scholarly journals Assessment of Uterocervical Angle Width as a Predictive Factor of Preterm Birth: A Systematic Review of the Literature

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
George Daskalakis ◽  
Marianna Theodora ◽  
Panagiotis Antsaklis ◽  
Michael Sindos ◽  
Themistoklis Grigoriadis ◽  
...  
Keyword(s):  
Systematic Review ◽  
Preterm Birth ◽  
Predictive Factor ◽  
Current Evidence ◽  
Significant Heterogeneity ◽  
Cochrane Central Register ◽  
Second Trimester ◽  
Outcome Reporting ◽  
Potential Marker ◽  
Present Systematic Review

Background. Uterocervical angle (UCA) has been recently proposed as a potential marker that could accurately predict preterm birth (PTB). The purpose of the present systematic review is to accumulate current evidence and provide directions for future research. Materials and Methods. We used the Medline (1966–2018), Scopus (2004–2018), Clinicaltrials.gov (2008–2018), EMBASE (1980-2018), Cochrane Central Register of Controlled Trials CENTRAL (1999-2018), and Google Scholar (2004-2018) databases in our search. Results. Eleven studies were finally included in the present systematic review that evaluated data from 3,018 women. The significant heterogeneity in terms of outcome reporting and outcome reporting measures (use of optimal cut-off values) precluded meta-analysis. However, existing data support that second trimester UCA measurement might be used as a predictive factor of PTB <34 weeks, as at least two studies in unselected singleton pregnancies and two studies in pregnancies with an ultrasonographically shortened cervix seem to support this hypothesis. The most commonly reported cut-off values were 105° and 95°. Conclusions. UCA measurement during the second trimester of pregnancy may be a useful method of determining women at risk of delivering preterm. However, more studies are needed to assess the reproducibility of these findings and reach conclusive evidence.

scholarly journals Current Evidence for Continuous Vital Signs Monitoring by Wearable Wireless Devices in Hospitalized Adults: Systematic Review

10.2196/18636 ◽  
2020 ◽  
Vol 22 (6) ◽  
pp. e18636 ◽  
Author(s):  
Jobbe P L Leenen ◽  
Crista Leerentveld ◽  
Joris D van Dijk ◽  
Henderik L van Westreenen ◽  
Lisette Schoonhoven ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Clinical Outcomes ◽  
Health Care Professionals ◽  
Continuous Monitoring ◽  
Vital Signs ◽  
Current Evidence ◽  
Cochrane Central Register ◽  
Wireless Devices

Background Continuous monitoring of vital signs by using wearable wireless devices may allow for timely detection of clinical deterioration in patients in general wards in comparison to detection by standard intermittent vital signs measurements. A large number of studies on many different wearable devices have been reported in recent years, but a systematic review is not yet available to date. Objective The aim of this study was to provide a systematic review for health care professionals regarding the current evidence about the validation, feasibility, clinical outcomes, and costs of wearable wireless devices for continuous monitoring of vital signs. Methods A systematic and comprehensive search was performed using PubMed/MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials from January 2009 to September 2019 for studies that evaluated wearable wireless devices for continuous monitoring of vital signs in adults. Outcomes were structured by validation, feasibility, clinical outcomes, and costs. Risk of bias was determined by using the Mixed Methods Appraisal Tool, quality assessment of diagnostic accuracy studies 2nd edition, or quality of health economic studies tool. Results In this review, 27 studies evaluating 13 different wearable wireless devices were included. These studies predominantly evaluated the validation or the feasibility outcomes of these devices. Only a few studies reported the clinical outcomes with these devices and they did not report a significantly better clinical outcome than the standard tools used for measuring vital signs. Cost outcomes were not reported in any study. The quality of the included studies was predominantly rated as low or moderate. Conclusions Wearable wireless continuous monitoring devices are mostly still in the clinical validation and feasibility testing phases. To date, there are no high quality large well-controlled studies of wearable wireless devices available that show a significant clinical benefit or cost-effectiveness. Such studies are needed to help health care professionals and administrators in their decision making regarding implementation of these devices on a large scale in clinical practice or in-home monitoring.

