scholarly journals Partial articular supraspinatus tendon avulsion: Should we repair? A systematic review of the evidence

2019 ◽  
Vol 12 (4) ◽  
pp. 253-264
Author(s):  
Duncan Tennent ◽  
Gemma Green
Keyword(s):  
Systematic Review ◽  
Grey Literature ◽  
Case Series ◽  
Supraspinatus Tendon ◽  
Classification Systems ◽  
Rotator Cuff Tears ◽  
Single Plane ◽  
Functional Scores ◽  
Level I ◽  
Tendon Avulsion

Introduction Partial articular sided rotator cuff tears are described as being a common cause of shoulder pain and to have a significant impact of patient quality of life. The natural history of partial articular supraspinatus tendon avulsion lesions is not clearly defined and there is limited evidence to determine optimal management. Aims To perform a systematic review of the literature regarding the evidence for partial articular supraspinatus tendon avulsion repair and to determine whether there is any difference between operative and non-operatively managed patients. Methods Conventional and grey literature were searched with defined terms to identify studies in human adults concerning management of partial articular sided supraspinatus avulsions. Results Out of 86 papers identified by the search terms, 28 were deemed eligible for review including 1966 shoulders. 4/28 papers were of level I–II evidence but all were comparing techniques. 4/28 papers were biomechanical cadaveric studies, assessing strength of repair and effect on stability. The remaining 20 studies were level IV–V evidence and consisted of case series and technical notes identifying varying techniques of repair and their outcomes. Conclusion Current literature suggests that all techniques used to repair partial articular supraspinatus tendon avulsion lesions give increased functional scores and reduced pain. However, this represents a heterogeneous group of patients with variable degrees of tear and is not reproducible. There are limited controlled studies to determine whether partial articular supraspinatus tendon avulsion lesions require repair. Current classification systems represent a single plane and are open to user variation. No evidence exists to determine which tears are stable and which may progress.

Organic eating disorders of pica, hperphagia, and severe food restriction: Presentation and prevalence after acquired brain injury

2011 ◽  
Vol 26 (S2) ◽  
pp. 715-715
Author(s):  
R. Faruqui ◽  
K. El-Kadi ◽  
A. Rowell
Keyword(s):  
Systematic Review ◽  
Eating Disorders ◽  
Brain Injury ◽  
Food Restriction ◽  
Grey Literature ◽  
Case Series ◽  
Acquired Brain Injury ◽  
Classification Systems ◽  
Disease Classification ◽  
Service Development

IntroductionPersistent Hyperphagia, Pica, and Severe Food Restriction are rare but potentially life threatening complications following acquired brain injury. These disorders are not formally coded in disease classification systems though do present with significant management challenges in both inpatient and outpatient settings.ObjectivesTo inform treatment and management strategies and service development for complex neuropsychiatric conditionsAimsTo study presentation and prevalence of organic eating disorders following acquired brain injury.MethodsSystematic review of medical literature on Medline, PsychInfo, CINAHL, Embase, Cochrane database of systematic reviews, using terms eating disorders, organic eating disorders, binge eating, bulimia, anorexia nervosa, atypical eating disorders, food restriction, pica, head injury, acquired brain injury, traumatic brain injury.Service consultations and identification of grey literatureResultsSystematic review identified case reports, case series, and case studies relevant to these disorders. It also identified lack of research in this area and absence of well structured longitudinal studies that can identify true prevalence in a representative sample. Persistent Hyperphagia has been reported in 2–3% of adult cases requiring inpatient post acute rehabilitation. Pica has been reported in young children after acquired brain injury only. Two reports identified this condition in post neurosurgery period. Severe food restriction, at times also described as atypical anorexia, has been reported following acquired brain injury. However, it remains rather difficult to estimate prevalence in different patient populations.ConclusionsOrganic eating disorders present with significant levels of challenges in patient management and do carry identifiable mortality risk.

scholarly journals Efficacy of threading lasso fixation in repairing partial articular supraspinatus tendon avulsion lesions: a retrospective study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Sun-Yu Chen ◽  
Zhan-Hao Xiao ◽  
Jian-Kun Wang
Keyword(s):  
Los Angeles ◽  
Clinical Outcomes ◽  
Case Series ◽  
Visual Analog Scale Score ◽  
Supraspinatus Tendon ◽  
Fixation Technique ◽  
Retrospective Case ◽  
The Mean ◽  
Tendon Avulsion

