A Systematic Review on Cannabis Hyperemesis Syndrome and its Management Options

Introduction: Several forms of cannabinoids are currently being used to manage nausea and vomiting (N/V). Emerging cases of refractory N/V, associated with chronic cannabis use among adults and older patients have been reported named cannabis hyperemesis syndrome (CHS). CHS is a condition that leads to repeated and severe N/V in long-term users of cannabinoids. Objective: To outline current treatments for the management of CHS. Methods: A systematic review was conducted using PubMed, Ovid MEDLINE, Cochrane Central, EMBASE and Google Scholar. Databases were used to search for articles on CHS published from January 2009 to June 2021, yielding 225 results of which 17 were deemed relevant and underwent review by two separate reviewers. Results: The duration of cannabis administration ranged between six months to 11 years may precipitate symptoms of CHS. The Rome IV diagnostic criteria of CHS requires cannabinoid use and persistence if N/V symptoms for at least the past six months. Cannabis cessation is noted to be the most successful management, but other treatments also demonstrated symptom relief and included hot water hydrotherapy, topical capsaicin cream, haloperidol, droperidol, benzodiazepines, propranolol and aprepitant administration. Conclusion: Overall future research on CHS is needed which enhance knowledge translation, education and creates awareness of the medical community about the side effects of cannabinoids and propose the best treatment options.

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A Systematic Review of the Omohyoid Muscle Syndrome (OMS): Clinical Presentation, Diagnosis, and Treatment Options

Annals of Otology Rhinology & Laryngology ◽

10.1177/0003489421995037 ◽

2021 ◽

pp. 000348942199503

Author(s):

Jerome Zhiyi Ong ◽

Alex Chengyao Tham ◽

Jian Li Tan

Keyword(s):

Systematic Review ◽

Botulinum Toxin ◽

Traumatic Event ◽

Botulinum Toxin Injection ◽

Treatment Options ◽

Neck Mass ◽

Good Prognosis ◽

Common Symptom ◽

Management Options ◽

Omohyoid Muscle

Objective: Omohyoid muscle syndrome (OMS) is a condition that causes a X-shaped lateral neck lump on swallowing, caused by the failure of the central tendon of the omohyoid muscle to restrict movement of the muscle during swallowing. We aim to review the etiology, pathophysiology, diagnostic tests, and management options for this condition. Data Sources: Pubmed, MEDLINE, EMBASE, and Cochrane databases were searched for all articles and abstracts related to OMS up to 29th July 2020. Review Methods: A systematic review was performed, data extracted from relevant full text articles. Both quantitative data and qualitative data were analyzed. Results: Twenty cases of OMS were reported. Patients presented at a mean age of 36.0. All cases were Asian. There is a 7:3 ratio of males to females. The most common symptom was a transient neck mass. Most cases were managed conservatively with good prognosis. Open or endoscopic transection of the muscle and ultrasound-guided botulinum toxin injection were 3 treatment options, with no recurrence at 4 years, 6 months, and 6 months respectively. Conclusion: OMS could be genetic as all cases were Asian in ethnicity. The deep cervical fascia which usually envelopes the omohyoid muscle may be weakened by stress as 20% of cases had a preceding traumatic event. Real-time ultrasonography establishes the diagnosis, demonstrating the anterolateral displacement of the sternocleidomastoid muscle by a thickened omohyoid muscle during swallowing. Surgical transection can achieve cure, but due to limited studies available, they should be reserved for patients who are extremely bothered. Intramuscular injection of botulinum toxin is an effective alternative, but recurrence is expected.

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Management of carcinoid syndrome (CS): A systematic review of systemic treatment options.

Journal of Clinical Oncology ◽

10.1200/jco.2018.36.4_suppl.516 ◽

2018 ◽

Vol 36 (4_suppl) ◽

pp. 516-516

Author(s):

Edward M. Wolin ◽

Al Bowen Benson

Keyword(s):

