scholarly journals Platelet-Rich Plasma Versus Corticosteroids for Plantar Fasciitis: A Systematic Review of Randomized Controlled Trials

2020 ◽  
Vol 8 (4) ◽  
pp. 232596712091570
Author(s):  
Eoghan T. Hurley ◽  
Yoshiharu Shimozono ◽  
Charles P. Hannon ◽  
Niall A. Smyth ◽  
Christopher D. Murawski ◽  
...  
Keyword(s):  
Systematic Review ◽  
Plantar Fasciitis ◽  
Platelet Rich Plasma ◽  
Cochrane Library ◽  
Level Of Evidence ◽  
Pain Scores ◽  
Vas Scores ◽  
American Orthopaedic ◽  
Meta Analyses ◽  
The Cochrane Library

Background: Plantar fasciitis is the most common cause of plantar heel pain. Several recent randomized control trials (RCTs) have been published comparing the use of platelet-rich plasma (PRP) and corticosteroids (CSs) for the treatment of plantar fasciitis. Purpose: To perform a systematic review of RCTs to compare whether PRP or CS injections result in decreased pain levels and improved patient outcomes in the treatment of plantar fasciitis. Study Design: Systematic review; Level of evidence, 1. Methods: Medline, EMBASE, and the Cochrane Library were screened according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines to identify RCTs comparing PRP and CS injections for plantar fasciitis. The visual analog scale (VAS) pain scores and the American Orthopaedic Foot and Ankle Society (AOFAS) scores were compared between groups at 1, 1.5, 3, 6, and 12 months, where possible. Statistical analysis was performed using RevMan, and P < .05 was considered to be statistically significant. Results: A total of 9 RCTs were identified comparing 239 patients with PRP with 240 patients with CS injections. At the follow-up time points, including 1-1.5, 3, 6, and 12 months, there were statistically significant differences in VAS scores in favor of PRP ( P = .004, P < .00001, P < .00001, and P < .00001, respectively). At 1 and 3 months, there was no difference in AOFAS scores ( P = .76 and P = .35, respectively). However, at 6 and 12 months, there was a difference in AOFAS scores in favor of PRP ( P < .00001 and P < .00001, respectively). Conclusion: In patients with chronic plantar fasciitis, the current clinical evidence suggests that PRP may lead to a greater improvement in pain and functional outcome over CS injections.

scholarly journals Augmentation of Meniscal Repair With Platelet-Rich Plasma: A Systematic Review of Comparative Studies

2020 ◽  
Vol 8 (6) ◽  
pp. 232596712092614
Author(s):  
John W. Belk ◽  
Matthew J. Kraeutler ◽  
Stephen G. Thon ◽  
Connor P. Littlefield ◽  
John H. Smith ◽  
...  
Keyword(s):  
Systematic Review ◽  
Platelet Rich Plasma ◽  
Meniscal Repair ◽  
International Knee Documentation Committee ◽  
Current Evidence ◽  
Cochrane Library ◽  
Level Of Evidence ◽  
Level 3 ◽  
The Cochrane Library

Background: The effect of platelet-rich plasma (PRP) augmentation for meniscal repair (MR) is unclear, as current evidence is limited to small, mostly nonrandomized studies. Purpose: To systematically review the literature to evaluate the efficacy and safety of MR with PRP augmentation. Study Design: Systematic review; Level of evidence, 3. Methods: A systematic review was performed by searching PubMed, the Cochrane Library, and Embase to identify studies (level of evidence 1-3) that compared the clinical efficacy of MR performed with versus without PRP. The search phrase used was platelet-rich plasma meniscus. Patients were assessed based on the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), the visual analog scale (VAS) for pain, the Lysholm score, the Knee injury and Osteoarthritis Outcome Score (KOOS), the subjective International Knee Documentation Committee (IKDC) score, and treatment failure. Results: We identified 6 studies (2 studies with level 1 evidence; 4 studies with level 3 evidence) that met inclusion criteria, for a total of 309 patients undergoing MR with PRP (mean age, 31.9 years) and 445 patients without PRP augmentation (mean age, 29.6 years). The mean follow-up was 32.8 months (range, 12-72 months). Overall, 17.0% of PRP patients experienced MR failure compared with 22.1% of non-PRP patients. No differences in VAS, Lysholm, or subjective IKDC scores were found between groups except in 1 study, in which postoperative subjective IKDC scores were significantly better in the PRP group ( P < .01). Another study found significantly better postoperative WOMAC scores among PRP patients, and 2 studies found significantly better KOOS subscores among PRP patients. Conclusion: There are a limited number of high-quality studies comparing outcomes and healing rates between patients undergoing MR with versus without PRP augmentation. Based on the available evidence, patients undergoing MR with PRP augmentation experience similar clinical outcomes at midterm follow-up when compared with conventional MR, and additional studies are needed to determine the efficacy of MR augmented with PRP.