Abstract Background The partial articular supraspinatus tendon avulsion (PASTA) lesion repair remains a topic of debate. We have performed in situ repair of PASTA lesions using a potentially viable threading lasso fixation technique. This retrospective case series aimed to evaluate the clinical outcomes of PASTA lesion repair using threading lasso fixation. To the best of our knowledge, this is the first study to review this technique and its outcomes in terms of pain and upper extremity function. Methods Twenty-five patients with PASTA lesions who were treated with threading lasso fixation were reviewed. All patients were followed up for at least 1 year. Preoperative and follow-up data were retrospectively collected and reviewed. Clinical outcomes were assessed to evaluate the efficacy of the surgery. Results There were no postoperative complications. The average follow-up period was 25.7 (22–27) months. At the last follow-up, all patients underwent follow-up magnetic resonance imaging; only two cases showed a partially healed tendon and no case converted to full-thickness tear. Furthermore, shoulder pain decreased and mobility was recovered, with statistically significant differences in all scoring measures. Specifically, the mean visual analog scale score decreased from 5.4 ± 1.2 before surgery to 1.1 ± 0.8 at the last follow-up (t = 14.908, P < 0.01), and the mean American Shoulder and Elbow Surgeons Shoulder Assessment Form score improved significantly from 51.6 ± 6.4 to 89.3 ± 5.2 (t = 22.859, P < 0.01). Additionally, the mean University of California Los Angeles score improved from 17.8 ± 3.5 preoperatively to 32.3 ± 1.4 (t = 19.233, P < 0.01). Conclusions Arthroscopic repair using threading lasso fixation is a novel transtendinous technique for patients with partial articular supraspinatus tendon avulsion. Tendon integrity is preserved with this method, which may result in improved function. Overall, threading lasso fixation technique is an effective treatment.

scholarly journals Prevalence and Site of Rotator Cuff Lesions in Shoulders With Recurrent Anterior Instability in a Young Population

2019 ◽  
Vol 7 (6) ◽  
pp. 232596711984987 ◽  
Author(s):  
Yusuke Ueda ◽  
Hiroyuki Sugaya ◽  
Norimasa Takahashi ◽  
Keisuke Matsuki ◽  
Morihito Tokai ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Arthroscopic Surgery ◽  
Case Series ◽  
Supraspinatus Tendon ◽  
Rotator Cuff Tears ◽  
Anterior Instability ◽  
Glenohumeral Instability ◽  
Anterior Border ◽  
Level Of Evidence ◽  
Rotator Cuff Lesions

Background: Partial articular supraspinatus tendon avulsion (PASTA) lesions are often seen in shoulders of throwing athletes. PASTA lesions in anterior instability are also found in recurrent anterior glenohumeral instability. Purpose: To investigate the prevalence and location of rotator cuff tears (RCTs), including PASTA lesions, in shoulders with recurrent anterior instability. Study Design: Case series; Level of evidence, 4. Methods: A total of 842 shoulders in 801 patients with recurrent anterior instability (647 men, 154 women; mean age, 24 years; age range, 13-40 years) who underwent arthroscopic surgery at the age of 40 years or younger were enrolled. During surgery, the thickness and the sites of RCTs as well as patient factors associated with RCTs were examined. Results: RCTs were found in 57 shoulders (7%) in 56 patients. There were 4 shoulders with full-thickness RCTs and 53 shoulders with PASTA lesions. All lesions but 1 involved the anterior border of the supraspinatus (SSP). Participation in high-level athletics and older age at injury were associated with RCTs. Conclusion: The incidence of RCTs was 7% in shoulders with recurrent anterior instability at age 40 years or younger. Most RCTs were PASTA lesions that involved the anterior border of the SSP.

scholarly journals Prescribing cascades in community-dwelling adults: protocol for a systematic review

2021 ◽  
Vol 4 ◽  
pp. 72
Author(s):  
Ann Doherty ◽  
Frank Moriarty ◽  
Fiona Boland ◽  
Barbara Clyne ◽  
Tom Fahey ◽  
...  
Keyword(s):  
Systematic Review ◽  
Grey Literature ◽  
Inappropriate Prescribing ◽  
Case Series ◽  
Evidence Base ◽  
Community Dwelling ◽  
Cochrane Library ◽  
Ageing Population ◽  
Potentially Inappropriate Prescribing ◽  
Inclusion Criteria

