scholarly journals Treatment of Fractures of the Thoracolumbar Spine: Recommendations of the Spine Section of the German Society for Orthopaedics and Trauma (DGOU)

2018 ◽  
Vol 8 (2_suppl) ◽  
pp. 34S-45S ◽  
Author(s):  
Akhil P. Verheyden ◽  
Ulrich J. Spiegl ◽  
Helmut Ekkerlein ◽  
Erol Gercek ◽  
Stefan Hauck ◽  
...  
Keyword(s):  
Literature Review ◽  
Systematic Literature Review ◽  
General Condition ◽  
Clinical Presentation ◽  
Thoracolumbar Spine ◽  
German Society ◽  
Level Of Evidence ◽  
Levels Of Care ◽  
Thoracolumbar Spine Fractures ◽  
Anterior Posterior

Study Design: Abstract consensus paper with systematic literature review. Objective: The aim of this study was to establish recommendations for treatment of thoracolumbar spine fractures based on systematic review of current literature and consensus of several spine surgery experts. Methods: The project was initiated in September 2008 and published in Germany in 2011. It was redone in 2017 based on systematic literature review, including new AOSpine classification. Members of the expert group were recruited from all over Germany working in hospitals of all levels of care. In total, the consensus process included 9 meetings and 20 hours of video conferences. Results: As regards existing studies with highest level of evidence, a clear recommendation regarding treatment (operative vs conservative) or regarding type of surgery (posterior vs anterior vs combined anterior-posterior) cannot be given. Treatment has to be indicated individually based on clinical presentation, general condition of the patient, and radiological parameters. The following specific parameters have to be regarded and are proposed as morphological modifiers in addition to AOSpine classification: sagittal and coronal alignment of spine, degree of vertebral body destruction, stenosis of spinal canal, and intervertebral disc lesion. Meanwhile, the recommendations are used as standard algorithm in many German spine clinics and trauma centers. Conclusion: Clinical presentation and general condition of the patient are basic requirements for decision making. Additionally, treatment recommendations offer the physician a standardized, reproducible, and in Germany commonly accepted algorithm based on AOSpine classification and 4 morphological modifiers.

scholarly journals Digital Storytelling in Older Adults With Typical Aging, and With Mild Cognitive Impairment or Dementia: A Systematic Literature Review

2021 ◽  
pp. 073346482110154
Author(s):  
Adriana Maria Rios Rincon ◽  
Antonio Miguel Cruz ◽  
Christine Daum ◽  
Noelannah Neubauer ◽  
Aidan Comeau ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Literature Review ◽  
Systematic Literature Review ◽  
Digital Storytelling ◽  
Level Of Evidence ◽  
Form Of Life ◽  
Self Confidence ◽  
Care Partners

The rates of dementia are on the rise as populations age. Storytelling is commonly used in therapies for persons living with dementia and can be in the form of life review, and reminiscence therapy. A systematic literature review was conducted to examine the range and extent of the use of digital technologies for facilitating storytelling in older adults and their care partners, and to identify the processes and methods, the technologies used and their readiness levels, the evidence, and the associated outcomes. Eight electronic databases were searched: Medline, EMBASE, PsycINFO, CINAHL, Abstracts in Social Gerontology, ERIC, Web of Science, and Scopus. We included 34 studies. Mild cognitive impairment or dementia represented over half of medical conditions reported in the studies. Overall, our findings indicate that the most common use of digital storytelling was to support older adults’ memory, reminiscence, identity, and self-confidence; however, the level of evidence of its effectiveness was low.

scholarly journals USE OF FLUNARIZINE AS A PREVENTIVE FOR VESTIBULAR MIGRAINE CRISES IN COMPARISON WITH OTHER DRUGS: SYSTEMATIC LITERATURE REVIEW

