scholarly journals Management of fracture-dislocations of the little finger carpometacarpal joint: a systematic review

2018 ◽  
Vol 43 (5) ◽  
pp. 530-538 ◽  
Author(s):  
Will A. Cobb ◽  
Lewis Dingle ◽  
Raina Zarb Adami ◽  
Jeremy Rodrigues
Keyword(s):  
Systematic Review ◽  
Comparative Studies ◽  
Search Strategy ◽  
Treatment Options ◽  
Early Mobilization ◽  
Inclusion Criteria ◽  
Carpometacarpal Joint ◽  
Search Results ◽  
Fracture Dislocations ◽  
K Wires

Fracture-dislocations of the carpometacarpal joint (CMCJ) of the little ray involve dorsal subluxation of the metacarpal base and they may be associated with injury of neighbouring CMCJs. Different treatment options are described, with no clear consensus on their management. This study presents a systematic review of comparative studies describing the management of these injuries. A bespoke search strategy was applied across multiple databases. Results were screened against specified stepwise inclusion criteria and data were extracted independently by two authors with discrepancy resolution by a third. Of 437 search results, six comparative studies were identified. Comparisons included non-operative or early mobilization versus fixation K-wires or open reduction and internal fixation. Conclusions were mixed; all studies had critical or significant risks of bias (using the ROBINS-I tool) and there was heterogeneity between studies.

scholarly journals MLTI-14. A SYSTEMATIC REVIEW OF TREATMENT PARADIGMS FOR PATIENTS WITH BREAST CANCER AND ONE OR MORE BRAIN METASTASES

2019 ◽  
Vol 1 (Supplement_1) ◽  
pp. i17-i17
Author(s):  
Yosef Ellenbogen ◽  
Karanbir Brar ◽  
Nebras Warsi ◽  
Jetan Badhiwala ◽  
Alireza Mansouri
Keyword(s):  
Breast Cancer ◽  
Systematic Review ◽  
Adverse Events ◽  
Brain Metastases ◽  
Treatment Options ◽  
Inclusion Criteria ◽  
Open Label ◽  
Treatment Groups ◽  
Molecular Features ◽  
Significant Difference

Abstract BACKGROUND: Upwards of 50% of patients with advanced breast cancer are diagnosed with brain metastases (BM). Treatment options for these patients have been rapidly evolving due to increased understanding of the tumor pathophysiology and its genetic underpinnings. This systematic review of randomized controlled trials (RCTs) aims to clarify the evidence guiding the treatment of brain metastases from breast cancer. METHODS: MEDLINE, EMBASE, Cochrane Controlled Register of Trials, ClincialTrials.gov, and Web of Science were searched from inception to October 2018 for RCTs comparing treatments for breast cancer BM. We screened studies, extracted data, and assessed risk of bias independently and in duplicate. Outcomes assessed were overall survival (OS), progression-free survival (PFS), and adverse events (Grade 3+). RESULTS: Among 3188 abstracts, only 3 RCTs (N=412; mean sample size per group N=54.7) meeting inclusion criteria were identified. The studies were phase II or III open-label parallel superiority trials. Inclusion criteria among these trials consisted of age >18 with radiologic evidence of >1 BM. Exclusion criteria consisted of poor-performance functional status (ECOG >2 or KPS < 70). The treatment groups included whole-brain radiation therapy (WBRT) vs WBRT + Temozolomide, WBRT vs WBRT + Efaproxiral, and Afatinib vs Vinorelbine vs investigators’ choice (86% of these patients received WBRT or SRS prior to study enrolment). While two trials found no significant difference in OS, one trial found significant improvement in OS with Efaproxiral in addition to WBRT compared to WBRT alone (HR 0.52; 95%CI 0.332–0.816). No significant differences were found with PFS or rate of adverse events amongst treatment groups. CONCLUSION: Considering the high prevalence of breast cancer BM and our improved understanding of genomic/molecular features of these tumors, a greater number of RCTs dedicated at this disease are needed.

scholarly journals Neuropathic Pain in Acute and Subacute Neuropathies: A Systematic Review

2018 ◽  
Vol 1 (21;1) ◽  
pp. 111-120 ◽  
Author(s):  
Artemios K. Artemiadis
Keyword(s):  
Systematic Review ◽  
Neuropathic Pain ◽  
Observational Studies ◽  
Search Strategy ◽  
Diagnostic Tools ◽  
Common Symptom ◽  
Peripheral Neuropathies ◽  
Inclusion Criteria ◽  
Medline Search ◽  
Somatosensory Nervous System