scholarly journals The effect of hemodilution on free flap survival: A systematic review of clinical and experimental studies

2020 ◽  
Vol 75 (4) ◽  
pp. 457-466
Author(s):  
Matteo Amoroso ◽  
Peter Apelgren ◽  
Anna Elander ◽  
Karin Säljö ◽  
Lars Kölby
Keyword(s):  
Systematic Review ◽  
Literature Search ◽  
Experimental Studies ◽  
Free Flaps ◽  
Risk Of Bias ◽  
Cochrane Library ◽  
Level Of Evidence ◽  
Grade Scale ◽  
Reconstructive Microsurgery ◽  
The Cochrane Library

BACKGROUND: Acute normovolemic hemodilution (ANH) has been proposed as a microsurgical technique to improve blood flow in free flaps. OBJECTIVE: Here, we present the first systematic review of clinical and experimental studies on the effect of ANH. METHODS: We performed a systematic literature search of PubMed, Medline, the Cochrane Library, Google Scholar, and ClinicalTrials.gov using search strategies and a review process in agreement with the PRISMA statement and the Cochrane Handbook for systematic reviews of interventions. PICO criteria were defined before bibliometric processing of the retrieved articles, which were analyzed with the SYRCLE RoB tool for risk of bias and the GRADE scale for level of evidence. RESULTS: We retrieved 74 articles from the literature search, and after processing according to PICO criteria, only four articles remained, all of which were experimental. The rating for risk of bias was uncertain according to SYRCLE RoB results, and the level of evidence was low according to GRADE evaluation. CONCLUSIONS: There is no clinical evidence for the effect of ANH on microcirculation in free flaps, and experimental studies provide weak evidence supporting the use of hemodilution in reconstructive microsurgery.

scholarly journals Effect of oromotor exercises on feeding in children with cerebral palsy: systematic review

2021 ◽  
Vol 26 (1) ◽  
Author(s):  
Rania El Nagar ◽  
Alaa AL-Nemr ◽  
Faten Abdelazeim
Keyword(s):  
Systematic Review ◽  
Cerebral Palsy ◽  
Descriptive Analysis ◽  
Sensory Stimulation ◽  
Cochrane Library ◽  
Feeding Problems ◽  
Level Of Evidence ◽  
Weak Evidence ◽  
Children With Cerebral Palsy ◽  
Meta Analyses

Abstract Background Feeding problems are prevalent in children with cerebral palsy (CP). Oromotor exercises (OME) should be started as soon as possible to enhance chewing and drooling. Oromotor exercises consist of active exercises, passive exercises, and sensory stimulation. The purpose of this review is to evaluate the effectiveness of oromotor exercises on feeding, chewing, and drooling in children with CP. Body The American Academy for Cerebral Palsy and Developmental Medicine and Preferred Reporting Items for Systematic Reviews and Meta-Analyses methodology were used to conduct a systematic review. Four databases (PubMed, Cochrane Library, PEDro, and Google Scholar) were searched; this review includes seven articles, participants were 173 participants ranging in age from 18 months to 18 years. Articles were assessed according to their level of evidence and quality assessment was done by AACPDM, PEDro scale, and JBI scale. Due to the heterogeneity across included studies, descriptive analysis was performed on all of them. Primary outcomes were chewing and drooling. Results showed the effectiveness of OME in improving drooling, but with weak evidence while not effective in improving chewing. Conclusion High-quality studies are required to develop a firm judgment on the influence of oromotor exercises on feeding. The current level of evidence to support the effectiveness of oromotor exercises in children with CP is currently insufficient.

scholarly journals Platelet-Rich Plasma Augmentation to Microfracture Provides a Limited Benefit for the Treatment of Cartilage Lesions: A Meta-analysis