2021 ◽  
Author(s):  
Lara Estupina Braghieri ◽  
Paula Lopes ◽  
Osmar Person ◽  
Fernando Junior ◽  
Priscila Bogar
Keyword(s):  
Literature Review ◽  
Systematic Literature Review ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Vestibular Migraine ◽  
Moderate Degree ◽  
Level Of Evidence ◽  
Grade Method ◽  
Episodic Vertigo ◽  
Preventive Drug

INTRODUCTION: Vestibular migraine is the main cause of episodic vertigo and the second most common cause of dizziness in adults. Treatment for vestibular migraine encompasses the prevention of crises and the control of acute symptoms. Flunarizine works by preventing the contraction of labyrinthine vessels and altering blood flow, thus preventing symptoms. Due to the high prevalence of the disease, its negative impacts on individual health and increased expenditure on public health, preventive pharmacological and non-pharmacological treatment must be implemented early. PURPOSE: To evaluate the efficacy of Flunarizine as a preventive for migraine and vestibular crises compared to other preventive drugs. MATERIAL AND METHODS: Scientific articles were searched in the databases using the terms (vestibular migraine OR migrainous vertigo) AND (flunarizine) AND (prophylaxis). Subsequently, a systematic literature review and meta-analysis was performed, including 3 randomized clinical trials comparing flunarizine and other preventive drugs in terms of efficacy and safety for preventing migraine vertigo attacks. The studies were analyzed using a ROB table, analysis using the GRADE method and meta-analysis. RESULTS: Qualitatively, the analysis showed that flunariniza was positive for decreasing the frequency of vertigo in cases of vestibular migraine, with a moderate degree of evidence, a relative risk of 0.34 and a confidence interval of 0.15 to 0.76. CONCLUSIONS: There are few studies available in the scientific literature on the use of flunarizine in vestibular migraine, many of which are heterogeneous among themselves, mainly in the way of evaluating and monitoring patients, carried out mainly through subjective methods. The meta-analysis showed a positive result for flunarizine as a preventive drug for the studied population. Furthermore, in all the studies analyzed, no serious side effects resulting from the use of the medication were reported, which makes it safe for patients to use. Flunarizine is a good drug for the prevention of vestibular migraine, especially in reducing the number of attacks, with a good level of evidence.

scholarly journals Communication and leadership in emergency situations: Systematic literature review and recommendations for practice

2017 ◽  
Vol 6 (2) ◽  
pp. 55 ◽  
Author(s):  
José Carlos Amado Martins ◽  
Ana Catarina Vaz De Sousa ◽  
Ana Rita Diogo Abrantes ◽  
Catarina Sofia Da Silva Pinto ◽  
Cristiana Isabel De Almeida Gomes ◽  
...  
Keyword(s):  
Literature Review ◽  
Best Practices ◽  
Systematic Literature Review ◽  
Three Dimensions ◽  
Inclusion Criteria ◽  
Level Of Evidence ◽  
Emergency Situations ◽  
Leadership Process ◽  
Recommendations For Practice ◽  
Team Interventions

Background: Communication and leadership are two interconnected concepts that are essential to achieving successful and high-quality team interventions in emergency situations.Objective: To identify communication and leadership best practices in emergency situations.Methods: A systematic literature review with meta-synthesis was conducted using the Joanna Briggs Institute (JBI) Reviewers’ Manual (JBI, 2014). A search was conducted to identify studies published between January 2006 and July 2016 using the terms communication, leadership, and emergency. Studies in the areas of pediatrics or simulated practice environments were excluded.Results: Nineteen of the 447 studies found in the search met the inclusion criteria. During synthesis, data were divided into three dimensions: leader’s characteristics, initial and lifelong training, and leadership process. Communication and leadership training were considered essential for developing skills required in emergency situations.Conclusions: Despite the low level of evidence of the included studies, this study puts forward recommendations for communication and leadership best practices in emergency situations.

scholarly journals NUMERICAL ANALYSIS OF SHORT AND LONG INSTRUMENTATION IN THE TREATMENT OF THORACOLUMBAR FRACTURES CONSIDERING THE LIGAMENTOUS PORTION