Device and non-device-guided slow breathing to reduce blood pressure in hypertensive patients: a systematic review protocol. (Preprint)

2021 ◽  
Author(s):  
Kamila Shelry Gonçalves ◽  
Ana Carolina Queiroz Godoy Daniel ◽  
José Luiz Tatagiba Lamas ◽  
Henrique Ceretta Oliveira ◽  
Renata Cristina De Campos Pereira Silveira ◽  
...  
Keyword(s):  
Systematic Review ◽  
Blood Pressure ◽  
Current Evidence ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Systematic Review Protocol ◽  
Hypertensive Patients ◽  
Gray Literature ◽  
Review Protocol ◽  
Slow Breathing

UNSTRUCTURED Introduction: Physiotherapy can include both device-guided slow breathing and device-guided slow breathing in the treatment of systemic arterial hypertension. Methods: A systematic search of all published randomized controlled trials on the effects of device-guided and non-device-guided slow breathing on hypertensive patients, without language restriction, will be carried out until January 2020 in nine databases: Pubmed / MEDLINE (Medical Literature Analysis and Retrieval System Online), Latin American and Caribbean Health Sciences Literature (LILACS), EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), Physiotherapy Evidence Database (PEDro), Cumulative Index to Nursing and Allied Health Literature ( CINAHL), Scopus, Web of Science, Livivo, as well as a search of clinical trial records databases, CT.GOV (Clinical trials.Gov), and bases for the Open Grey gray literature, Gray Literature Report, ProQuest Central (Citation, Abstract or Indexing and Dissertations and Theses). In all of these databases, potentially eligible studies including completed and ongoing ECAs were researched. The quality assessment of the included studies will be conducted using the Cochrane Risk of Bias Tool for Randomized Trials. The overall quality of the evidence for each outcome will be assessed using the Grading of Recommendations, Development and Evaluation (GRADE) system. Discussion: This systematic review will provide a summary of the current evidence on the effects of both device-guided slow breathing and device-guided slow breathing on blood pressure levels. This information can contribute to decision making by health professionals related to the use of these interventions in hypertensive patients. Following the guidelines, this systematic review protocol was registered with the Prospective International Register of Systematic Reviews (PROSPERO) number CRD42020147554.

PIK3CA Mutations and Their Impact on Survival Outcomes of Patients with Cervical Cancer: A Systematic Review

2020 ◽  
Vol 64 (6) ◽  
pp. 547-555
Author(s):  
Vasilios Pergialiotis ◽  
Christina Nikolaou ◽  
Dimitrios Haidopoulos ◽  
Maximos Frountzas ◽  
Nikolaos Thomakos ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cervical Cancer ◽  
Cancer Progression ◽  
Meta Analysis ◽  
Current Evidence ◽  
Survival Outcomes ◽  
Cochrane Central Register ◽  
Wild Type ◽  
Pik3ca Mutations ◽  
The Impact

<b><i>Introduction:</i></b> Several studies have implicated the PIK3/AKT pathway in the pathophysiology of cancer progression as its activation seems to be aberrant in several forms of cancer. The purpose of the present systematic review is to evaluate the impact of PIK3CA mutations on survival outcomes of patients with cervical cancer. <b><i>Methods:</i></b> We used the Medline (1966–2020), Scopus (2004–2020), ClinicalTrials.gov (2008–2020), EMBASE (1980–2020), Cochrane Central Register of Controlled Trials (CENTRAL) (1999–2020), and Google Scholar (2004–2020) databases in our primary search along with the reference lists of electronically retrieved full-text papers. Statistical meta-analysis was performed with the RevMan 5.3 software. <b><i>Results:</i></b> Overall, 12 articles were included in the present study that comprised 2,196 women with cervical cancer. Of those, 3 studies did not report significant differences in survival outcomes among patients with mutated versus wild-type PIK3CA tumors, 5 studies reported decreased survival outcomes, and 3 studies revealed increased survival rates. The meta-analysis revealed that patients with the mutated PIK3CA genotypes had worse overall survival compared to patients with wild-type PIK3CA (HR 2.31; 95% CI: 1.51, 3.55; 95% PI: 0.54, 9.96; data from 3 studies) and the same was observed in the case of DFS rates (HR 1.82; 95% CI: 1.47, 2.25; 95% PI: 1.29, 2.56; data from 4 studies). <b><i>Conclusion:</i></b> Current evidence concerning the impact of PIK3CA mutations on survival outcomes of patients with cervical cancer is inconclusive, although the majority of included studies support a potential negative effect, primarily among those with squamous cell carcinoma tumors.

scholarly journals Effects of aerobic exercise in the treatment of older adults with chronic musculoskeletal pain: a protocol of a systematic review

