overall body of evidence will be assessed and reported using GRADE-CERQual (Grading of Recommendations, Assessment, Development and Evaluation–Confidence in the Evidence from Reviews of Qualitative research) for qualitative studies and GRADE for quantitative studies. These approaches will be applied to mixed-methods studies, respectively, where necessary.Ethics and disseminationThis systematic review raises no ethical issues. Results will be published in a peer reviewed journal and disseminated to key stakeholders to inform practice.PROSPERO registration numberCRD42020169224.

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