Systematic Review: Surgery for Patients with Metastatic Melanoma during Active Treatment with Ipilimumab

2014 ◽  
Vol 80 (8) ◽  
pp. 805-810 ◽  
Author(s):  
Justin J. Baker ◽  
Karyn B. Stitzenberg ◽  
Frances A. Collichio ◽  
Michael O. Meyers ◽  
David W. Ollila
Keyword(s):  
Systematic Review ◽  
Foreign Language ◽  
Cutaneous Melanoma ◽  
Surgical Intervention ◽  
Stage Iv ◽  
Limited Data ◽  
Inclusion Criteria ◽  
Search Terms ◽  
Institutional Experience ◽  
Stage Iv Melanoma

Studies of ipilimumab have shown improved overall survival in patients with metastatic cutaneous melanoma. As a result, use of ipilimumab in patients with Stage IV melanoma is rapidly increasing. Patients with Stage IV melanoma often require urgent operations for complications from metastases, but little is known about the safety of surgical intervention for patients receiving ipilimumab. We performed a systematic review of the literature using PubMed. Our search terms were melanoma and ipilimumab. We excluded foreign language articles, review articles, and those not addressing cutaneous melanoma. We identified 194 publications matching the search criteria. Only six of those met the inclusion criteria. In these six publications, seven patients who had undergone surgical intervention during treatment with ipilimumab were described. There were no documented surgical complications. We reviewed our institutional experience and identified an additional three patients. No postoperative complications could be attributed directly to ipilimumab. There are limited data on the safety of surgical intervention during treatment with ipilimumab. Preliminary reports suggest there is no reason to withhold or delay surgery for patients receiving ipilimumab therapy.

Explanatory Theories of Intimate Partner Homicide Perpetration: A Systematic Review

2020 ◽  
pp. 152483802095380
Author(s):  
Laurie M. Graham ◽  
Rebecca J. Macy ◽  
Cynthia F. Rizo ◽  
Sandra L. Martin
Keyword(s):  
Systematic Review ◽  
Ecological Model ◽  
Intimate Partner ◽  
Future Research ◽  
Intimate Partner Homicide ◽  
Inclusion Criteria ◽  
Search Terms ◽  
Social Ecological ◽  
Theoretical Perspectives ◽  
The Social

Theories play an important role in guiding intimate partner homicide (IPH) prevention research and practice. This study is the first systematic review of theories employed to explain why someone might kill their intimate partner. This review used rigorous methods to locate and synthesize literature that described explanatory theories of IPH perpetration. Using set search terms, we systematically searched 15 databases and repositories for theory-focused documents (i.e., theory papers or analyses) published in English from 2003 to 2018. Eighteen documents met these inclusion criteria and identified 22 individual theories that seek to explain why people might kill their intimate partners. These theories fell within four broader theoretical perspectives: feminist, evolutionary, sociological/criminological, and combined. Key tenets and focal populations of these 22 theories were identified and organized into a compendium of explanatory theories of IPH perpetration. Potential strengths and limitations of each of the four perspectives were described. Review findings underscored the likely importance of addressing gender as well as risk and protective factors at all levels of the social ecological model in efforts to understand IPH perpetration. The review findings highlighted the need for both integrated theories and a broader conceptual organizing framework to guide work aimed at IPH perpetration prevention to leverage the strengths of disparate theoretical perspectives. With the goal of informing future research, a preliminary iteration of such a framework is presented.

Evidence for the treatment of moderate depression: a systematic review

2017 ◽  
Vol 34 (3) ◽  
pp. 197-204 ◽  
Author(s):  
D. Aherne ◽  
A. Fitzgerald ◽  
C. Aherne ◽  
N. Fitzgerald ◽  
M. Slattery ◽  
...  
Keyword(s):  
Systematic Review ◽  
Depressive Disorders ◽  
Controlled Trial ◽  
Combined Treatment ◽  
Antidepressant Medication ◽  
Inclusion Criteria ◽  
Randomized Controlled ◽  
Search Terms ◽  
Moderate Depression ◽  
Different Levels