Introduction: Internationally, health systems face the challenge of managing a growing ageing population living with multimorbidity and polypharmacy. Potentially inappropriate prescribing is common among patients with polypharmacy, increasing the risk for adverse drug reactions (ADRs). Several prescribing indicator sets exist to improve prescribing and reduce potentially inappropriate prescribing, but do not address prescribing cascades. Prescribing cascades occur when a medication is prescribed to treat an ADR to another prescribed medication, whether intentionally or unintentionally, and constitute an important area to consider when characterising problematic polypharmacy. This is a protocol for a systematic review examining prescribing cascades in community-dwelling adults. Methods: The review will be reported adhering to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. A systematic search of Medline (Ovid), EMBASE, PsycINFO, CINAHL and the Cochrane Library will be conducted from inception to March 2021, using a predetermined strategy. Grey literature will be searched using Open Grey, MedNar, Dart Europe, and the Turning Research Into Practice (TRIP) databases. No restrictions will be placed on language or publication year. Inclusion criteria are: population - community-dwelling adults (≥18 years); risk - prescription medication with the potential to cause side effects; outcomes - initiation of a new medicine to ‘treat’ or reduce the risk of experiencing an ADR. Prospective and retrospective cohort studies, case control and case series studies will be included. Two reviewers will independently screen titles and abstracts; studies meeting inclusion criteria will undergo independent full-text screening by two reviewers.  A narrative synthesis will be conducted. Study quality will be independently assessed using the relevant Joanna Briggs Institute Critical Appraisal Checklist. Discussion: This systematic review will identify examples of prescribing cascades for community-dwelling adults and contribute to developing an evidence base regarding such cascades. Registration: PROSPERO [CRD42021243163, 31/03/2021].

scholarly journals Characteristics and Recovery Methods of Studies Falsely Excluded During Literature Screening –A Systematic Review

2021 ◽  
Author(s):  
Lisa Affengruber ◽  
Andreea Dobrescu ◽  
Emma Persad ◽  
Irma Klerings ◽  
Gernot Wagner ◽  
...  
Keyword(s):  
Systematic Review ◽  
Information Science ◽  
Citation Index ◽  
Grey Literature ◽  
Case Series ◽  
Rapid Review ◽  
Reference List ◽  
Search Methods ◽  
Increased Risk ◽  
The Impact

Abstract Background: Due to the growing need to provide evidence syntheses under time constraints, researchers have begun focusing on the exploration of rapid review methods, which often employ single-reviewer literature screening. However, single-reviewer screening misses, on average, 13% of relevant studies, compared to 3% with dual-reviewer screening. Little guidance exists regarding methods to recover studies falsely excluded during literature screening. Likewise, it is unclear whether specific study characteristics can predict an increased risk of false exclusion. This systematic review aimed to identify supplementary search methods that can be used to recover studies falsely excluded during literature screening. Moreover, it strove to identify study-level predictors that indicate an elevated risk of false exclusions of studies during literature screening. Methods: We performed literature searches for eligible studies in Medline, Science Citation Index Expanded, Social Sciences Citation Index, Current Contents Connect, Embase, Epistemonikos.org, and Information Science & Technology Abstracts from 1999 to June 23, 2020. We searched for grey literature, checked reference lists, and conducted hand searches in two relevant journals and similar articles searches current to January 28, 2021. Two investigators independently screened the literature; one investigator performed the data extraction, a second investigator checked for correctness and completeness. Two reviewers assessed the risk of bias of eligible studies. We synthesized the results narratively. Results: Three methods studies, two with a case study design and one with a case series design, met the inclusion criteria. One study reported that all falsely excluded publications (8%) could be recovered through reference list checking compared to other supplementary search methods. No included methods study analyzed the impact of recovered studies on conclusions or meta-analyses. Two studies reported that up to 8% of studies were falsely excluded due to uninformative titles and abstracts, and one study showed that 11% of non-English studies were falsely excluded. Conclusions: Due to the limited evidence based on two case studies and one case series, we can draw no firm conclusion about the most reliable and most valid method to recover studies falsely excluded during literature screening or about the characteristics that might predict a higher risk of false exclusion. Systematic review registration: https://osf.io/v2pjr/

scholarly journals A systematic review on conservative and non-operative treatment options for Osgood-Schlatter disease

2020 ◽  
Author(s):  
Cornelia Neuhaus ◽  
Christian Appenzeller-Herzog ◽  
Oliver Faude
Keyword(s):  
Systematic Review ◽  
Operative Treatment ◽  
Treatment Options ◽  
Grey Literature ◽  
Case Series ◽  
Outcome Data ◽  
Control Group ◽  
Retrospective Case ◽  
Review Articles ◽  
Knee Pathology