Systematic Review ◽

Clinical Trials ◽

Systemic Treatment ◽

Treatment Options ◽

Symptom Relief ◽

Safety Data ◽

Significant Heterogeneity ◽

Carcinoid Heart Disease ◽

Systemic Treatments ◽

Symptom Response

516 Background: CS is a major cause of symptom burden (diarrhea/flushing) in patients (pts) with neuroendocrine tumors and is associated with shortened survival and severe complications such as carcinoid heart disease. We performed a systematic review of clinical evidence for CS systemic treatments. Methods: PubMed, Embase, and Cochrane databases were searched. Large ( > 60 pt) prospective clinical trials investigating the efficacy/safety of systemic treatment options for pts with CS were eligible for inclusion. Data extracted included study design, pt population, interventions, prior treatments, permitted concomitant medications, study endpoints/statistical analyses, and efficacy/safety outcomes. Results: Six large prospective clinical trials (total 953 pts) were identified from 144 search results. Significant heterogeneity existed in pt populations, control groups (placebo vs active comparator), duration of therapy, study endpoints, and efficacy/safety data reporting. Interventions assessed were long-acting and subcutaneous octreotide (OCT & OCT SC), lanreotide (LAN), telotristat ethyl (TE)+somatostatin analogues (SSA), pasireotide (PAS), and everolimus (EVE)+OCT. Symptom response was variably assessed by the frequency of diarrhea/flushing and/or receipt of rescue short-acting SSA in 5/6 studies; a significant improvement in at least one of these measures occurred in 4 studies (OCT and OCT SC; LAN; TE+SSA). Failure to meet symptom response criteria ranged from 29-82% in the studies. Reported reductions in CgA and/or 5-HIAA reached statistical significance in 3 studies (LAN; EVE+OCT; TE+SSA). Interventions were generally well tolerated. Two phase 3 trials focused specifically on management of CS symptoms refractory to SSA; strategies included switching to PAS or an increased dose of OCT (40 mg q28d) for refractory diarrhea/flushing, or receipt of TE with continued SSA for refractory diarrhea. Conclusions: SSA provide substantial symptom relief for pts with CS. For refractory symptoms, TE can be added, SSA dose increased, and metastasis debulking can be used (with surgery, hepatic artery embolization, ablation, and PRRT). The addition of biologic agents to SSA can further improve CS management.

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A systematic review of the effectiveness of palliative interventions to treat rectal tenesmus in cancer

Palliative Medicine ◽

10.1177/0269216317697897 ◽

2017 ◽

Vol 31 (10) ◽

pp. 975-981 ◽

Cited By ~ 3

Author(s):

Áine Ní Laoire ◽

Lucy Fettes ◽

Fliss EM Murtagh

Keyword(s):

Systematic Review ◽

Advanced Cancer ◽

Assessment Tool ◽

Treatment Options ◽

Grey Literature ◽

Case Series ◽

Clinical Excellence ◽

Cochrane Library ◽

Future Research ◽

Systematic Review Methodology

Background: Rectal tenesmus is a distressing symptom in patients with advanced cancer and challenging to treat. There is lack of consensus on the appropriate management of tenesmus in this patient population. Aim: To identify and examine the effectiveness of interventions to palliate rectal tenesmus caused by advanced cancer when surgery, radiotherapy or chemotherapy are no longer treatment options. Design: A systematic review of the literature following standard systematic review methodology and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidance. Data sources: A comprehensive search of the electronic databases MEDLINE, EMBASE and the Cochrane Library was conducted from date of inception to April 2016. PubMed ‘related articles’ search, grey literature search and hand-searches of the bibliographies of relevant papers and textbooks were also performed. Non-cancer patients were excluded. Any studies involving surgery or radiotherapy to treat tenesmus were excluded. Studies involving interventions to treat pelvic pain syndromes without specific outcome measures on severity of tenesmus were excluded. The quality of the studies was assessed using a National Institute for Health and Clinical Excellence–recommended quality assessment tool. Results: From 861 studies, 9 met full criteria and were selected. All were case series investigating the use of pharmacological interventions (diltiazem, nifedipine, methadone, mexiletine hydrochloride, lidocaine and bupivacaine), anaesthetic interventions (lumbar sympathectomy, neurolytic superior hypogastric plexus block), and endoscopic laser interventions. The included studies showed substantial heterogeneity, and therefore, a meta-analysis was not feasible. Conclusion: From this review, we identified a significant gap in research into the palliation of rectal tenesmus. A multimodal approach may be necessary due to the complexity of the pathophysiology of tenesmus. Future research should focus on randomised controlled trials of drug therapies whose potential effectiveness is suggested by case series.