ObjectivesThis study aims to investigate existing evidence for the effectiveness of psychological treatments and/or antidepressant medication as a treatment for those diagnosed with moderate levels of depression.MethodsA PRISMA systematic review of articles using electronic research databases (2000–2014) was conducted to identify studies investigating the effectiveness of psychotherapy and/or medication as a treatment for people with moderate levels of depression. Search terms included moderate depression, psychotherapy and/or medication, depressive disorders, antidepressants, psychotherapy, mental health services, and randomized-controlled trial (RCT). The included studies were then assessed, extracted, and synthesised.ResultsA total of 14 studies met the inclusion criteria (11 RCTs and three additional studies) for this review. The findings of the systematic review indicate that there is limited evidence available specific to the treatment of moderate depression and that this research seems to suggest that psychotherapy or combined treatment has a beneficial effect.ConclusionsGiven that depression is one of the biggest challenges the world faces at present, further research is required to examine the effectiveness of treatment for different levels of depression severity.

scholarly journals Pain neuroscience education on YouTube: a systematic review

2018 ◽  
Author(s):  
Lauren C. Heathcote ◽  
Joshua W. Pate ◽  
Anna L. Park ◽  
Hayley B. Leake ◽  
G. Lorimer Moseley ◽  
...  
Keyword(s):  
Systematic Review ◽  
Target Concept ◽  
Inclusion Criteria ◽  
Pain Education ◽  
Related Information ◽  
Research Institution ◽  
Search Terms ◽  
Neuroscience Education ◽  
Health Related ◽  
Youtube Videos

AbstractObjectivesThe Internet in general, and YouTube in particular, is now one of the most popular sources of health-related information. Pain neuroscience education has become a primary tool for managing persistent pain, based in part on the discovery that information about pain can change pain. Our objective was to examine the availability, characteristics, and content of YouTube videos providing pain neuroscience education.MethodsWe conducted a systematic review of videos on YouTube using the search terms “pain education”, “what is pain”, and “pain brain” in January 2018. Videos were included if they were in English, were under 10 minutes long, and included information on the neuroscience of pain. Videos were coded for i) descriptive characteristics (e.g., number of views, duration on YouTube), ii) source and style, iii) whether or not they addressed seven pre-determined target concepts of pain neuroscience education (e.g., ‘Pain is not an accurate marker of tissue state’), and iv) how engaging they were.ResultsWe found 106 unique videos that met the inclusion criteria. The videos ranged from having four views to over five million views (Mdn = 1163 views), with the three most highly viewed videos accounting for 75% of the total views. Animated videos were much more highly viewed than non-animated videos. Only a small number of videos had been posted by a clearly-identifiable reputable source such as an academic or medical research institution (10%), although a number of videos were posted by healthcare professionals and professional medical societies. For a small number of videos (7%), the source was unclear. We found 17 videos that addressed at least one target concept of pain neuroscience science education, only nine of which were considered to be engaging. The target concept ‘Pain is a brain output’ was considered to be well addressed by the most videos (N = 11), followed by ‘Pain is a protector’ (N = 10). We found only one video that adequately addressed all seven target concepts of pain neuroscience education.DiscussionYouTube contains a variety of videos that practitioners, patients, and families may view to access pain neuroscience education information. A small portion of these videos addressed one or more target concepts of pain neuroscience education in an engaging manner. It is yet to be determined to what extent patients are able to learn information from these videos, to what extent the videos promote behavior change, and thus to what extent the videos may be useful for clinical practice.

scholarly journals SARS-CoV-2 (COVID-19): What Do We Know About Children? A Systematic Review

2020 ◽  
Vol 71 (9) ◽  
pp. 2469-2479 ◽  
Author(s):  
Nisha S Mehta ◽  
Oliver T Mytton ◽  
Edward W S Mullins ◽  
Tom A Fowler ◽  
Catherine L Falconer ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Outcomes ◽  
Epidemiological Studies ◽  
Asymptomatic Infection ◽  
Medical Attention ◽  
Limited Data ◽  
Search Terms ◽  
Case Rate ◽  
Pediatric Populations ◽  
Few Data