2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Naiane Teixeira Bastos de Oliveira ◽  
Irlei dos Santos ◽  
Gisela Cristiane Miyamoto ◽  
Cristina Maria Nunes Cabral
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Aerobic Exercise ◽  
Musculoskeletal Pain ◽  
Included Study ◽  
Chronic Musculoskeletal Pain ◽  
Current Evidence ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
And Function

Abstract Background Chronic musculoskeletal pain affects the quality of life of older adults by interfering in their ability to perform activities of daily living. Aerobic exercise programs have been used in the treatment of various health conditions, including musculoskeletal disorders. However, there is still little evidence on the effects of aerobic exercise for the treatment of older adults with chronic musculoskeletal pain. Thus, the objective of this study is to assess the effects of aerobic exercise in improving pain and function of older adults with chronic pain as a consequence of different chronic musculoskeletal conditions. Methods The databases to be used in the search are PubMed, EMBASE, CINAHL, PEDro, and Cochrane Central Register of Controlled Trials (CENTRAL). Randomized controlled trials that used aerobic exercise in the treatment of older adults with chronic musculoskeletal pain will be included. Primary outcomes will be pain and function. We will use the PEDro scale to evaluate the methodological quality and statistical description of each included study, and the strength of the recommendations will be summarized using GRADE. Discussion The results of this systematic review will provide a synthesis of the current evidence on the effects of aerobic exercise in the treatment of older adults with chronic musculoskeletal pain. In addition, this information can help health professionals in decision-making about the use of aerobic exercise in the treatment of older adults with chronic musculoskeletal pain. Ethics and dissemination This systematic review was recorded prospectively, and the results will be part of a doctoral thesis to be published in a peer-reviewed international journal and possibly presented at international conferences. Systematic review registration PROSPERO, CRD42019118903.

Clinical, Endoscopic and Histological Outcomes in Induction of Moderate-to-Severe Ulcerative Colitis: A Systematic Review with Meta-Analysis

2020 ◽  
Author(s):  
Fernando Magro ◽  
Maria Manuela Estevinho ◽  
Cláudia Camila Dias ◽  
Luís Correia ◽  
Paula Lago ◽  
...  
Keyword(s):  
Systematic Review ◽  
Ulcerative Colitis ◽  
Assessment Tool ◽  
Meta Analysis ◽  
Pharmacological Intervention ◽  
Controlled Trials ◽  
Significant Heterogeneity ◽  
Cochrane Central Register ◽  
Histological Remission ◽  
The Impact

Abstract Background and Aims Interest in histology for ulcerative colitis [UC] has increased recently. This systematic review and meta-analysis aims to assess, for the first time, whether histological outcomes are more informative than endoscopic and clinical outcomes in distinguishing the impact of intervention over placebo in induction trials. Methods MEDLINE, ScienceDirect and Cochrane Central Register of Controlled Trials were searched to identify randomized placebo-controlled trials [RCTs] enrolling moderate-to-severe UC patients. Studies were assessed using the Quality Assessment Tool for Studies with Diverse Designs. We analysed the pooled proportion of patients achieving clinical, endoscopic and histological remission and response after a pharmacological intervention and compared the results with those of placebo-treated patients by using a random-effects model. Results From 889 identified records, 13 RCTs were included. The odds ratio [OR] for remission was higher in patients receiving intervention than in those under placebo for clinical (OR 2.13, 95% confidence interval [CI] 1.33–3.43), endoscopic [OR 1.46, 95% CI 0.19–11.18] and histological remission [OR 1.85, 95% CI 1.20–2.84]. Significant differences were observed for all response outcomes [clinical: OR 2.27, 95% CI 1.84–2.85; endoscopic: OR 2.16, 95% CI 1.51–3.10; histological: OR 3.63, 95% CI, 1.41–9.36]. No significant heterogeneity existed; no subgroup effects were found for duration of the induction or histological scale [p &gt; 0.05]. Clinical and histological remission and endoscopic response were concordant in discriminating interventions from placebo. Conclusion Histological outcomes are informative in trials of moderate-to-severe UC. Further studies analysing histology at the end of induction are needed to confirm its relevance in distinguishing the efficacy of an intervention over placebo in comparison to clinical and endoscopic outcomes and to explore its prognostic value.