2020 ◽  
Vol 8 (4) ◽  
pp. 232596712091050 ◽  
Author(s):  
Angelo Boffa ◽  
Davide Previtali ◽  
Sante Alessandro Altamura ◽  
Stefano Zaffagnini ◽  
Christian Candrian ◽  
...  
Keyword(s):  
Systematic Review ◽  
Comparative Studies ◽  
Platelet Rich Plasma ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Assessment Tools ◽  
Cochrane Library ◽  
Level Of Evidence ◽  
Cartilage Lesions

Background: Microfracture is the most common first-line option for the treatment of small chondral lesions, although increasing evidence shows that the clinical benefit of microfracture decreases over time. Platelet-rich plasma (PRP) has been suggested as an effective biological augmentation to improve clinical outcomes after microfracture. Purpose: To evaluate the clinical evidence regarding the application of PRP, documenting safety and efficacy of this augmentation technique to improve microfracture for the treatment of cartilage lesions. Study Design: Systematic review; Level of evidence, 3. Methods: A systematic review was performed in PubMed, EBSCOhost database, and the Cochrane Library to identify comparative studies evaluating the clinical efficacy of PRP augmentation to microfracture. A meta-analysis was performed on articles that reported results for visual analog scale (VAS) for pain, International Knee Documentation Committee (IKDC), and American Orthopaedic Foot and Ankle Society (AOFAS) scores. Risk of bias was documented through use of the Cochrane Collaboration Risk of Bias 2.0 and Risk of Bias in Non-randomized Studies of Interventions assessment tools. The quality assessment was performed according to the Grading of Recommendations Assessment, Development and Evaluation guidelines. Results: A total of 7 studies met the inclusion criteria and were included in the meta-analysis: 4 randomized controlled trials, 2 prospective comparative studies, and 1 retrospective comparative study, for a total of 234 patients. Of the 7 studies included, 4 studies evaluated the effects of PRP treatment in the knee, and 3 studies evaluated effects in the ankle. The analysis of all scores showed a difference favoring PRP treatment in knees (VAS, P = .002 and P < .001 at 12 and 24 months, respectively; IKDC, P < .001 at both follow-up points) and ankles (both VAS and AOFAS, P < .001 at 12 months). The improvement offered by PRP did not reach the minimal clinically important difference (MCID). Conclusion: PRP provided an improvement to microfracture in knees and ankles at short-term follow-up. However, this improvement did not reach the MCID, and thus it was not clinically perceivable by the patients. Moreover, the overall low evidence and the paucity of high-level studies indicate further research is needed to confirm the potential of PRP augmentation to microfracture for the treatment of cartilage lesions.

scholarly journals The Effect of Hysteroscopy on the Reproductive Outcomes of Infertile Women Without Intrauterine Pathologies: A Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Soo Yeon Yang ◽  
Seon Heui Lee ◽  
Seung-Joo Chon
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Reproductive Outcomes ◽  
Vitro Fertilization ◽  
Infertile Women ◽  
Ovid Medline ◽  
Meta Analyses ◽  
The Cochrane Library

(1) Background: The aim of this work was to systematically review existing studies on whether hysteroscopy improves the reproductive outcomes of women with infertility even in the absence of intrauterine pathologies when compared to women who did not receive a hysteroscopy. (2) Methods: We established the Participant-Intervention-Comparison-Outcome strategy and used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement to conduct a systematic review of 11 studies which were retrieved from 3 electronic databases: Ovid-Medline, Ovid-Embase, and the Cochrane Library. Two independent investigators extracted the data from the included studies and used the Cochrane risk-of-bias tool to assess their quality. (3) Results: The primary outcome measures were the clinical pregnancy rates (CPRs) and live birth rates (LBRs) in the in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) cycles. Hysteroscopy in infertile women without intrauterine pathologies showed higher CPRs and LBRs than those in the same population who did not receive hysteroscopy in cases of recurrent implantation failure and IVF (odds ratio: 1.79 and 1.46, 95% confidence interval: 1.46-2.30 and 1.08-1.97 for CPR and LBR, respectively); however, the degree of significance was not as high for LBR. (4) Conclusions: Hysteroscopy before IVF/ICSI in infertile women without intrauterine pathologies may potentially be effective in improving the CPRs and LBRs in patients with RIF. Robust and high-quality randomized trials are warranted to confirm this finding.

