Assessment and Treatment of Pain during In-Office Otolaryngology Procedures: A Systematic Review

2019 ◽  
Vol 161 (2) ◽  
pp. 218-226 ◽  
Author(s):  
Ethan Frank ◽  
Bradley Carlson ◽  
Amanda Hu ◽  
Derrick R. Randall ◽  
Shanalee Tamares ◽  
...  
Keyword(s):  
Systematic Review ◽  
Pain Assessment ◽  
Pain Control ◽  
English Language ◽  
Current Data ◽  
Risk Of Bias ◽  
Control Measures ◽  
Qualitative Assessment ◽  
Language Studies ◽  
Office Procedures

ObjectiveTo qualitatively assess practices of periprocedural pain assessment and control and to evaluate the effectiveness of interventions for pain during in-office procedures reported in the otolaryngology literature through a systematic review.Data SourcesPubMed, CINAHL, and Web of Science searches from inception to 2018.Review MethodsEnglish-language studies reporting qualitative or quantitative data for periprocedural pain assessment in adult patients undergoing in-office otolaryngology procedures were included. Risk of bias was assessed via the Cochrane Risk of Bias or Cochrane Risk of Bias in Non-Randomized Studies of Interventions tools as appropriate. Two reviewers screened all articles. Bias was assessed by 3 reviewers.ResultsEighty-six studies describing 32 types of procedures met inclusion criteria. Study quality and risk of bias ranged from good to serious but did not affect assessed outcomes. Validated methods of pain assessment were used by only 45% of studies. The most commonly used pain assessment was patient tolerance, or ability to simply complete a procedure. Only 5.8% of studies elicited patients’ baseline pain levels prior to procedures, and a qualitative assessment of pain was done in merely 3.5%. Eleven unique pain control regimens were described in the literature, with 8% of studies failing to report method of pain control.ConclusionMany reports of measures and management of pain for in-office procedures exist but few employ validated measures, few are standardized, and current data do not support any specific pain control measures over others. Significant opportunity remains to investigate methods for improving patient pain and tolerance of in-office procedures.

scholarly journals Prevalence of retinopathy in prediabetes: protocol for a systematic review and meta-analysis

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e040997
Author(s):  
Varo Kirthi ◽  
Paul Nderitu ◽  
Uazman Alam ◽  
Jennifer Evans ◽  
Sarah Nevitt ◽  
...  
Keyword(s):  
Systematic Review ◽  
Diabetic Retinopathy ◽  
Data Extraction ◽  
Meta Analysis ◽  
International Diabetes Federation ◽  
Current Data ◽  
Risk Of Bias ◽  
Fundus Photography ◽  
Primary Data ◽  
Cochrane Library

IntroductionThere is growing evidence of a higher than expected prevalence of retinopathy in prediabetes. This paper presents the protocol of a systematic review and meta-analysis of retinopathy in prediabetes. The aim of the review is to estimate the prevalence of retinopathy in prediabetes and to summarise the current data.Methods and analysisThis protocol is developed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) guidelines. A comprehensive electronic bibliographic search will be conducted in MEDLINE, EMBASE, Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Google Scholar and the Cochrane Library. Eligible studies will report prevalence data for retinopathy on fundus photography in adults with prediabetes. No time restrictions will be placed on the date of publication. Screening for eligible studies and data extraction will be conducted by two reviewers independently, using predefined inclusion criteria and prepiloted data extraction forms. Disagreements between the reviewers will be resolved by discussion, and if required, a third (senior) reviewer will arbitrate.The primary outcome is the prevalence of any standard features of diabetic retinopathy (DR) on fundus photography, as per International Clinical Diabetic Retinopathy Severity Scale (ICDRSS) classification. Secondary outcomes are the prevalence of (1) any retinal microvascular abnormalities on fundus photography that are not standard features of DR as per ICDRSS classification and (2) any macular microvascular abnormalities on fundus photography, including but not limited to the presence of macular exudates, microaneurysms and haemorrhages. Risk of bias for included studies will be assessed using a validated risk of bias tool for prevalence studies. Pooled estimates for the prespecified outcomes of interest will be calculated using random effects meta-analytic techniques. Heterogeneity will be assessed using the I2 statistic.Ethics and disseminationEthical approval is not required as this is a protocol for a systematic review and no primary data are to be collected. Findings will be disseminated through peer-reviewed publications and presentations at national and international meetings including Diabetes UK, European Association for the Study of Diabetes, American Diabetes Association and International Diabetes Federation conferences.PROSPERO registration numberCRD42020184820.