2019 ◽  
Vol 18 (2) ◽  
pp. 144-150
Author(s):  
André Rafael Hubner ◽  
Danilo Mourão Ribeiro ◽  
Eduardo Dassoler ◽  
Daniel Gasparin ◽  
Charles Leonardo Israel ◽  
...  
Keyword(s):  
Numerical Analysis ◽  
Thoracolumbar Spine ◽  
Three Dimensional ◽  
Maximum Tensile Stress ◽  
Thoracolumbar Fractures ◽  
Level Of Evidence ◽  
Safety Coefficient ◽  
Computed Tomography Images ◽  
Three Dimensional Models ◽  
Anterior Posterior

ABSTRACT Objective: This study aims to numerically evaluate the surgical treatment of thoracolumbar fractures, comparing the strengths between the long and short fixations using the pedicle of the fractured vertebra, taking into account the supraspinous, intertransverse, and anterior longitudinal ligaments. Methods: A numerical analysis of the techniques of long and short fixation of a thoracolumbar spine fracture was performed using computed tomography images that were converted into three-dimensional models and analyzed through the ANSYS program. The two types of treatments were analyzed considering the tensions generated in the immediate postoperative period, when the fracture has not yet been consolidated. The anterior, posterior, supraspinal and intertransverse longitudinal ligaments were added, in addition to considering different vertebral geometries. Results: Taking into account that the maximum tensile stress of the material used in the metal implant, in the case of titanium, was 960 MPa, the highest tension found in the analysis of the short instrumentation was 346.83 MPa, reaching only 36.13% of the load the material supports, being, therefore, within a safety limit. The analysis performed in the spine with long instrumentation showed the highest tension value of 229.22 MPa. Conclusions: Considering the values found and the resistance of the synthesis material used, the short and long fixation can be considered in the treatment of thoracolumbar fractures with similarity and a good safety coefficient. Level of Evidence III; Case-Control.

scholarly journals A Systematic Literature Review of Dorsal Root Ganglion Neurostimulation for the Treatment of Pain

Pain Medicine ◽  
2020 ◽  
Vol 21 (8) ◽  
pp. 1581-1589 ◽  
Author(s):  
Timothy R Deer ◽  
Corey W Hunter ◽  
Pankaj Mehta ◽  
Dawood Sayed ◽  
Jay S Grider ◽  
...  
Keyword(s):  
Dorsal Root Ganglion ◽  
Literature Review ◽  
Systematic Literature Review ◽  
Dorsal Root ◽  
Task Force ◽  
Controlled Trial ◽  
Risk Of Bias ◽  
Level Of Evidence ◽  
Bias Assessment ◽  
Randomized Controlled

Abstract Objective To conduct a systematic literature review of dorsal root ganglion (DRG) stimulation for pain. Design Grade the evidence for DRG stimulation. Methods An international, interdisciplinary work group conducted a literature search for DRG stimulation. Abstracts were reviewed to select studies for grading. General inclusion criteria were prospective trials (randomized controlled trials and observational studies) that were not part of a larger or previously reported group. Excluded studies were retrospective, too small, or existed only as abstracts. Studies were graded using the modified Interventional Pain Management Techniques–Quality Appraisal of Reliability and Risk of Bias Assessment, the Cochrane Collaborations Risk of Bias assessment, and the US Preventative Services Task Force level-of-evidence criteria. Results DRG stimulation has Level II evidence (moderate) based upon one high-quality pivotal randomized controlled trial and two lower-quality studies. Conclusions Moderate-level evidence supports DRG stimulation for treating chronic focal neuropathic pain and complex regional pain syndrome.