scholarly journals Systematic Review of the Surgical Outcomes of Elbow Plicae

2020 ◽  
Vol 8 (10) ◽  
pp. 232596712095516
Author(s):  
In-Ho Jeon ◽  
Hua Liu ◽  
Akriti Nanda ◽  
Hyojune Kim ◽  
Dong Min Kim ◽  
...  
Keyword(s):  
Systematic Review ◽  
Radial Head ◽  
Surgical Outcomes ◽  
English Language ◽  
Cochrane Library ◽  
Medical Subject Headings ◽  
Level Of Evidence ◽  
Residual Symptoms ◽  
Language Studies ◽  
Meta Analyses

Background: Surgical resection is usually required for symptomatic elbow plicae that have failed nonoperative therapy. However, evidence of surgical outcomes has not been presented. Purpose: To review the surgical outcomes for the treatment of synovial plicae in the radiocapitellar joint. Study Design: Systematic review; Level of evidence, 4. Methods: We searched the PubMed, Ovid/MEDLINE, Cochrane Library, Google Scholar, and Embase databases using keywords as well as Medical Subject Headings terms and Emtree ([(elbow OR humeroradial joint OR radiohumeral joint) AND (meniscus OR plica)] OR snapping elbow OR snapping triceps OR synovial fold syndrome OR synovial fringe) for English-language studies. We conducted a systematic review using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Results: A total of 14 articles comprising four level 5 and ten level 4 studies were identified, including 279 patients (284 elbows). The triggering factors reported for 58 patients were heavy labor (29 patients; 50.0%), sporting activities (17 patients; 29.3%), and nonspecific trauma (12 patients; 20.7%). Overall, 92 patients (33.0%) were administered a steroid injection before surgery. Arthroscopic plica resection was performed in 266 patients (95.3%). Intraoperatively, plicae were mostly found in the posterior (44.0%) and posterolateral (28.6%) sites, and chondromalacia of the radial head was observed in 25 patients (9.2%). Of the reported surgical outcomes, 67.7% showed a resolution of symptoms. However, 9.3% of patients had residual symptoms, which were likely associated with pre-existing radial head chondromalacia. The complication rate was reported as 1.8%. Conclusion: Symptomatic elbow plicae were mostly treated arthroscopically, with most of the results being favorable. Pre-existing chondromalacia and the underestimation of concomitant intra-articular abnormalities may yield an inferior outcome.

scholarly journals General practice pharmacists in Australia: A systematic review

PLoS ONE ◽  
2021 ◽  
Vol 16 (10) ◽  
pp. e0258674
Author(s):  
Thilini Sudeshika ◽  
Mark Naunton ◽  
Louise S. Deeks ◽  
Jackson Thomas ◽  
Gregory M. Peterson ◽  
...  
Keyword(s):  
Systematic Review ◽  
General Practice ◽  
Medication Management ◽  
Cochrane Library ◽  
Care Services ◽  
Funding Model ◽  
Primary Activity ◽  
General Practices ◽  
Meta Analyses ◽  
The Cochrane Library

Background The inclusion of pharmacists into general practices in Australia has expanded in recent years. This systematic review aimed to synthesise the literature of qualitative and quantitative studies, and identify the knowledge gaps, related to pharmacists working in general practice in Australia. Methods This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed, EBSCOhost, EMBASE, and the Cochrane Library were searched from the inception of databases to January 2021. The search was focused on studies investigating general practice pharmacists in Australia. The quality of each study was appraised using the Mixed Method Appraisal Tool criteria. The narrative synthesis approach was utilised to describe data due to the heterogeneity among study designs and measures. Results Twenty-five studies were included in this review. General practice pharmacists engaged in various non-dispensing patient care services, with medication management reviews being the primary activity reported. General practice pharmacists’ characteristics and an environment with a willingness of collaboration were the notable influencing factors for successfully including pharmacists in general practices. Factors that posed a challenge to the adoption of general practice pharmacists were lack of funding and other resources, poorly defined roles, and absence of mentoring/training. Conclusion This review has summarised the characteristics, activities, benefits, barriers, and facilitators of including pharmacists in general practices in Australia. General practice pharmacists are well accepted by stakeholders, and they can engage in a range of patient-centred activities to benefit patients. There is a need for more robust research to explore the patient and economic outcomes related to clinical activities that a pharmacist can perform in general practice, as a foundation to developing an appropriate and sustainable funding model. The findings of this review will be beneficial for pharmacists, researchers, policymakers, and readers who wish to implement the role of general practice pharmacists in the future.