Background: Neuropathic pain (NP) is a common symptom caused by lesions or diseases of the somatosensory nervous system. Acute/subacute peripheral neuropathies (APN) are rare, however can be particularly painful. Objectives: The aim of this systematic review was to estimate the incidence of NP in APN and overview the various etiologies of such neuropathies. Study Design: Systematic review. Setting: Medline search. Methods: We hand-searched Medline for observational studies published between 1995 and 2017. Results: Our search strategy identified 1,400 papers. Of these, 70 met our inclusion criteria and were included in this review. Out of a total of 2,341 patients, 1,139 patients were diagnosed with NP (pooled incidence of NP 48.7%). In Guillain-Barré syndrome (GBS), the commonest cause of APN, the pooled estimate of NP was 34.8%. Other causes of painful APN include immunemediated, vasculitic, metabolic, nutritional, toxic, paraneoplastic, and infectious. Limitations: An important limitation was that GBS accounted for the majority of patients with APN, as such the calculated incidence reflected mainly this disease entity. Another important limitation was that very few studies targeted primarily NP. Thus, it is highly likely that observational studies reporting NP were missed. Finally there could always be a publication bias due to underreporting and gray literature. Conclusions: NP is a cardinal manifestation of APN. The use of validated diagnostic tools and accepted diagnostic criteria of NP is recommended for both clinical and research purposes. Key words: Neuropathic, pain, acute, subacute, neuropathy, polyneuropathy, frequency, incidence

scholarly journals Dental Findings in Kabuki Syndrome: A Systematic Review for Dentistry

2020 ◽  
Vol 22 (2) ◽  
pp. 61-69
Author(s):  
Ricardo Barbosa-Lima ◽  
Amanda Lopes ◽  
Juliely N. F. De Moura ◽  
Sabrina N. Ribeiro ◽  
Matheus S. N. T. Cardoso
Keyword(s):  
Systematic Review ◽  
Clinical Case ◽  
Search Strategy ◽  
Case Reports ◽  
Kabuki Syndrome ◽  
Inclusion Criteria ◽  
Qualitative Synthesis ◽  
Genetic Condition ◽  
Language Data ◽  
Eleven Case

Kabuki syndrome consists in a series of congenital anomalies involving intellectual disability, hypotonia, and facial and body dysmorphism. In addition to these cardinal signs, craniofacial and dental changes are frequently observed, although they are not fully understood. Thus, the aim of this article is to present the dental findings in patients with Kabuki syndrome. This is a systematic review developed according to the PRISMA protocol. A search strategy with descriptors ("kabuki syndrome" AND "dentistry") was applied to six databases. As inclusion criteria, we selected clinical case reports that addressed dental findings in one or more patients with Kabuki syndrome between 1999 and 2019, without restrictions regarding gender, age or language. Data collection in all databases was performed by a calibrated evaluator and titles, abstracts and full-text studies were systematically analyzed. Eleven case reports that fit the proposed inclusion criteria were found. After the qualitative synthesis, teeth absence or agenesis were the most reported findings, being observed by nine authors. Less frequent dental findings in patients with this syndrome are taurodontism, microdontia, fusion, gemination and conical or screwdriver-shaped teeth. In fact, when any syndrome or genetic condition is related to manifestations of dental interest, the dental surgeon should be able to investigate them, especially teeth agenesis or absence. For this reason, the dentist should be aware of the manifestations of Kabuki syndrome, contributing to patients' understanding and management.

scholarly journals Pneumocystis Pneumonia and Acute Myeloid Leukemia: A Systematic Review

2021 ◽  
Author(s):  
Atousa Hakamifard ◽  
Shervin Shokouhi ◽  
Masoud Mardani ◽  
Nariman Mosaffa ◽  
Hamed Azhdari Tehrani
Keyword(s):  
Systematic Review ◽  
Acute Myeloid Leukemia ◽  
Myeloid Leukemia ◽  
Search Strategy ◽  
Pneumocystis Pneumonia ◽  
Bone Marrow Suppression ◽  
Inclusion Criteria ◽  
Exclusion Criteria ◽  
Immunological Mechanism ◽  
Acute Myeloid

Abstract: Background: Pneumocystis pneumonia (PCP) incidence in acute myeloid leukemia (AML) patients have not been well described and some studies have shown the risk of this infection in these groups of patients. In this systematic review, we reviewed the published studies about PCP in AML to evaluate the PCP incidence and outcomes in these patients and then focuses on its immunological mechanism. Method: All articles reviewed in this collection are from recruited sites: PubMed and Embase databases. No time limit was considered for article searching. The following keywords were used: (“Pneumonia, Pneumocystis” OR Pneumocystis Pneumonia” OR “Pneumocystis jirovecii”), AND (“leukemia, myeloid, acute OR acute myeloid leukemia”). Our search strategy yielded 356 articles. After implementing the exclusion and inclusion criteria, the final papers were selected and reviewed. Result: By our search, 356 articles were found (316 in PubMed and 40 in Embase). After the implementation of inclusion and exclusion criteria, seven papers remained. A total of seven articles with a total number of 41 patients were included. Conclusion: Affected patients appear to have a clear resistance to PCP infection despite chemotherapy and bone marrow suppression due to the preservation of a specific immunological milieu in the lung. In fact, may be due to immunological stability of the lungs that remains intact. Further studies are needed.