Presentation and Management of Killian Jamieson Diverticulum: A Comprehensive Literature Review

2019 ◽  
Vol 129 (4) ◽  
pp. 394-400 ◽  
Author(s):  
Narmien Haddad ◽  
Pratima Agarwal ◽  
Jessica R. Levi ◽  
Jeremiah C. Tracy ◽  
Lauren F. Tracy
Keyword(s):  
Literature Review ◽  
Thyroid Nodule ◽  
Surgical Management ◽  
Endoscopic Surgery ◽  
Clinical Presentation ◽  
Cricopharyngeal Myotomy ◽  
Level Of Evidence ◽  
Transcervical Approach ◽  
Comprehensive Literature Review ◽  
Imaging Characteristics

Objective: To examine the clinical presentation, diagnostic evaluation, and management of Killian–Jamieson diverticula (KJD) through literature review. Methods: A comprehensive literature review was conducted through December 2018 using keywords Killian–Jamieson diverticula/diverticulum. Data extracted included clinical presentation, imaging characteristics, surgical management, and postoperative care. Sources: PubMed and Google Scholar. Results: Sixty-eight cases of KJD in 59 reports (29M:39F; median 58 years old) were identified for review. The most common presentation was dysphagia (n = 39), suspected thyroid nodule (n = 24) and globus (n = 14). The majority of KJD (n = 51) occur on the left, with rare reports of right side (n = 11) and bilateral (n = 5) presentation. Thirty-two cases describe surgical management: 22 utilizing a transcervical approach, with (n = 13) or without (n = 9) cricopharyngeal myotomy; and 10 reported endoscopic surgery. Diverticula managed transcervically averaged 3.8 cm in size in comparison to average 2.8 cm in the endoscopic group. Time to diet initiation after transcervical surgery averaged 4 days versus 2 days after endoscopic surgery. Complications were reported in 2/68 cases; both were diverticula recurrence after endoscopic surgery. Conclusion: Killian–Jamieson diverticula is a rare diagnosis that should be considered in the evaluation of dysphagia, globus, and also suspected thyroid nodule. When patient symptoms warrant intervention, a transcervical approach, with or without cricopharyngeal myotomy, is most commonly utilized. In recent years, an endoscopic approach has been presented as an alternative for smaller diverticula. Further understanding of the optimal treatment and postoperative management for KJD requires larger cohorts. Level of Evidence: 4

scholarly journals Classification of Osteoporotic Thoracolumbar Spine Fractures: Recommendations of the Spine Section of the German Society for Orthopaedics and Trauma (DGOU)

2018 ◽  
Vol 8 (2_suppl) ◽  
pp. 46S-49S ◽  
Author(s):  
Klaus John Schnake ◽  
Thomas R. Blattert ◽  
Patrick Hahn ◽  
Alexander Franck ◽  
Frank Hartmann ◽  
...  
Keyword(s):  
Interobserver Reliability ◽  
Thoracolumbar Spine ◽  
Osteoporotic Fractures ◽  
Posterior Wall ◽  
German Society ◽  
Adequate Treatment ◽  
Osteoporotic Vertebral Fractures ◽  
Thoracolumbar Spine Fractures ◽  
Fractures Of The Spine ◽  
Reliable Classification

Study Design: Expert opinion. Objectives: Osteoporotic vertebral fractures are of increasing medical importance. For an adequate treatment strategy, an easy and reliable classification is needed. Methods: The working group “Osteoporotic Fractures” of the Spine Section of the German Society for Orthopaedics and Trauma (DGOU) has developed a classification system (OF classification) for osteoporotic thoracolumbar fractures. The consensus decision followed an established pathway including review of the current literature. Results: The OF classification consists of 5 groups: OF 1, no vertebral deformation (vertebral edema); OF 2, deformation with no or minor (<1/5) involvement of the posterior wall; OF 3, deformation with distinct involvement (>1/5) of the posterior wall; OF 4, loss of integrity of the vertebral frame or vertebral body collapse or pincer-type fracture; OF 5, injuries with distraction or rotation. The interobserver reliability was substantial (κ = .63). Conclusions: The proposed OF classification is easy to use and provides superior clinical differentiation of the typical osteoporotic fracture morphologies.

scholarly journals A Systematic Literature Review of Brain Neurostimulation Therapies for the Treatment of Pain