Background: Osgood-Schlatter disease (OSD) is a sport- and growth-associated knee pathology with painful osteochondrosis around the tibial tuberosity. Up to 10% of adolescents are affected by OSD. Treatment is primarily conservative or non-operative and includes injections, ice, braces, casts, tape and/or physiotherapy. However, treatment outcomes are often insufficiently described and there is lack of evidence for current best practice.Objective: The aims of this systematic review are to comprehensively identify conservative or non-operative treatment options for OSD, to compare their effectiveness in selected outcomes, and to describe potential research gaps. and to describe potential research gaps.Methods: This systematic review was conducted according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. CENTRAL, CINAHL, EMBASE and MEDLINE via Ovid, and PEDro were searched through to January 6, 2020. In addition, ongoing and unpublished clinical studies, dissertations, and other grey literature on OSD were retrieved. We included prospective, retrospective, case control, randomised, and non-randomised studies reporting on the effectiveness of any conservative or non-operative treatment of 6- to 28-year-old OSD patients. Studies written in English, German, or French were included. The quality of the included studies was assessed using the PEDro scale and extracted outcome data were narratively synthesized. In addition, we also systematically retrieved review articles for extraction of treatment recommendations.Results: Of 767 identified studies, thirteen were included: two randomised controlled trials (RCTs), two prospective and eight retrospective observational studies, and one case series. Eight studies had no control group. The included studies were published from 1948 to 2019 and included 747 patients (563 male, 119 female, 65 sex not reported) with 937 affected knees. The study quality was poor to moderate. The two included RCTs examined the effectiveness of surplus dextrose-injection in OSD patients treated with local anaesthetics injection and came to opposite conclusions. Other than that, inter-study heterogeneity prohibited any descriptive cumulative analyses. Among the 15 review articles, the most prevalent treatment recommendations were activity modification (15/15), quadriceps and hamstring stretching (13/15), medication (11/15), ice (11/15), strengthening of the quadriceps (9/15), and knee straps or brace (8/15).Conclusion: Conflicting evidence exists to support the use of dextrose injections. Certain therapeutic approaches, such as stretching, seem to work, but no RCT comparing specific exercises with sham or usual care treatment exists. Carefully controlled studies on well- described treatment approaches are needed to establish which conservative or non-operative treatment options are most effective for patients with OSD.

scholarly journals Exercise prescription for overhead athletes with shoulder pathology: a systematic review with best evidence synthesis

2017 ◽  
Vol 52 (4) ◽  
pp. 231-237 ◽  
Author(s):  
Alexis A Wright ◽  
Eric J Hegedus ◽  
Daniel T Tarara ◽  
Samantha C Ray ◽  
Steven L Dischiavi
Keyword(s):  
Systematic Review ◽  
Upper Extremity ◽  
Exercise Prescription ◽  
Evidence Synthesis ◽  
Inclusion Criteria ◽  
Single Plane ◽  
Overhead Athletes ◽  
Shoulder Pathology ◽  
Best Evidence Synthesis ◽  
Level I

ObjectiveTo produce a best evidence synthesis of exercise prescription used when treating shoulder pathology in the overhead athlete.DesignA systematic review of exercises used in overhead athletes including case studies and clinical commentaries.Data sourcesMEDLINE, PubMed, SPORTDiscus and CINAHL from database inception through July 8, 2016.MethodsWe examined data from randomised controlled trials and prospective cohort (level I–IV evidence) studies that addressed exercise intervention in the rehabilitation of the overhead athlete with shoulder pathology. Case studies and clinical commentaries (level V evidence) were examined to account for expert opinion-based research. Data were combined using best evidence synthesis and graded (A–F) recommendations (Centre for Evidence-Based Medicine).ResultsThere were 33 unique exercises in six level I–IV studies that met our inclusion criteria. Most exercises were single-plane, upper extremity exercises performed below 90oof elevation. There were 102 unique exercises in 33 level V studies that met our inclusion criteria. These exercises emphasised plyometrics, kinetic chain and sport-specific training.Conclusions and relevanceOverall, evidence for exercise interventions in overhead athletes with shoulder pathology is dominated by expert opinion (grade D). There is great variability between exercise approaches suggested by experts and those investigated in research studies and the overall level of evidence is low. The strongest available evidence (level B) supports the use of single-plane, open chain upper extremity exercises performed below 90° of elevation and closed chain upper extremity exercises. Clinical expert pieces support a more advanced, global treatment approach consistent with the complex, multidimensional nature of sport.