Abstract Background Few pediatric cases of coronavirus disease 2019 (COVID-19) have been reported and we know little about the epidemiology in children, although more is known about other coronaviruses. We aimed to understand the infection rate, clinical presentation, clinical outcomes, and transmission dynamics for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), in order to inform clinical and public health measures. Methods We undertook a rapid systematic review and narrative synthesis of all literature relating to SARS-CoV-2 in pediatric populations. The search terms also included SARS-CoV and MERS-CoV. We searched 3 databases and the COVID-19 resource centers of 11 major journals and publishers. English abstracts of Chinese-language papers were included. Data were extracted and narrative syntheses conducted. Results Twenty-four studies relating to COVID-19 were included in the review. Children appear to be less affected by COVID-19 than adults by observed rate of cases in large epidemiological studies. Limited data on attack rate indicate that children are just as susceptible to infection. Data on clinical outcomes are scarce but include several reports of asymptomatic infection and a milder course of disease in young children, although radiological abnormalities are noted. Severe cases are not reported in detail and there are few data relating to transmission. Conclusions Children appear to have a low observed case rate of COVID-19 but may have rates similar to adults of infection with SARS-CoV-2. This discrepancy may be because children are asymptomatic or too mildly infected to draw medical attention and be tested and counted in observed cases of COVID-19.

A systematic review of the incidence of venous thromboembolism (VTE) and effectiveness of prophylaxis in patients with multiple myeloma (MM) receiving thalidomide

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 9056-9056
Author(s):  
C. M. Wu ◽  
A. Y. Lee
Keyword(s):  
Systematic Review ◽  
Low Dose ◽  
Low Molecular Weight ◽  
Limited Data ◽  
Inclusion Criteria ◽  
Control Groups ◽  
Randomized Controlled ◽  
Dose Warfarin ◽  
Routine Prophylaxis ◽  
Level I

9056 Background: Thalidomide (T) is effective for treating MM but is associated with an increased incidence of VTE, especially when combined with other agents. Consequently, prophylaxis in patients receiving T-containing regimens has been recommended. However, the true risk of VTE is uncertain and the effectiveness of prophylaxis has not been established. We performed a systematic review to determine the incidence of VTE and the effect of prophylaxis in MM patients receiving T-containing regimens. Methods: MEDLINE and EMBASE were searched from 1966 to 11/16/2006. Only randomized controlled trials (RCT) and prospective cohort studies (PC) were included. Studies evaluating post-transplant maintenance therapy were excluded. Both authors independently screened and reviewed identified publications, and extracted data of pre-specified variables. Incidence estimates were calculated as proportions along with 95% CI. Results: 363 papers were identified but only 80 were relevant and reviewed. 45 studies (6 RCT and 39 PC) involving 1,886 patients receiving T-containing regimens met inclusion criteria. 9 studies clearly stated objective testing was used to confirm a diagnosis of VTE. The incidence of VTE is summarized in the table . We found 12 trials that used prophylaxis. None included appropriate control groups to allow assessment of effectiveness. Based on limited data, the incidences of VTE with prophylaxis were: ASA 13.9% (95% CI 9.1–19.9%), fixed low- dose warfarin 21.9% (95% CI 16.9–27.5%), therapeutic-dose warfarin 0% (95% CI 0–5.5%), and low molecular weight heparin 13.3% (95% CI 10.5- 16.6%). Conclusions: The incidence of VTE in MM patients receiving T-containing regimens ranges from 3% to 22%, depending on the patient type and agents used. Given the lack of level I/II evidence, recommendation for routine prophylaxis for patients receiving T- containing regimens is premature. A safe and effective antithrombotic regimen has yet to be identified. [Table: see text] No significant financial relationships to disclose.

Role of thermography in the assessment of temporomandibular disorders and other musculoskeletal conditions: A systematic review

2021 ◽  
pp. 095441192110236
Author(s):  
Andre Moreira ◽  
Ricardo Batista ◽  
Susana Oliveira ◽  
Catarina Aguiar Branco ◽  
Joaquim Mendes ◽  
...  
Keyword(s):  
Systematic Review ◽  
Infrared Thermography ◽  
Temporomandibular Disorders ◽  
Infrared Imaging ◽  
Assessment Method ◽  
Cochrane Library ◽  
Inclusion Criteria ◽  
Search Terms ◽  
Reliable Assessment