Epidemiology of Depression and Anxiety in Gout: A Systematic Review and Metaanalysis

2020 ◽  
Vol 48 (1) ◽  
pp. 129-137 ◽  
Author(s):  
Alyssa Howren ◽  
Drew Bowie ◽  
Hyon K. Choi ◽  
Sharan K. Rai ◽  
Mary A. De Vera
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Search Strategy ◽  
Positive Association ◽  
Future Research ◽  
Depression And Anxiety ◽  
Inclusion Criteria ◽  
Random Effects Models ◽  
Cochrane Database ◽  
Epidemiology Of Depression

Objective.To conduct a systematic review of depression and anxiety among patients with gout that specifically evaluates the prevalence, incidence, determinants, and effects of these mental health comorbidities.Methods.We conducted a literature search in Medline, Embase, Cochrane Database of Systematic Reviews, CINAHL, and PsycINFO using indexed terms and key words to identify studies reporting on depression/anxiety in patients with gout. This review included full-text articles published in English that reported on patients with gout, evaluated depression/anxiety using a routinely reported measure, and provided estimates or sufficient data on the prevalence, incidence, determinants, or effects of depression/anxiety. Metaanalyses were conducted using random effects models.Results.Twenty of 901 articles identified through the search strategy met our inclusion criteria. All 20 studies evaluated depression, while only 10 assessed anxiety (50%). Metaanalyses suggest a positive association between mental health disorders and gout, as resultant pooled OR were 1.29 (95% CI 1.07–1.56) for depression and 1.29 (95% CI 0.96–1.73) for anxiety. Findings from four studies reporting on the incidence of depression in patients with gout resulted in a pooled HR of 1.17 (95% CI 1.01–1.36). Significant determinants of depression included number of tophi, frequency of flares, and oligo/polyarticular gout.Conclusion.Our systematic review suggests that depression and anxiety are significantly associated with gout, highlighting the need for future research to focus on the onset of mental disorders after gout diagnosis. We also identify potential targets for intervention.

Challenging the dogma: severely angulated neck fractures of the fifth metacarpal must be treated surgically

2020 ◽  
Vol 46 (1) ◽  
pp. 30-36
Author(s):  
Michel E. H. Boeckstyns
Keyword(s):  
Systematic Review ◽  
Conservative Treatment ◽  
Internal Fixation ◽  
Comparative Studies ◽  
Closed Reduction ◽  
Treatment Options ◽  
Clinical Results ◽  
Threshold Values ◽  
Angulated Neck ◽  
Angular Deformities

Cadaveric studies suggest that the acceptable deformity in fifth metacarpal neck fractures is maximally 30° palmar angulation. This systematic review verifies the validity of these threshold values. Eighteen prospective comparative studies on operative and/or conservative treatment options in adults were included. None of the studies demonstrated any correlation between the residual or initial angulation and the clinical results despite accepting more severe angular deformities. Closed reduction and immobilization without internal fixation improved the palmar angle by 5° to 9° in three studies and 29° in a fourth. Operative treatments compared with non-reducing conservative treatments showed no benefit of the surgery other than aesthetic issues. The synthesis of this review indicates that 90% of fractures of the metacarpal neck with apex angulation up to 70° can be treated successfully with a functional metacarpal brace without reduction. Disability of the Arm, Shoulder and Hand questionnaire scores <10 are uniformly reported. I modified my own practice accordingly a decade ago to treating these fractures conservatively regardless of the palmar angulation, except in patients with exceptional demands or other fracture deformities.

scholarly journals Are self-ligating brackets related to less formation of Streptococcus mutans colonies? A systematic review

2014 ◽  
Vol 19 (1) ◽  
pp. 60-68 ◽  
Author(s):  
Leonard Euler Andrade Gomes do Nascimento ◽  
Margareth Maria Gomes de Souza ◽  
Angela Rita Pontes Azevedo ◽  
Lucianne Cople Maia
Keyword(s):  
Systematic Review ◽  
Streptococcus Mutans ◽  
Selection Criteria ◽  
Search Strategy ◽  
Cochrane Central Register ◽  
Inclusion Criteria ◽  
Central Register ◽  
Data Collection And Analysis