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Isoflavone Supplements for Menopausal Women: A Systematic Review

Nutrients ◽

10.3390/nu11112649 ◽

2019 ◽

Vol 11 (11) ◽

pp. 2649 ◽

Cited By ~ 15

Author(s):

Li-Ru Chen ◽

Nai-Yu Ko ◽

Kuo-Hu Chen

Keyword(s):

Systematic Review ◽

Hormone Replacement ◽

Hot Flashes ◽

Future Research ◽

Mineral Density ◽

Trial Duration ◽

Beneficial Effects ◽

Ovid Medline ◽

Menopausal Women

Isoflavones have gained popularity as an alternative treatment for menopausal symptoms for people who cannot or are unwilling to take hormone replacement therapy. However, there is still no consensus on the effects of isoflavones despite over two decades of vigorous research. This systematic review aims to summarize the current literature on isoflavone supplements, focusing on the active ingredients daidzein, genistein, and S-equol, and provide a framework to guide future research. We performed a literature search in Ovid Medline using the search terms “isoflavone” and “menopause”, which yielded 95 abstracts and 68 full-text articles. We found that isoflavones reduce hot flashes even accounting for placebo effect, attenuate lumbar spine bone mineral density (BMD) loss, show beneficial effects on systolic blood pressure during early menopause, and improve glycemic control in vitro. There are currently no conclusive benefits of isoflavones on urogenital symptoms and cognition. Due to the lack of standardized research protocols including isoflavone component and dosage, outcomes, and trial duration, it is difficult to reach a conclusion at this point in time. Despite these limitations, the evidence thus far favors the use of isoflavones due to their safety profile and benefit to overall health.

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Barriers to Trauma Care in South and Central America: a systematic review

European Journal of Orthopaedic Surgery & Traumatology ◽

10.1007/s00590-021-03080-3 ◽

2021 ◽

Author(s):

Florence Kinder ◽

Sarah Mehmood ◽

Harry Hodgson ◽

Peter Giannoudis ◽

Anthony Howard

Keyword(s):

Systematic Review ◽

South America ◽

Trauma Care ◽

Rural Areas ◽

Grey Literature ◽

Future Research ◽

Inclusion Criteria ◽

High Quality ◽

Clinical Trial Registration ◽

Ovid Medline

Abstract Introduction Trauma is widespread in Central and South America and is a significant cause of morbidity and mortality. Providing high quality emergency trauma care is of great importance. Understanding the barriers to care is challenging; this systematic review aims to establish current the current challenges and barriers in providing high-quality trauma care within the 21 countries in the region. Methods OVID Medline, Embase, EBM reviews and Global Health databases were systematically searched in October 2020. Records were screened by two independent researchers. Data were extracted according to a predetermined proforma. Studies of any type, published in the preceding decade were included, excluding grey literature and non-English records. Trauma was defined as blunt or penetrating injury from an external force. Studies were individually critically appraised and assessed for bias using the RTI item bank. Results 57 records met the inclusion criteria. 20 countries were covered at least once. Nine key barriers were identified: training (37/57), resources and equipment (33/57), protocols (29/57), staffing (17/57), transport and logistics (16/57), finance (15/57), socio-cultural (13/57), capacity (9/57), public education (4/57). Conclusion Nine key barriers negatively impact on the provision of high-quality trauma care and highlight potential areas for improving care in Central & South America. Many countries in the region, along with rural areas, are under-represented by the current literature and future research is urgently required to assess barriers to trauma management in these countries. No funding was received. Clinical Trial Registration: PROSPERO CRD42020220380.

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Dietary Interventions for Gastroparesis in Pediatric and Adult Populations: A Systematic Review Protocol

10.21203/rs.3.rs-100214/v1 ◽

2020 ◽

Author(s):

Debra Okafor ◽

Tanya Su ◽

Keya Lee ◽

Bruno Chumpitazi ◽

Robert J Shulman ◽

...

Keyword(s):