The aim of this review was to evaluate whether thermal imaging may constitute a reliable assessment method of musculoskeletal and temporomandibular disorders (TMD/MSD). A systematic review was conducted in the Pubmed, Scopus, Cochrane library, Web of Science, and Lilacs databases. The search terms were “musculoskeletal disorders,”“temporomandibular disorders,”“infrared thermography,”“thermography,” and “infrared imaging.” The inclusion criteria were: studies published between January 1985 and January 2021, performed in humans, with sample size equal or greater than 20 patients, written in English, Portuguese, French and/or Spanish, and full text available. The exclusion criteria were: systematic reviews, case studies, and/or studies focused on pathologies beyond the review’s domain. The risk of bias was evaluated using CASP 2018. A total of 2032 articles were retrieved. Of these, 25 studies met the inclusion criteria and were included to withdraw the following information: title, type of study, first author and year of publication, objective, number of participants, comparisons, and principal conclusions. No RCT were found. Despite some disparity, points of convergence among the majority of authors could be found. In general, healthy individuals show subtle thermal differences between contralateral homolog areas. Concerning orofacial structures, unilateral symptomatic individuals may show thermal differences equal or greater than 0.4°C. Infrared thermography accuracy in diagnosing TMD/MSD is still considered low to moderate. Despite some limitations, IRT might constitute a valuable supporting diagnostic tool in the medical field of TMD and MSD.

scholarly journals Drug resistance and molecular epidemiology of Mycobacterium tuberculosis in Mexico: A systematic review

2014 ◽  
Vol 56 (1) ◽  
pp. 63 ◽  
Author(s):  
Samantha Flores-Treviño ◽  
Soraya Mendoza-Olazarán ◽  
Elvira Garza-González
Keyword(s):  
Systematic Review ◽  
Genetic Diversity ◽  
Drug Resistance ◽  
Mycobacterium Tuberculosis ◽  
Resistance Mutation ◽  
Beijing Genotype ◽  
Inclusion Criteria ◽  
Novel Mutations ◽  
Search Terms ◽  
Frequent Mutations

 Objective. To compare drug resistance (DR) rates and genetic diversity of Mycobacterium tuberculosis strains from different states of Mexico. Materials and methods. A systematic review of English and Spanish-language articles using MEDLINE and Google Scholar. Search terms included Mycobacterium tuberculosis, Mexico, resistance, mutation and epidemiology. Results. Fifteen studies for phenotypic DR rates (n=2 694), twelve studies for genotypic DR (n=748) and eleven studies for genetic diversity (n=2 044) met our inclusion criteria. Mean DR and multidrug resistance (MDR) rates were 37.5% and 20.6%, respectively. The most frequent mutations were rpoB531 (53.1%), katG315 (50.6%), embB306 (32.1%), rpsL43 (14.6%) and pncA359 (16.7%) in DR strains. Novel mutations were found. Predominant shared types were SIT53 (T1, n=188, 3.9%), SIT119 (X1, n=125, 6.9%), SIT19 (EAI2-Manila, n=80, 6.3%) and SIT42 (LAM9, n=77, 3.0%). SIT1 Beijing genotype has been reported in six states from Mexico. Conclusions. DR and MDR rates continue to increase. Genetic diversity of M. tuberculosis strains in Mexico is high. Reports of Beijing strains are increasing.

scholarly journals The role of topical steroids in the treatment of primary pruritus ani: a systematic review

2018 ◽  
Vol 5 (10) ◽  
pp. 3198
Author(s):  
Mario Trejo-Ávila ◽  
Omar Vergara-Fernández
Keyword(s):  
Systematic Review ◽  
Topical Steroid ◽  
Similar Proportion ◽  
Topical Steroids ◽  
Primary Therapy ◽  
Inclusion Criteria ◽  
Pruritus Ani ◽  
Duration Of Symptoms ◽  
Search Terms

Background: Steroids can alleviate symptoms long enough for the patient to stop the compulsive pruritus-scratch cycle and allow for healing excoriated perianal skin, owing to potent anti-inflammatory and anti-proliferative effects. This systematic review was designed to evaluate the use of topical steroids for the treatment of primary pruritus ani.Methods: Studies were retrieved after searching the electronic databases Medline, Google Scholar, and Co-chrane Central. The search terms, pruritus ani, anal itching, idiopathic pruritus ani, primary pruritus ani and topical steroids were used. Outcomes were efficacy in reduction of pruritus and side-effects.Results: A total of 7 studies met our inclusion criteria accounting for 181 total of cases of primary pruritus ani treated with topical steroids between 1982 and 2007. On regard of the 181 cases, mean age of patients ranged from 35.4 to 49.5 years old, and similar proportion of males (51.6%) and females (48.4%) was found. Mean duration of symptoms (pruritus ani) varies widely among the studies, with a minimum 5.2 weeks to a maximum 6.5 years. The majority of studies employed hydrocortisone ointment at different concentrations (0.25% and 1%) as the primary therapy. On regard of the overall effectiveness of topical steroid therapy in patients with primary pruritus ani, it ranges between 73.9% to 100%. Few or no side effects were reported in the studies.Conclusions: This systematic review found a lack of high-quality studies on the efficacy of topical steroids in the treatment of primary pruritus ani.