scholarly journals Impacts on employment, finances, and lifestyle for working age people facing an expected premature death: A systematic review

2017 ◽  
Vol 16 (3) ◽  
pp. 347-364 ◽  
Author(s):  
Slavica Kochovska ◽  
Tim Luckett ◽  
Meera Agar ◽  
Jane L. Phillips
Keyword(s):  
Systematic Review ◽  
English Language ◽  
Financial Burden ◽  
Premature Death ◽  
Well Being ◽  
Family Responsibilities ◽  
Language Studies ◽  
Working Age ◽  
Nonmalignant Disease ◽  
The Impact

ABSTRACTObjective:The working ages (25–65 years) are a period when most people have significant work, financial, and family responsibilities. A small proportion of working age people will face an expected premature death from cancer or other life-limiting illness. Understanding the impact an expected premature death has on this population is important for informing support. The current study set out to summarize research describing the effects that facing an expected premature death has on employment, financial, and lifestyle of working age people and their families.Method:A systematic review using narrative synthesis approach. Four electronic databases were searched in July 2016 for peer-reviewed, English language studies focusing on the financial, employment, and lifestyle concerns of working age adults living with an advanced life-limiting illness and/or their carers and/or children.Results:Fifteen quantitative and 12 qualitative studies were included. Two-thirds (n = 18) were focused on cancer. All studies identified adverse effects on workforce participation, finances, and lifestyle. Many patients were forced to work less or give up work/retire early because of symptoms and reduced functioning. In addition to treatment costs, patients and families were also faced with child care, travel, and home/car modification costs. Being younger was associated with greater employment and financial burden, whereas having children was associated with lower functional well-being. Changes in family roles were identified as challenging regardless of diagnosis, whereas maintaining normalcy and creating stability was seen as a priority by parents with advanced cancer. This review is limited by the smaller number of studies focussing on the needs of working age people with nonmalignant disease.Significance of results:Working age people facing an expected premature death and their families have significant unmet financial, employment, and lifestyle needs. Comparing and contrasting their severity, timing, and priority for people with nonmalignant conditions is required to better understand their unique needs.

Reduction of ileocolic intussusception under sedation or anaesthesia: a systematic review of complications

2021 ◽  
pp. archdischild-2021-322706
Author(s):  
Moran Gal ◽  
Shirly Gamsu ◽  
Ron Jacob ◽  
Daniel M Cohen ◽  
Itai Shavit
Keyword(s):  
Systematic Review ◽  
Intestinal Perforation ◽  
English Language ◽  
Data Extraction ◽  
Current Data ◽  
Pulmonary Aspiration ◽  
Ileocolic Intussusception ◽  
Newcastle Ottawa Scale ◽  
Permanent Neurological Deficit ◽  
Ottawa Scale

BackgroundDespite the increased use of sedation in children undergoing stressful procedures, reduction of ileocolic intussusception (RII) is usually performed on awake children without any form of sedation.ObjectiveTo evaluate the incidence of severe complications of RII under sedation or anaesthesia.DesignA systematic review including English language original articles of any date.PatientsChildren undergoing RII (pneumatic or hydrostatic) under sedation or anaesthesia.Data sourcesOvid Embase, Scopus, PubMed, the Cochrane Database of Systematic Reviews and the internet search engine Google Scholar.Data extractionThree authors independently reviewed each article for eligibility. The Newcastle-Ottawa Scale was used to assess the quality of included studies.Main outcome measuresThe primary outcome was the incidence of intestinal perforation during RII. The secondary outcomes were the incidence of sentinel adverse events defined as death, cardiopulmonary resuscitation, permanent neurological deficit and pulmonary aspiration syndrome.ResultsThe search yielded 368 articles. Nine studies with 1391 cases were included in the analysis. Of the nine studies, six had a score of ≤6 stars in the Newcastle-Ottawa Scale assessment, indicating low-to-moderate quality. Propofol-based sedation was used in 849 (59.2%) cases; 5 (0.6%) had intestinal perforation. Intestinal perforation was not reported in patients who were sedated with other sedatives. One patient had pulmonary aspiration syndrome.ConclusionsAlthough caution remains warranted, current data suggest that the incidence of severe complications due to RII under sedation or anaesthesia is low. Due to the lack of prospective data, it is difficult to ascertain the exact incidence of severe complications.