Systematic Review ◽

Pediatric Patients ◽

Meta Analysis ◽

Treatment Options ◽

Future Research ◽

Dietary Interventions ◽

Time Data ◽

Comprehensive Overview ◽

Specific Patient ◽

Patient Reported

Abstract Background: Dietary interventions are the first-line treatment for patients with gastroparesis. It is unclear which diets are the most efficacious as well as clear guidance as to which diets should be recommended to adult versus pediatric patients. We plan to conduct this systematic review to assess the literature on the efficacy and effectiveness of dietary interventions on clinical outcomes in adult and pediatric patients with gastroparesis. Methods: We will search PubMed and EMBASE databases, evaluating randomized control trials and cohort studies that reported dietary interventions in gastroparesis. Our primary outcomes are to evaluate changes in symptom-specific patient-reported outcomes, changes in perception of quality of life, and changes in gastric emptying time. Data collected from the studies will be analyzed using meta-analysis. Depending on the outcome, we will use quantitative summary estimates (e.g., standardized mean difference with 95% Confidence Intervals, 95%CI) or dichotomous outcomes (e.g., odds ratio and 95%CI).Discussion: This review will explore the use of dietary interventions in the treatment of both adult and pediatric patients with gastroparesis, which has yet to be published in the literature. By assessing what has been investigated by researchers as effective non-pharmacologic treatments in patients, and providing a comprehensive overview of treatment options, healthcare providers will be able to better guide patient care. Furthermore, this review will act as a means to provide direction for future research. Systematic Review Registration: PROSPERO registration ID: CRD42020210536.

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Core outcome sets (COS) related to pregnancy and childbirth: a systematic review

10.22541/au.160876858.83048752/v1 ◽

2020 ◽

Author(s):

Marie Österberg ◽

Christel Hellberg ◽

AnnKristine Jonsson ◽

Sara Fundell ◽

Frida Trönnberg ◽

...

Keyword(s):

Systematic Review ◽

Core Outcome Set ◽

Obstetric Care ◽

Consensus Method ◽

Future Research ◽

Core Outcome ◽

Pregnancy And Childbirth ◽

Ovid Medline ◽

Outcome Set ◽

Data Collection And Analysis

Background: Systematic reviews of clinical trials frequently reveal heterogeneity in the number and types of outcomes reported. To counteract this, a Core Outcome Set (COS) may be applied. Objectives: A systematic review of all completed and ongoing COS related to pregnancy and childbirth Search strategy: COMET up to January 2020, Ovid MEDLINE, EMBASE, PsycINFO, Academic Search Elite, CINAHL and SocINDEX up to June 2019. Selection criteria: Studies which prioritized outcomes using some form of consensus method (such as the Delphi technique) were included. Data collection and analysis: All included studies were checked for compliance with the Core Outcome Set–STAndards for Reporting. Information about population, setting, method and outcomes was extracted. Main results: Nineteen completed studies and thirty-nine ongoing studies were included. The number of outcomes included in various COS ranged from 6 to 48. Most COS were for conditions related to physical complications during pregnancy. No COS were identified for perinatal mental health. Conclusion: This review discloses a growing number of COS within the field of pregnancy and childbirth. Many of the completed studies follow the proposed reporting. However, several of the COS included a large number of outcomes. There is a need to consider the number of outcomes which may be included in a COS while retaining its applicability in future research. Funding This article is adapted from a report undertaken by the SBU, who provided funding for the study. Keywords: Childbirth, Core outcome set, Maternal health, Obstetric care, Pregnancy

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Practice guideline recommendations summary: Treatment of tics in people with Tourette syndrome and chronic tic disorders

Neurology ◽

10.1212/wnl.0000000000007466 ◽

2019 ◽

Vol 92 (19) ◽

pp. 896-906 ◽

Cited By ~ 55

Author(s):

Tamara Pringsheim ◽

Michael S. Okun ◽

Kirsten Müller-Vahl ◽

Davide Martino ◽

Joseph Jankovic ◽

...

Keyword(s):

Systematic Review ◽

Tourette Syndrome ◽

Treatment Options ◽

Tic Disorders ◽

Future Research ◽

Comorbid Disorders ◽

Institute Of Medicine ◽

Patient Representatives ◽

History Of ◽

Chronic Tic Disorders

ObjectiveTo make recommendations on the assessment and management of tics in people with Tourette syndrome and chronic tic disorders.MethodsA multidisciplinary panel consisting of 9 physicians, 2 psychologists, and 2 patient representatives developed practice recommendations, integrating findings from a systematic review and following an Institute of Medicine–compliant process to ensure transparency and patient engagement. Recommendations were supported by structured rationales, integrating evidence from the systematic review, related evidence, principles of care, and inferences from evidence.ResultsForty-six recommendations were made regarding the assessment and management of tics in individuals with Tourette syndrome and chronic tic disorders. These include counseling recommendations on the natural history of tic disorders, psychoeducation for teachers and peers, assessment for comorbid disorders, and periodic reassessment of the need for ongoing therapy. Treatment options should be individualized, and the choice should be the result of a collaborative decision among patient, caregiver, and clinician, during which the benefits and harms of individual treatments as well as the presence of comorbid disorders are considered. Treatment options include watchful waiting, the Comprehensive Behavioral Intervention for Tics, and medication; recommendations are provided on how to offer and monitor these therapies. Recommendations on the assessment for and use of deep brain stimulation in adults with severe, treatment-refractory tics are provided as well as suggestions for future research.