Improved Survival with Immunotherapy but Lack of Synergistic Effect with Radiation for Stage IV Melanoma of the Head and Neck

2019 ◽  
Vol 85 (10) ◽  
pp. 1118-1124
Author(s):  
Blake Babcock ◽  
Medora Rodrigues ◽  
Donovan Kearns ◽  
Naveenraj Solomon ◽  
Mark E. Reeves ◽  
...  
Keyword(s):  
Overall Survival ◽  
Synergistic Effect ◽  
Head And Neck ◽  
Cutaneous Melanoma ◽  
Survival Benefit ◽  
Retrospective Studies ◽  
Cox Regression ◽  
Stage Iv ◽  
National Cancer Database ◽  
Stage Iv Melanoma

Prospective randomized studies have demonstrated a survival benefit of immunotherapy in stage IV cutaneous melanoma. Some retrospective studies have hypothesized a synergistic effect of radiation and immunotherapy. Our objective was to identify whether there is a survival benefit for patients treated with radiation and immunotherapy in stage IV cutaneous melanoma of the head and neck (CMHN). The National Cancer Database was used to identify patients with stage IV CMHN between 2012 and 2014. These patients were stratified based on receipt of radiation and immunotherapy. Adjusted Cox regression was used to analyze overall survival. A total of 542 patients were identified with stage IV CMHN, of whom 153 (28%) patients received immunotherapy. Receipt of immunotherapy (hazard ratio [HR] 0.69, P = 0.02) and negative LNs (HR 0.50, P = 0.002) were independently associated with improved survival, whereas radiation conferred no survival benefit (HR 1.17, P = 0.26). Patients who received immunotherapy without radiation were associated with significantly improved survival compared with those who received immunotherapy with radiation ( P < 0.0001). However, of patients who received radiation, the addition of immunotherapy did not seem to improve survival ( P = 0.979). In stage IV CMHN, immunotherapy confers a 32 per cent survival benefit. The use of immunotherapy in patients who require radiation, however, is not associated with improved survival.

scholarly journals Management of sigmoid volvulus using percutaneous endoscopic colostomy

2020 ◽  
Vol 102 (9) ◽  
pp. 654-662
Author(s):  
S Jackson ◽  
MO Hamed ◽  
J Shabbir
Keyword(s):  
Systematic Review ◽  
Observational Studies ◽  
Case Reports ◽  
Sigmoid Volvulus ◽  
Major Surgery ◽  
Inclusion Criteria ◽  
Search Terms ◽  
Post Procedure ◽  
Tube Removal

Introduction The aim of this systematic review was to appraise the current literature on the use of percutaneous endoscopic colostomy (PEC) as an alternative to major surgery and endoscopic decompression alone for treating sigmoid volvulus in frail, comorbid patients. Methods A systematic literature search of literature published between April 2000 and January 2017 was carried out using the MEDLINE®, Embase™ and CINAHL® (Cumulative Index to Nursing and Allied Health Literature) databases. The search terms were “percutaneous endoscopic colostomy”, “PEC”, “sigmoidopexy”, “sigmoidostomy” and “sigmoid volvulus”. The studies identified were screened and those that did not fulfil the inclusion criteria were excluded. Findings Seven observational studies and seven case reports (comprising eighty-one patients) were found to match our inclusion criteria. All patients had recurrent sigmoid volvulus and were treated with PEC either with a single PEC tube or with two PEC tubes inserted. Sigmoid volvulus recurred in 10 of the 81 patients; 3 of these individuals developed recurrence with PEC tubes in situ and 7 following tube removal. There were seven deaths after the procedure. The most frequent morbidity associated with PEC tube insertion was site infection (n=6). Conclusions Our systematic review highlights the use of PEC as an alternative in managing recurrent sigmoid volvulus in frail, comorbid patients unfit for or refusing surgery, with the best outcomes seen in those patients where two PEC tubes were inserted and remained in situ indefinitely. Further studies are needed to improve the safety and efficacy of the procedure as well as post-procedure care.

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