Thrombolytic Salvage of the Frostbitten Upper Extremity: A Systematic Review

Hand ◽  
2020 ◽  
pp. 155894472094006
Author(s):  
James Drinane ◽  
Adee J. Heiman ◽  
Joseph A. Ricci ◽  
Ashit Patel
Keyword(s):  
Systematic Review ◽  
Thrombolytic Therapy ◽  
Upper Extremity ◽  
Animal Studies ◽  
English Language ◽  
Case Series ◽  
Current Data ◽  
Ischemic Tissue ◽  
Promising Treatment ◽  
Salvage Rate

Background Vascular thrombosis secondary to frostbite can lead to ischemic tissue damage in severe cases. Threatened extremities may be salvaged with thrombolytics to restore perfusion; however, current data are limited to single institution case series. The authors performed a systematic review to determine the efficacy of thrombolytic therapy in treating upper extremity frostbite. Methods PubMed, EBSCO, and Google Scholar were queried using the keywords “thrombolytics,” “frostbite,” “fibrinolytics,” and “tPA.” Exclusion criteria were failure to delineate anatomic parts injured, failure to report number of limbs salvaged, animal studies, and non-English language publications. Thrombolytic therapy was defined as intraarterial (IA) or intravenous (IV) administration of tissue plasminogen activator (tPA), alteplase, urokinase, streptokinase, or any tPA derivative. Results A total of 42 studies were identified, with 13 satisfying inclusion criteria. Eight studies reported catheter-directed IA thrombolysis, four reported systemic IV administration, and 1 reported both methods. A total of 157 patients received thrombolytics. In all, 73 upper extremity digits were treated by IA route and 136 digits were treated by IV route. Overall upper extremity digit salvage rate was 59%. There was a significantly higher salvage rate in digits treated by the IA route compared to the IV route. Conclusions Thrombolytics, particularly when administered by the intra-arterial route, are emerging as a promising treatment of severe frostbite of the upper extremity, increasing digit salvage rates.

scholarly journals Chronic Diseases and Employment: Which Interventions Support the Maintenance of Work and Return to Work among Workers with Chronic Illnesses? A Systematic Review

2019 ◽  
Vol 16 (10) ◽  
pp. 1864 ◽  
Author(s):  
Soja Nazarov ◽  
Ulf Manuwald ◽  
Matilde Leonardi ◽  
Fabiola Silvaggi ◽  
Jérôme Foucaud ◽  
...  
Keyword(s):  
Systematic Review ◽  
Return To Work ◽  
Chronic Diseases ◽  
English Language ◽  
Chronic Illnesses ◽  
Language Studies ◽  
Action Project ◽  
Behavioral Therapies ◽  
Cognitive Behavioral Therapies

The increase of chronic diseases worldwide impact quality of life, cause economic and medical costs, and make it necessary to look for strategies and solutions that allow people with chronic diseases (PwCDs) to lead an active working life. As part of the CHRODIS Plus Joint European Action project, a systematic review was conducted to identify studies of interventions that support the maintenance of work and return to work (RTW) among workers with chronic illnesses. These interventions should target employees with the following conditions: diabetes, cardiovascular diseases, metabolic vascular syndrome, respiratory diseases, musculoskeletal disorders, mental disorders, and neurological disorders. An extensive search was performed in PubMed, EMBASE, and PsycINFO for English language studies. Included in this review were 15 randomized controlled trials (RCT) for adult employees (aged 18+). We found that workplace-oriented and multidisciplinary programs are the most supportive to RTW and reducing the absence due to illness. In addition, cognitive behavioral therapies achieve positive results on RTW and sick leave. Finally, coaching is effective for the self-management of chronic disease and significantly improved perceptions of working capacity and fatigue.