OBJECTIVE: To verify, by means of a systematic review, whether the design of brackets (conventional or self-ligating) influences adhesion and formation of Streptococcus mutans colonies. METHODS: Search strategy: four databases (Cochrane Central Register of Controlled Trials, Ovid ALL EMB Reviews, PubMed and BIREME) were selected to search relevant articles covering the period from January 1965 to December 2012. Selection Criteria: in first consensus by reading the title and abstract. The full text was obtained from publications that met the inclusion criteria. Data collection and analysis: Two reviewers independently extracted data using the keywords: conventional, self-ligating, biofilm, Streptococcus mutans, and systematic review; and independently evaluated the quality of the studies. In case of divergence, the technique of consensus was adopted. RESULTS: The search strategy resulted in 1,401 articles. The classification of scientific relevance revealed the high quality of the 6 eligible articles of which outcomes were not unanimous in reporting not only the influence of the design of the brackets (conventional or self-ligating) over adhesion and formation of colonies of Streptococcus mutans, but also that other factors such as the quality of the bracket type, the level of individual oral hygiene, bonding and age may have greater influence. Statistical analysis was not feasible because of the heterogeneous methodological design. CONCLUSIONS: Within the limitations of this study, it was concluded that there is no evidence for a possible influence of the design of the brackets (conventional or self-ligating) over colony formation and adhesion of Streptococcus mutans.

scholarly journals Bathing Method for Preterm Infants: A Systematic Review

2019 ◽  
Author(s):  
Dior Manta Tambunan ◽  
Henny Suzana Mediani
Keyword(s):  
Systematic Review ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Preterm Infants ◽  
Search Strategy ◽  
Physiological Responses ◽  
Behavioral Responses ◽  
Current Evidence ◽  
Inclusion Criteria ◽  
Premature Babies

Background: Current research suggests that routine daily bathing for preterm infants can render many adverse effects on physiological responses and comfort distress of the infant. Repeated stress on premature babies can have destructive longterm effects on brain development. Objectives: To identify the best current evidence regarding bathing method for preterm infants in enhancing neuro developmental care by using atraumaticcareapproach. Methods:Acomprehensiveliteraturesearchwasperformed in PubMed, ScienceDirect, Wiley Online Library, EbscoHost, Proquest from year of 2008 – May 2019 with the search strategy keywords: bathing, behavioral responses, physiological parameters, premature babies, preterm infants. Inclusion criteria for this study were an original research or systematic review about preterm/premature infants with gestational age is 30 – 37 weeks. PRISMA guideline was applied as a search strategy tool, compared to the used of another conceptualizing tool. Results: A total of 883 of records were identified. After removal of duplicates and initial screening, nine articles met the inclusion criteria of bathing methods for preterm infants. There are several bathing methods were identified: sponge bath, conventional/immersion tub bath, and swaddle bath which is related to physiological responses and behavioral distress during and after bathing intervention. This systematic review showed that swaddle bath had a positive effect on physiological measurement and behavioral responses to preterm infants compared to conventional tub bath and sponge bath which can increase physiological and behavioral discomfort to the preterm infants. Conclusion: This study showed that some of the processes actually reduce negative effects of bathing on the health of the preterm infants. Swaddle bath has proven to be the best and safest type of bathing method for preterm infants during hospitalization that produces fewer changes regarding physiological and behavioral distress to the preterm infants. It is recommended that swaddle bath should be used for preterm infants during they are hospitalized and to be considered as a standard operating procedure in the perinatology unit and neonatal intensive care unit or pediatric intensive care unit.

scholarly journals Neuropsychological and behavioral assessment of impulsivity in adolescents: a systematic review

2016 ◽  
Vol 38 (3) ◽  
pp. 128-135
Author(s):  
Alice Rodrigues Willhelm ◽  
Paula Madeira Fortes ◽  
Fernanda Rasch Czermainski ◽  
Aline Schwalm Andrade Rates ◽  
Rosa Maria Martins de Almeida
Keyword(s):  
Systematic Review ◽  
Inhibitory Control ◽  
Behavioral Assessment ◽  
Second Step ◽  
Review Of The Literature ◽  
Inclusion Criteria ◽  
Brain Organization ◽  
Search Results ◽  
Keywords Child ◽  
The Web

Abstract Introduction: The aim of neuropsychological assessment is to understand the multifaceted relationship between behavior, cognition and brain organization. The main objective of this study was to conduct a systematic review of the literature on impulsivity and inhibitory control in healthy adolescents and preadolescents. Method: Three researchers conducted a systematic review on November 25, 2014. The first step was to conduct searches on the Web of Knowledge and PubMed databases for articles in English using the following keywords: child; adolescents; impulsivity; inhibition; inhibitory control; and neuropsychology. The second step was to analyze all the references cited in the articles selected from the search results in order to identify further literature. Results: Just 13 articles met all the inclusion criteria. There was no consistency in the aims of these studies, or in the instruments or procedures employed. Conclusion: There was no uniformity among the articles that met all the criteria in terms of any of the items analyzed. There was considerable heterogeneity in these studies of impulsivity and inhibitory control, and few of them evaluated healthy samples.

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