Pain Medicine ◽  
2020 ◽  
Vol 21 (7) ◽  
pp. 1415-1420
Author(s):  
Timothy R Deer ◽  
Steven Falowski ◽  
Jeff E Arle ◽  
Jan Vesper ◽  
Julie Pilitsis ◽  
...  
Keyword(s):  
Literature Review ◽  
Systematic Literature Review ◽  
Task Force ◽  
Work Group ◽  
The United States ◽  
Risk Of Bias ◽  
Current Evidence ◽  
Level Of Evidence ◽  
Bias Assessment ◽  
Moderate Evidence

Abstract Objective To conduct a systematic literature review of brain neurostimulation for pain. Design Grade the evidence for deep brain neurostimulation (DBS). Methods An international, interdisciplinary work group conducted a literature search for brain stimulation. Abstracts were reviewed to select studies for grading. Randomized controlled trials (RCTs) meeting inclusion/exclusion criteria were graded by two independent reviewers. General inclusion criteria were prospective trials (RCTs and observational) that were not part of a larger or previously reported group. Excluded studies were retrospective or existed only as abstracts. Studies were graded using the modified Interventional Pain Management Techniques–Quality Appraisal of Reliability and Risk of Bias Assessment, the Cochrane Collaborations Risk of Bias assessment, and the United States Preventative Services Task Force level-of-evidence criteria. Results Two high-quality RCTs and three observational trials supported DBS, resulting in Level II (moderate) evidence. Conclusion Moderate evidence supports DBS to treat chronic pain. Additional Level I RCTs are needed to further the strength of the evidence in this important area of medicine, but the current evidence suggests that DBS should be considered as an option in treating complex pain cases.

Influence of Staff Behavior on Infectious Risk in Operating Rooms: What Is the Evidence?

2015 ◽  
Vol 36 (1) ◽  
pp. 93-106 ◽  
Author(s):  
Gabriel Birgand ◽  
Philippe Saliou ◽  
Jean-Christophe Lucet
Keyword(s):  
Literature Review ◽  
Operating Room ◽  
Systematic Literature Review ◽  
Surgical Site Infections ◽  
Published Data ◽  
Level Of Evidence ◽  
Particle Count ◽  
Infectious Risk ◽  
Staff Behavior ◽  
The Impact

SUMMARYA systematic literature review was performed to assess the impact of surgical-staff behaviors on the risk of surgical site infections. Published data are limited, heterogeneous, and weakened by several methodological flaws, underlying the need for more studies with accurate tools.OBJECTIVETo assess the current literature regarding the impact of surgical-staff behaviors on the risk of surgical-site infection (SSI).DESIGNSystematic literature review.METHODSWe searched the Medline, EMBASE, Ovid, Web of Science, and Cochrane databases for original articles about the impact of intraoperative behaviors on the risk of SSI published in English before September 2013.RESULTSWe retrieved 27 original articles reporting data on number of people in the operating room (n=14), door openings (n=14; number [n=6], frequency [n=7], reasons [n=4], or duration [n=3]), surgical-team discipline (evidence of distraction; n=4), compliance with traffic measures (n=6), or simulated behaviors (n=3). Most (59%) articles were published in 2009–2013. End points were the 30-day SSI rate (n=8), air-particle count (n=2), or microbiological air counts (n=6); 11 studies were only descriptive. Number of people in the operating room and SSI rate or airborne contaminants (particle/bacteria) were correlated in 2 studies. Door openings and airborne bacteria counts were correlated in 2 observational studies and 1 experimental study. Two cohort studies showed a significant association between surgeon interruptions/distraction or noise and SSI rate. The level of evidence was low in all studies.CONCLUSIONSPublished data about the impact of operating-room behaviors on the risk of infection are limited and heterogeneous. All studies exhibit major methodological flaws. More studies with accurate tools should be performed to address the influence of operating room behaviors on the infectious risk.Infect Control Hosp Epidemiol 2015;36(1): 93–106

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