Epistaxis Risk Associated with Intranasal Corticosteroid Sprays: A Systematic Review and Meta-analysis

2019 ◽  
Vol 161 (1) ◽  
pp. 18-27 ◽  
Author(s):  
Eric L. Wu ◽  
William C. Harris ◽  
Casey M. Babcock ◽  
Bailin H. Alexander ◽  
Charles A. Riley ◽  
...  
Keyword(s):  
Systematic Review ◽  
Allergic Rhinitis ◽  
Relative Risk ◽  
English Language ◽  
Meta Analysis ◽  
Included Study ◽  
Pubmed Central ◽  
Intranasal Corticosteroids ◽  
Language Studies ◽  
Increased Risk

Objective Intranasal corticosteroids (INCSs) are widely utilized for the treatment of allergic rhinitis. Epistaxis is a known adverse effect of INCSs, but it is not known if the risk of epistaxis differs among INCSs. Data Sources Systematic review of primary studies identified through Medline, Embase, Web of Science, PubMed Central, and Cochrane databases. Review Methods Systematic review was conducted according to the PRISMA standard. English-language studies were queried through February 1, 2018. The search identified randomized controlled trials of INCSs for treatment of allergic rhinitis that reported incidence of epistaxis. An itemized assessment of the risk of bias was conducted for each included study, and meta-analysis was performed of the relative risk of epistaxis for each INCS. Results Of 949 identified studies, 72 met the criteria for analysis. Meta-analysis demonstrated an overall relative risk of epistaxis of 1.48 (95% CI, 1.32-1.67) for all INCSs. The INCSs associated with the highest risk of epistaxis were beclomethasone hydrofluoroalkane, fluticasone furoate, mometasone furoate, and fluticasone propionate. Beclomethasone aqueous, ciclesonide hydrofluoroalkane, and ciclesonide aqueous were associated with the lowest risk of epistaxis. Conclusions about epistaxis with use of budesonide, triamcinolone, and flunisolide are limited due to the low number of studies and high heterogeneity. Conclusions While a differential effect on epistaxis among INCS agents is not clearly demonstrated, this meta-analysis does confirm an increased risk of epistaxis for patients using INCSs as compared with placebo for treatment of allergic rhinitis.

scholarly journals Food Environmental Interventions Protocol Using Social Marketing or Incentive-Based Strategies for Improving Dietary Behaviours and Health Outcomes - Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Kimi Sawada ◽  
Yoshiko Yamamoto ◽  
Katharina da Silva Lopes ◽  
Norio Watanabe
Keyword(s):  
Systematic Review ◽  
Social Marketing ◽  
Financial Incentive ◽  
Communicable Disease ◽  
Eating Behaviour ◽  
Risk Of Bias ◽  
Qualitative Assessment ◽  
Behavioural Science ◽  
Environmental Interventions ◽  
Review Protocol

Abstract Background: In recent years, behavioural science theories such as social marketing or incentive-based food price strategies have been proposed to promote healthy and desirable eating habits potentially staving off a global increase in certain non-communicable disease (NCDs) such as obesity.This paper describes a systematic review protocol that validates the effectiveness of social marketing including financial incentive interventions in preventing unhealthy eating behaviour and diet-related NCDs.Methods: We will search online databases for interventions using randomized controlled trials (RCTs) and cluster RCTs. We will assess social marketing included financial incentive interventions in setting such as supermarkets, places of work, or school cafeterias and vending machines for all people. Two authors will read the papers independently, discuss the content, and come to a consensus on the judgment. If two authors cannot reach an agreement, they will consult with the other authors to reach a resolution. For the qualitative assessment, methodology relying on the Cochrane Collaboration Risk of Bias Tool 2 will be used to confirm the risk of bias for the included trials. Discussion: This is a protocol for a systematic review, and the main purpose of the review is to identify the effectiveness of social marketing and incentive-based approaches to increase desirable eating and consumption behaviours to prevent NCDs in communities, workplaces, and schools. Trial registration: This review protocol is registered with PROSPERO(CRD××) on〇, 〇, 2020.

scholarly journals Olfactory and gustatory dysfunction in 2019 novel coronavirus: An updated systematic review and meta-analysis

2020 ◽  
Author(s):  
Marzieh Esmaeili ◽  
Fatemeh Abdi ◽  
Gita Shafiee ◽  
Hadis Rastad ◽  
Hamid Asayesh ◽  
...  
Keyword(s):  
Systematic Review ◽  
English Language ◽  
Meta Analysis ◽  
Random Effect ◽  
Eligibility Criteria ◽  
Language Studies ◽  
Pooled Prevalence ◽  
Comprehensive Search ◽  
Novel Coronavirus