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Maintenance Therapy with Nebulizers in Patients with Stable COPD: Need for Reevaluation

Pulmonary Therapy ◽

10.1007/s41030-020-00120-x ◽

2020 ◽

Vol 6 (2) ◽

pp. 177-192

Author(s):

Paul D. Terry ◽

Rajiv Dhand

Keyword(s):

Quality Of Life ◽

Systematic Review ◽

Maintenance Therapy ◽

Symptom Relief ◽

Relative Effectiveness ◽

Future Research ◽

Inhalation Technique ◽

Inhalation Device ◽

Satisfaction With Treatment

AbstractPatients with stable COPD rely heavily on inhaled bronchodilators and corticosteroids to control symptoms, maximize quality of life, and avoid exacerbations and costly hospitalizations. These drugs are typically delivered by hand-held inhalers or nebulizers. The majority of patients are prescribed inhalers due to their perceived convenience, portability, and lower cost, relative to nebulizers. Unfortunately, poor inhaler technique compromises symptom relief in most of these patients. In contrast to one or two puffs through an inhaler, nebulizers deliver a drug over many breaths, through tidal breathing, and hence are more forgiving to poor inhalation technique. To what extent susceptibility to errors in their use may influence the relative effectiveness of these two types of inhalation device has received little attention in COPD research. In 2005, a systematic review of the literature concluded that nebulizers and inhalers are equally effective in patients who are adequately trained to use their inhalation device. This conclusion was based on two small clinical trials that only examined objective measures of lung function. Since then, additional studies have found that maintenance therapy administered by nebulizers could improve patients’ reported feelings of symptom relief, quality of life, and satisfaction with treatment, compared to therapy administered by inhalers. Because it has been 15 years since the publication of the systematic review, in this article we summarize the results of studies that compared the effectiveness of inhalers with that of nebulizers in patients with stable COPD and discuss their implications for clinical practice and need for future research.

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Conceptualising paediatric health disparities: a metanarrative systematic review and unified conceptual framework

BMJ Open ◽

10.1136/bmjopen-2016-015456 ◽

2017 ◽

Vol 7 (8) ◽

pp. e015456 ◽

Cited By ~ 4

Author(s):

Jennifer L Ridgeway ◽

Zhen Wang ◽

Lila J Finney Rutten ◽

Michelle van Ryn ◽

Joan M Griffin ◽

...

Keyword(s):

Systematic Review ◽

Health Disparities ◽

Child Health ◽

Conceptual Framework ◽

Explanatory Models ◽

Individual Characteristics ◽

Future Research ◽

Cochrane Central Register ◽

Adult Health ◽

Ovid Medline

ObjectiveThere exists a paucity of work in the development and testing of theoretical models specific to childhood health disparities even though they have been linked to the prevalence of adult health disparities including high rates of chronic disease. We conducted a systematic review and thematic analysis of existing models of health disparities specific to children to inform development of a unified conceptual framework.MethodsWe systematically reviewed articles reporting theoretical or explanatory models of disparities on a range of outcomes related to child health. We searched Ovid Medline In-Process & Other Non-Indexed Citations, Ovid MEDLINE, Ovid Embase, Ovid Cochrane Central Register of Controlled Trials, Ovid Cochrane Database of Systematic Reviews, and Scopus (database inception to 9 July 2015). A metanarrative approach guided the analysis process.ResultsA total of 48 studies presenting 48 models were included. This systematic review found multiple models but no consensus on one approach. However, we did discover a fair amount of overlap, such that the 48 models reviewed converged into the unified conceptual framework. The majority of models included factors in three domains: individual characteristics and behaviours (88%), healthcare providers and systems (63%), and environment/community (56%), . Only 38% of models included factors in the health and public policies domain.ConclusionsA disease-agnostic unified conceptual framework may inform integration of existing knowledge of child health disparities and guide future research. This multilevel framework can focus attention among clinical, basic and social science research on the relationships between policy, social factors, health systems and the physical environment that impact children's health outcomes.

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