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

2017 ◽  
Vol 31 (10) ◽  
pp. 975-981 ◽  
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.

scholarly journals LO041: Predicting the return of spontaneous circulation using near-infrared spectroscopy monitoring: a systematic review and meta-analysis

CJEM ◽  
2016 ◽  
Vol 18 (S1) ◽  
pp. S44-S44
Author(s):  
A. Cournoyer ◽  
J. Chauny ◽  
M. Iseppon ◽  
A. Denault ◽  
S. Cossette ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cardiac Arrest ◽  
Infrared Spectroscopy ◽  
Near Infrared Spectroscopy ◽  
Near Infrared ◽  
Grey Literature ◽  
Case Series ◽  
Spontaneous Circulation ◽  
Mean Deviation ◽  
Return Of Spontaneous Circulation

Introduction: Tissue oximetry using near-infrared spectroscopy (NIRS) is a non-invasive monitor of cerebral oxygenation. This new technology has been used during cardiac arrest because of its ability to give measures in low blood flow situations. The aim of this systematic review was to assess the evidence regarding the association between NIRS values and resuscitation outcomes in patients undergoing cardiopulmonary resuscitation. We hypothesized that higher NIRS values would be associated with better outcomes and that the strength of that association would differ depending on the timing of the NIRS measurements. Methods: This review was registered (Prospero CRD42015017380) and is reported as per the PRISMA guidelines. Medline, Embase and CENTRAL were searched from their inception to September 18th, 2015 using a specifically designed search strategy. Grey literature was also searched using Web of Science and Google Scholar. NIRS manufacturers and authors of included citations were contacted to inquire on unpublished results. Finally, the references of all retained articles were reviewed in search of additional relevant studies. Studies reporting NIRS monitoring in adults during cardiac arrest were eligible for inclusion. Case reports and case series of fewer than five patients were automatically excluded. Two reviewers assessed the quality of included articles and extracted the data. Results: Out of 3275 unique citations, 19 non-randomized observational studies (15 articles and four conference abstracts) were included in this review, for a total of 2436 patients. Six studies were evaluated at low risk of bias, nine at intermediate risk and four at high risk. We found a stronger association between the return of spontaneous circulation (ROSC) and the highest NIRS value measured during resuscitation (standard mean deviation (SMD) 3.46 (95%CI 2.31-4.62)) than between ROSC and the mean NIRS measures (SMD 1.33 (95%CI 0.92-1.74)) which was superior to the one between ROSC and initial measures (SMD 0.45 (95%CI 0.02-0.88)). Conclusion: Patients with good outcomes have significantly higher NIRS value during resuscitation than their counterparts. The association between ROSC and NIRS measurements was influenced the timing of measurements during resuscitation.

scholarly journals Frequency and distribution of neglected tropical diseases in Mozambique: a systematic review

2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Berta Grau-Pujol ◽  
Marilia Massangaie ◽  
Jorge Cano ◽  
Carmen Maroto ◽  
Alcino Ndeve ◽  
...  
Keyword(s):  
Systematic Review ◽  
Neglected Tropical Diseases ◽  
Case Reports ◽  
Grey Literature ◽  
Case Series ◽  
Epidemiological Data ◽  
Effective Control ◽  
Tropical Diseases ◽  
Case Control Studies ◽  
Cross Sectional

Abstract Background Neglected tropical diseases (NTDs) affect more than one billion people living in vulnerable conditions. In spite of initiatives recently contributing to fill NTDs gaps on national and local prevalence and distribution, more epidemiological data are still needed for effective control and elimination interventions. Main text Mozambique is considered one of the countries with highest NTDs burden although available data is scarce. This study aims to conduct a systematic review on published available data about the burden and distribution of the different NTDs across Mozambique since January 1950 until December 2018. We identified manuscripts from electronic databases (Pubmed, EmBase and Global Health) and paper publications and grey literature from Mozambique Ministry of Health. Manuscripts fulfilling inclusion criteria were: cross-sectional studies, ecological studies, cohorts, reports, systematic reviews, and narrative reviews capturing epidemiological information of endemic NTDs in Mozambique. Case-control studies, letters to editor, case reports and case series of imported cases were excluded. A total of 466 manuscripts were initially identified and 98 were finally included after the revision following PRISMA guidelines. Eleven NTDs were reported in Mozambique during the study span. Northern provinces (Nampula, Cabo Delgado, Niassa, Tete and Zambezia) and Maputo province had the higher number of NTDs detected. Every disease had their own report profile: while schistosomiasis have been continuously reported since 1952 until nowadays, onchocerciasis and cysticercosis last available data is from 2007 and Echinococcosis have never been evaluated in the country. Thus, both space and time gaps on NTDs epidemiology have been identified. Conclusions This review assembles NTDs burden and distribution in Mozambique. Thus, contributes to the understanding of NTDs epidemiology in Mozambique and highlights knowledge gaps. Hence, the study provides key elements to progress towards the control and interruption of transmission of these diseases in the country.

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