Abstract BackgroundEvidence showed that partial or complete loss of smell and taste might be a possible primary symptom of the 2019 novel coronavirus (COVID-19). This study aimed to systematically review and pool all available evidence on the olfactory and gustatory dysfunction in COVID-19 patients. MethodsIn this systematic review, a comprehensive search was carried out systematically through e-databases including PubMed, EMBASE, Scopus, and Web of Science (WoS); that was limited to English-language studies published from 2019 up to 6th May 2020. Afterward, all studies reported the taste and smell dysfunction in the COVID-19 patients were included. The quality of the studies was assessed by the Mixed Methods Appraisal Tool (MMAT). The pooled prevalence of olfactory and gustatory dysfunction was estimated using the random effects meta-analysis method.ResultsAmong 28 eligible included studies in this systematic review, finally, 22 studies met the eligibility criteria and were included in the meta-analysis. According to the random effect meta-analysis, the global pooled prevalence (95% confidence interval) of any olfactory dysfunction, anosmia, and hyposmia was 55% (40%-70%), 40% (22%-57%), and 40% (20%-61%) respectively. The pooled estimated prevalence of any gustatory dysfunction, ageusia, and dysgeusia was 41% (23%-59%), 31% (3%-59%), and 34% (19%-48%) respectively. ConclusionOlfactory and gustatory dysfunction is prevalent among COVID-19 patients. Therefore, olfactory and gustatory dysfunction seems to be part of important symptoms and notify for the diagnosis of COVID-19, especially in the early phase of the infection.

Biological Sex Differences in Depression: A Systematic Review

2018 ◽  
Vol 20 (4) ◽  
pp. 383-392 ◽  
Author(s):  
Ainitze Labaka ◽  
Olatz Goñi-Balentziaga ◽  
Andrea Lebeña ◽  
Joana Pérez-Tejada
Keyword(s):  
Systematic Review ◽  
Sex Differences ◽  
Depressive Disorder ◽  
English Language ◽  
Brain Activity ◽  
Future Research ◽  
Physiological Measures ◽  
Biological Sex ◽  
Language Studies ◽  
Biological Patterns

Depression is the leading cause of disability worldwide, and its prevalence is 2 times higher in women than in men. There is, however, a lack of data on sex-specific pathophysiology of this disorder. The purpose of this systematic review is to identify the biological sex differences found in major depressive disorder (MDD) in studies published in the last 10 years. We conducted a literature search using the Medline, PsycInfo, PubMed, and Web of Science databases, selecting English-language studies that included physiological measures compared by sex in addition to MDD. We identified 20 relevant studies, which consisted primarily of mixed methodology and samples. The reported physiological measures comprised a variety of serum biomarkers, gene mRNA expression, and brain activity. Findings suggest different biological patterns in those with MDD depending on sex. Specifically, women presented higher levels of inflammatory, neurotrophic, and serotonergic markers and a stronger correlation between levels of some inflammatory and neurotrophic factors and the severity of symptoms. This review provides information about possible different biological patterns for women and men with depressive disorder and may have important implications for treatment. Future research should include homogeneous samples; make comparisons based on sex, control sex hormone fluctuations and pharmacological treatment; and use consistent criteria for evaluating psychobiological changes in MDD.

scholarly journals Personal resilience in psychiatrists: systematic review

2019 ◽  
Vol 43 (5) ◽  
pp. 209-215 ◽  
Author(s):  
Ranjita Howard ◽  
Catherine Kirkley ◽  
Nicola Baylis
Keyword(s):  
Systematic Review ◽  
English Language ◽  
Empirical Studies ◽  
Well Being ◽  
Future Research ◽  
Factors Affecting ◽  
Language Studies ◽  
Workplace Factors ◽  
Personal Resilience ◽  
International English

Aims and methodThe concept of personal resilience is relevant to physician well-being, recruitment and retention, and to delivering compassionate patient care. This systematic review aims to explore factors affecting personal resilience among psychiatrists, in particular, those that may impair well-being and those that facilitate resilience practice. A literature search was performed of the Ovid®, Embase®, CINAHL and PsycINFO databases, using keywords to identify empirical studies involving psychiatrists that examined resilience, stress and burnout from the past 15 years.ResultsThirty-three international English language studies were included, showing that a combination of workplace, personal and non-workplace factors negatively and positively influenced well-being and resilience.Clinical implicationsGiven that workplace factors were the most commonly cited, it would appear that any resilience package that predominantly targets interventions at the workplace level would be particularly fruitful. Future research, however, needs to address the absence of a universal measurement of well-being and its moderators so that any potential interventions are better evaluated.

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