996 Epigenetic methylation in endometrial cancer (EC): an umbrella review of published evidence

IntroductionUterine malignancies, the vast majority of which are endometrial cancers, constitute the most common type of gynecological neoplasms in developed countries. The primary treatment for endometrial cancer is hysterectomy and bilateral salpingoophorectomy. Women with endometrial cancer can be subjected to either total abdominal hysterectomy (TAH) or to an increasingly recommended total laparoscopic hysterectomy (TLH). We decided to verify whether published evidence supports TLH as an effective, less invasive than TAH albeit still equally radical treatment for endometrial malignancies.Material and methodsThe systematic review included articles indexed in MEDLINE (PubMed) and EBSCO, published between January 1974 and January 2017. The search was based on the following keywords and combinations thereof: “laparoscopy”, “laparotomy”, “endometrial cancer”, “comparative”. Twenty-six full-text articles were included in the meta-analysis.ResultsA total of 5,996 patients were eligible for the analysis, among them 2,833 (47.2%) women subjected to TLH and 3,163 (52.8%) who underwent TAH. Total laparoscopic hysterectomy is associated with shorter hospital stay, faster recovery, lesser blood loss and fewer intra- and postoperative blood transfusions, reduced pain, and a lower reoperation rate than conventional TAH.ConclusionsAll analyzed studies demonstrated that TLH is a safe and effective treatment option in endometrial cancer patients. This procedure is markedly less invasive than TAH. However, considering several contraindications for laparoscopy, such as peritoneal invasion, cardiorespiratory failure, history of previous surgery and large size of the uterus, qualification for a given procedure needs to be preceded by a detailed evaluation.

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RISK FACTORS ASSOCIATED WITH ENDOMETRIAL CANCER: AN UMBRELLA REVIEW

10.26226/morressier.599bdc7bd462b80296ca1a61 ◽

2017 ◽

Cited By ~ 1

Author(s):

Olivia Raglan

Keyword(s):

Risk Factors ◽

Endometrial Cancer ◽

Umbrella Review ◽

Factors Associated

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Understanding hesitancy around vaccines and vaccination: an umbrella review

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.1421 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

K Giannakou ◽

E Vachtsioli

Keyword(s):

Systematic Reviews ◽

Vaccine Coverage ◽

Vaccine Safety ◽

Global Perspective ◽

Vaccine Uptake ◽

Vaccine Hesitancy ◽

Publication Date ◽

Umbrella Review ◽

Safety And Efficacy ◽

Published Evidence

Abstract Background Vaccination has been evaluated and was found to be the most successful and cost-effective interventions to preventing illness and improve health outcomes. However, internationally, an increase in vaccine hesitancy has led to a decrease in vaccination uptake. We conducted an umbrella review to assess the factors related to under-vaccination and non-vaccination from a global perspective. Methods PubMed, EMBASE and Science Direct were searched from inception to December 2019 for systematic reviews and meta-analyses that examined the factors affecting vaccination choices. No restrictions on language, publication date, vaccination type, setting, or population were applied. Narrative and extensive reviews were excluded. A narrative synthesis was undertaken to present the results thematically. Results Twenty-two systematic reviews met the inclusion criteria. The published evidence on this topic shows that, overall, a variety of complex factors exist related to vaccine hesitancy. Across all articles included, the main areas of concern were around vaccine safety and efficacy. Mistrust towards vaccine-related bodies (e.g. pharmaceutical companies, health professionals, researchers etc.), inconvenience, cost, and overall lack of information/knowledge were also identified as major barriers to vaccine uptake. Barriers vary depending on population, place and vaccines. Conclusions Our results show a variety of complex factors influencing the decision to accept, delay or reject some or all vaccines, indicating the necessity of a multi-faceted approach to address them in order to improve vaccine coverage. Key messages The results of this review show that concerns regarding vaccine safety and efficacy were the most significant barriers. Further research, policies, programs, and community-driven initiatives are needed to enhance acceptability and uptake of vaccination.

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Characteristics of the Frequency-Following Response to Speech in Neonates and Potential Applicability in Clinical Practice: A Systematic Review

Journal of Speech Language and Hearing Research ◽

10.1044/2020_jslhr-19-00322 ◽

2020 ◽

Vol 63 (5) ◽

pp. 1618-1635

Author(s):

Céline Richard ◽

Mary Lauren Neel ◽

Arnaud Jeanvoine ◽

Sharon Mc Connell ◽

Alison Gehred ◽

...

Keyword(s):

Systematic Review ◽

Cochrane Library ◽

Neurodevelopmental Outcomes ◽

Frequency Following Response ◽

Ovid Medline ◽

Published Evidence ◽

Mesh Terms ◽

Potential Applicability ◽

Clinical Potential

Purpose We sought to critically analyze and evaluate published evidence regarding feasibility and clinical potential for predicting neurodevelopmental outcomes of the frequency-following responses (FFRs) to speech recordings in neonates (birth to 28 days). Method A systematic search of MeSH terms in the Cumulative Index to Nursing and Allied HealthLiterature, Embase, Google Scholar, Ovid Medline (R) and E-Pub Ahead of Print, In-Process & Other Non-Indexed Citations and Daily, Web of Science, SCOPUS, COCHRANE Library, and ClinicalTrials.gov was performed. Manual review of all items identified in the search was performed by two independent reviewers. Articles were evaluated based on the level of methodological quality and evidence according to the RTI item bank. Results Seven articles met inclusion criteria. None of the included studies reported neurodevelopmental outcomes past 3 months of age. Quality of the evidence ranged from moderate to high. Protocol variations were frequent. Conclusions Based on this systematic review, the FFR to speech can capture both temporal and spectral acoustic features in neonates. It can accurately be recorded in a fast and easy manner at the infant's bedside. However, at this time, further studies are needed to identify and validate which FFR features could be incorporated as an addition to standard evaluation of infant sound processing evaluation in subcortico-cortical networks. This review identifies the need for further research focused on identifying specific features of the neonatal FFRs, those with predictive value for early childhood outcomes to help guide targeted early speech and hearing interventions.

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