Mirror therapy simultaneously combined with electrical stimulation for upper limb motor function recovery after stroke: a systematic review and meta-analysis of randomized controlled trials

2020 ◽  
pp. 026921552095193
Author(s):  
Alberto Saavedra-García ◽  
Jose A Moral-Munoz ◽  
David Lucena-Anton
Keyword(s):  
Systematic Review ◽  
Electrical Stimulation ◽  
Motor Function ◽  
Upper Limb ◽  
Meta Analysis ◽  
Mean Difference ◽  
Current Evidence ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Mirror Therapy

Objective: To evaluate the current evidence on the effectiveness of simultaneous combination of mirror therapy and electrical stimulation in the recovery of upper limb motor function after stroke, compared with conventional therapy, mirror therapy or electrical stimulation isolated. Data sources: Articles published in PubMed, Web of Science, Scopus, Physiotherapy Evidence Database (PEDro), Cochrane Central register of controlled trials and ScienceDirect up to July 2020. Review methods: The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were followed. Methodological quality was assessed using the PEDro tool. The RevMan 5.4 statistical software was used to obtain the meta-analysis, through the standardized mean difference and 95% confidence intervals (CI), and to evaluate the risk of bias. The GRADE approach was employed to assess the certainty of evidence. Results: Eight articles were included in this systematic review, seven were included in the meta-analysis. A total of 314 participants were analyzed. The overall quality of the articles included in this review was good. There was no overall significant mean difference on upper limb motor function after stroke using the Upper-Extremity Fugl-Meyer Assessment by 1.56 (95% CI = –2.08, 5.20; P = 0.40; moderate-certainty evidence) and the Box and Block Test results by 1.39 (95% CI = –2.14, 4.92; P = 0.44; high-certainty evidence). There was overall significant difference in the Action Research Arm Test by 3.54 (95% CI = 0.18, 6.90; P = 0.04; high-certainty evidence). Conclusion: Direct scientific evidence about the effectiveness of the combined therapy of mirror therapy and electrical stimulation simultaneously for the improvement of the upper limb motor function after stroke is lacking. Further high-quality and well-designed research is needed.

scholarly journals Lumbar Fusion for Degenerative Disease: A Systematic Review and Meta-Analysis

Neurosurgery ◽  
2017 ◽  
Vol 80 (5) ◽  
pp. 701-715 ◽  
Author(s):  
Daniel Yavin ◽  
Steven Casha ◽  
Samuel Wiebe ◽  
Thomas E Feasby ◽  
Callie Clark ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cohort Studies ◽  
Spinal Stenosis ◽  
Lumbar Fusion ◽  
Meta Analysis ◽  
Current Evidence ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Safety And Efficacy ◽  
Relative Safety

Abstract BACKGROUND: Due to uncertain evidence, lumbar fusion for degenerative indications is associated with the greatest measured practice variation of any surgical procedure. OBJECTIVE: To summarize the current evidence on the comparative safety and efficacy of lumbar fusion, decompression-alone, or nonoperative care for degenerative indications. METHODS: A systematic review was conducted using PubMed, MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials (up to June 30, 2016). Comparative studies reporting validated measures of safety or efficacy were included. Treatment effects were calculated through DerSimonian and Laird random effects models. RESULTS: The literature search yielded 65 studies (19 randomized controlled trials, 16 prospective cohort studies, 15 retrospective cohort studies, and 15 registries) enrolling a total of 302 620 patients. Disability, pain, and patient satisfaction following fusion, decompression-alone, or nonoperative care were dependent on surgical indications and study methodology. Relative to decompression-alone, the risk of reoperation following fusion was increased for spinal stenosis (relative risk [RR] 1.17, 95% confidence interval [CI] 1.06-1.28) and decreased for spondylolisthesis (RR 0.75, 95% CI 0.68-0.83). Among patients with spinal stenosis, complications were more frequent following fusion (RR 1.87, 95% CI 1.18-2.96). Mortality was not significantly associated with any treatment modality. CONCLUSION: Positive clinical change was greatest in patients undergoing fusion for spondylolisthesis while complications and the risk of reoperation limited the benefit of fusion for spinal stenosis. The relative safety and efficacy of fusion for chronic low back pain suggests careful patient selection is required (PROSPERO International Prospective Register of Systematic Reviews number, CRD42015020153).