Platelet-Rich Plasma Versus Corticosteroids for the Treatment of Plantar Fasciitis: A Systematic Review and Meta-analysis

2020 ◽  
pp. 036354652093729
Author(s):  
Erik Hohmann ◽  
Kevin Tetsworth ◽  
Vaida Glatt
Keyword(s):  
Systematic Review ◽  
High Risk ◽  
Plantar Fasciitis ◽  
Platelet Rich Plasma ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Foot And Ankle ◽  
Analog Scale ◽  
American Orthopaedic ◽  
Corticosteroid Injections

Background: Plantar fasciitis is a common cause of heel pain. Corticosteroid injections are commonly used and proven to be effective, and lately platelet-rich plasma (PRP) has been used with mixed results. Purpose: To perform a systematic review and meta-analysis comparing intralesional injections of PRP and steroid infiltration. Study Design: Systematic review and meta-analysis. Methods: A systematic review of Medline, Embase, Scopus, and Google Scholar including all level 1 and 2 studies from 2010 to 2019 was perfomed. American Orthopaedic Foot and Ankle Society and visual analog scale for pain scores were used as outcome variables. Publication bias and risk of bias was assessed with the Cochrane Collaboration tools. The Grading of Recommendations, Assessment, Development and Evaluations system was used to assess the quality of the body of evidence. Heterogeneity was assessed with χ2 and I2 statistics. Results: Fifteen studies were included in the analysis. Nine studies had a high risk of bias. There was 1 study with high quality, 9 with moderate, 2 studies with low, and 3 with very low quality. The pooled estimate for the American Orthopaedic Foot and Ankle Society score demonstrated nonsignificant differences at 1 month ( P = .4) and 3 months ( P = .076). At 6 months ( P = .009) and 12 months ( P = .009), it indicated significant differences in favor of PRP. The pooled estimate for visual analog scale demonstrated nonsignificant differences at 1 month ( P = .653). At 3 months ( P = .0001), 6 months ( P = .002), and 12 months ( P = .019), it yielded significant differences in favor of PRP. Conclusion: The results of this systematic review and meta-analysis suggest that PRP is superior to corticosteroid injections for pain control at 3 months and lasts up to 1 year. In the short term, there is no advantage of corticosteroid infiltration. However, the low study quality, high risk of bias, and different protocols for PRP preparation reduce the internal and external validity of these findings, and these results must be viewed with caution.

Transfusion-associated necrotizing enterocolitis re-evaluated: a systematic review and meta-analysis

2018 ◽  
Vol 46 (6) ◽  
pp. 665-676 ◽  
Author(s):  
Stientje Esther Rai ◽  
Amneet Kaur Sidhu ◽  
Rohin Jayaram Krishnan
Keyword(s):  
Systematic Review ◽  
Necrotizing Enterocolitis ◽  
Meta Analysis ◽  
Subsequent Development ◽  
Practice Change ◽  
Cochrane Library ◽  
Random Effects Model ◽  
Eligibility Criteria ◽  
Meta Analyses ◽  
The Cochrane Library

Abstract Context: Significant controversy exists surrounding the possible association between recent packed red blood cell (PRBC) transfusion and the subsequent development of necrotizing enterocolitis (NEC) in infants. Previous studies and meta-analyses reporting a statistically significant association led to a practice change to withhold enteral feeds in the peri-transfusion period in many centers in an effort to prevent NEC; however, results from more recent studies do not support the existence of an association and, thus, question the validity of this practice change. Objective: This study aimed to perform a systematic review and meta-analysis to determine whether exposure to recent PRBC transfusion (defined as within 48 h) is associated with the subsequent development of NEC stage ≥II (Bell’s criteria) in infants. Methods: Medline, Embase, CINAHL, and the Cochrane Library were searched from inception to October 7, 2015. A gray literature search was also performed. Studies comparing the risk of NEC in infants exposed and unexposed to recent PRBC transfusion were included. Thirteen studies met eligibility criteria, and 10 (n=15,675 infants) were included in the meta-analysis. Three authors independently extracted data, and meta-analysis was performed using a random effects model. Results: We found a statistically significant 45% reduction in the unadjusted odds of NEC in infants exposed to a recent PRBC transfusion (odds ratio=0.55, 95% confidence interval=0.31–0.98). Conclusion: Our results show a protective effect of recent PRBC transfusion on the subsequent development of NEC. The practice of withholding enteral feeds during the peri-transfusion period should be re-evaluated in light of these results.

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