scholarly journals Does Vitamin D Deficiency in Different Periods of Gestation Have the Same Effect on Preterm Birth? A Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
bin Yi ◽  
Rui-han Lian ◽  
Ping-an Qi ◽  
Tao Yuan ◽  
Pei-jing Yan ◽  
...  
Keyword(s):  
Systematic Review ◽  
Vitamin D ◽  
Preterm Birth ◽  
Vitamin D Deficiency ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Second Trimester ◽  
Case Control Studies ◽  
Cross Sectional ◽  
Vitamin D Levels

Abstract Background: Current studies suggest that vitamin D deficiency during pregnancy can produce a certain effect for preterm birth, but there is no research showing whether vitamin D deficiency has a consistent effect in different pregnancies; thus, we conducted a systematic review and meta-analysis of 24 observational studies, grouping them according to the gestational age at the time of serum sampling, to investigate whether vitamin D deficiency in different periods of gestation has different effects on preterm birth and to provide an evidence-based basis for pregnant women to measure and supplement vitamin D. Methods: The databases PubMed-Medline, EMBASE, the Cochrane Library, Web of Science, EBSCO, CBM, and CNKI were searched until July 2019. Two researchers independently assessed the eligibility and quality of studies, and STATA 12.0 software was used for meta-analysis. Result: Seven cohort studies, 13 case-control studies, and four cross-sectional studies were included from 2500 articles by inclusion and exclusion criteria. After adjusting for age, race, and other confounding factors, meta-analysis results showed that vitamin D deficiency in the first trimester, the second trimester and the third trimester did not increase the risk of preterm birth (odds ratio (OR) = 1.01, 95% confidence interval (CI) (0.88, 1.16), P = 0.867; OR = 1.12, 95%CI (0.92, 1.37), P = 0.249; OR = 1.05, 95%CI (0.87, 1.27), P = 0.602). However, there was moderate heterogeneity in the study of vitamin D deficiency in the second trimester, and subgroup analysis suggested that vitamin D deficiency in the second trimester may increase the risk of preterm birth (OR = 1.33, 95%CI (1.15, 1.54), P = 0.000). A sensitivity analysis of the second trimester showed that excluding any one study did not significantly change the results. Conclusions: Vitamin D deficiency in early and late pregnancy may not be associated with preterm birth, while vitamin D deficiency in middle pregnancy is likely to have an important effect on preterm birth. Vitamin D levels should be measured in the second trimester of pregnancy, and vitamin D supplements should be provided if necessary.

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 Feasibility and acceptability of study methods and psychosocial interventions for body image targeting women diagnosed with breast cancer: a protocol for a systematic review

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e057309
Author(s):  
Jennifer Brunet ◽  
Jenson Price ◽  
Aurelie Baillot
Keyword(s):  
Breast Cancer ◽  
Systematic Review ◽  
Body Image ◽  
Systematic Reviews ◽  
Psychosocial Interventions ◽  
Current Evidence ◽  
Future Research ◽  
Cochrane Central Register ◽  
Study Methods ◽  
Manual Search

IntroductionImproving body image may help to enhance the quality of life of women diagnosed with breast cancer. Although evidence suggests psychosocial interventions can effectively improve body image in this population, no review to date has assessed their feasibility or acceptability. This manuscript reports the protocol for a review summarising current evidence for the feasibility and acceptability of psychosocial interventions for body image targeting women diagnosed with breast cancer and the study methods used to evaluate the interventions in question to provide recommendations to optimise the success and sustainability of psychosocial interventions for body image and future studies. Results will also help to identify gaps in the existing evidence to provide direction for future research.Methods and analysisWe searched the following databases for articles published in the English language from January 2000 to June 2021 using a systematic search strategy: MEDLINE, Cumulative Index to Nursing and Allied Health Literature, Cochrane Central Register of Controlled Trials, PsychINFO and EMBASE. This search will be supplemented with a manual search of reference lists from relevant systematic reviews and included articles. Eligible studies will include peer-reviewed publications reporting on feasibility and acceptability in the evaluation of psychosocial interventions for body image targeting women diagnosed with breast cancer. All study designs are eligible, although articles are required to have reported on an intervention evaluation. Two reviewers will independently carry out study selection, extraction of quantitative and qualitative data and quality assessment. Data will be summarised in a narrative review and thematic analysis.Ethics and disseminationNo ethical approval is required because this is a protocol for a systematic review. On completion, results will be submitted for publication in a peer-reviewed scientific journal and for presentation at a relevant conference.Trial registrationThis protocol has been registered in the Prospective Register of Systematic Reviews international registry (ID: CRD42021269062, 11 September 2021).

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