scholarly journals Ocular adverse events from pharmacological treatment in patients with multiple sclerosis—A systematic review of the literature

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Juliana Muñoz-Ortiz ◽  
Juliana Reyes-Guanes ◽  
Estefanía Zapata-Bravo ◽  
Laura Mora-Muñoz ◽  
Juan Antonio Reyes-Hurtado ◽  
...  

Abstract Purpose The aim of this study was to review the scientific evidence and describe the ocular treatment-emergent adverse events (TEAEs) related to pharmacological treatment in patients with multiple sclerosis. Methods A systematic review of literature was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines in the MEDLINE, LILACS, EMBASE, and COCHRANE databases. Articles were filtered based on title and abstract considering the selection criteria and subsequently filtered by full-text reading. The resulting articles were evaluated using the Joanna Briggs Institute Quality Tools. Study characteristics and results were extracted and presented in structured tables to conduct a narrative synthesis. Results A total of 2852 published articles were extracted using our strategy. After removing duplicates, 2841 articles were screened based on title and abstract, 102 articles were evaluated using quality tools, and 69 articles were filtered by full-text reading. Through this search strategy, 60 articles met all the inclusion criteria and seven articles, through a search update conducted in the same manner, were included. This resulted in 67 articles meeting the inclusion criteria, of which 11 were experimental and 56 were observational. The therapies related to ocular TEAEs were alemtuzumab, amantadine, fingolimod, steroids, CTLA-4 Ig, estriol, interferon β, natalizumab, hyperbaric oxygen, rituximab, siponimod, teriflunomide, and tovaxin. Fingolimod and siponimod were commonly associated with macular edema, interferon β was associated with retinopathy, alemtuzumab was associated with thyroid eye disease, amantadine was associated with corneal edema, and steroids were associated with acute retinal necrosis. Opportunistic infections were also found, and there was one life-threatening case. Conclusions Our search revealed different methodological assessments of the topic. However, longitudinal studies regarding ocular TEAEs related to multiple sclerosis therapy are necessary to provide evidence-based recommendations, especially in understudied regions such as Latin America and Africa. Physicians should monitor ocular symptoms in patients being treated for multiple sclerosis and consider an interdisciplinary approach. Systematic review registration PROSPERO ID CRD42020106886

2020 ◽  
Vol 01 ◽  
Author(s):  
Carla Pires ◽  
Ana Fernandes

Background: Natural products are commonly used for treating health problems. These products may be associated with adverse events, which are defined as "noxious and unintended response to a medicinal product" by the European Medicine Agency. Objectives: To identify studies describing at least one adverse event (or with potential to promote an adverse event) related to the use of natural products, as well as to describe the involved product(s) and adverse event(s). Methods: A pre-systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria. Keywords: "natural product(s)" and ["adverse drug reaction(s)" or "adverse effect(s)"]. Screened databases: PubMed, SciELO, DOAJ and Google Scholar. Inclusion criteria: papers describing at least one adverse event associated with the use of natural products and published between 2017 and 2019. Exclusion criteria: Repeated studies, reviews and papers written in other languages than English, Portuguese, French or Spanish. Results: 104 studies were identified (20 PubMed; 0 SciELO; 2 DOAJ; 82 Google Scholar), but only 10 were selected (4 PubMed and 6 Google Scholar): 1 in-vitro study; 2 non-clinical studies, 1 study reporting in-vitro and clinical data and 5 studies were cases reports. Globally, 997 reports of adverse drug reactions with natural products were identified, mainly non-severe cases. Conclusion: Since a limited number of studies was found, we conclude that adverse events due to natural products may be underreported, or natural products may have a good safety profile. This review contributes for assuring the safety of natural products consumers, by evaluating the knowledge/information on the potential adverse events and interactions of these products.


2012 ◽  
Vol 47 (2) ◽  
pp. 221-223 ◽  
Author(s):  
Tamara C. Valovich McLeod ◽  
Candace Leach

Reference/Citation: Alla S, Sullivan SJ, Hale L, McCrory P. Self-report scales/checklists for the measurement of concussion symptoms: a systematic review. Br J Sports Med. 2009;43 (suppl 1):i3–i12. Clinical Question: Which self-report symptom scales or checklists are psychometrically sound for clinical use to assess sport-related concussion? Data Sources: Articles available in full text, published from the establishment of each database through December 2008, were identified from PubMed, Medline, CINAHL, Scopus, Web of Science, SPORTDiscus, PsycINFO, and AMED. Search terms included brain concussion, signs or symptoms, and athletic injuries, in combination with the AND Boolean operator, and were limited to studies published in English. The authors also hand searched the reference lists of retrieved articles. Additional searches of books, conference proceedings, theses, and Web sites of commercial scales were done to provide additional information about the psychometric properties and development for those scales when needed in articles meeting the inclusion criteria. Study Selection: Articles were included if they identified all the items on the scale and the article was either an original research report describing the use of scales in the evaluation of concussion symptoms or a review article that discussed the use or development of concussion symptom scales. Only articles published in English and available in full text were included. Data Extraction: From each study, the following information was extracted by the primary author using a standardized protocol: study design, publication year, participant characteristics, reliability of the scale, and details of the scale or checklist, including name, number of items, time of measurement, format, mode of report, data analysis, scoring, and psychometric properties. A quality assessment of included studies was done using 16 items from the Downs and Black checklist1 and assessed reporting, internal validity, and external validity. Main Results: The initial database search identified 421 articles. After 131 duplicate articles were removed, 290 articles remained and were added to 17 articles found during the hand search, for a total of 307 articles; of those, 295 were available in full text. Sixty articles met the inclusion criteria and were used in the systematic review. The quality of the included studies ranged from 9 to 15 points out of a maximum quality score of 17. The included articles were published between 1995 and 2008 and included a collective total of 5864 concussed athletes and 5032 nonconcussed controls, most of whom participated in American football. The majority of the studies were descriptive studies monitoring the resolution of concussive self-report symptoms compared with either a preseason baseline or healthy control group, with a smaller number of studies (n = 8) investigating the development of a scale. The authors initially identified 20 scales that were used among the 60 included articles. Further review revealed that 14 scales were variations of the Pittsburgh Steelers postconcussion scale (the Post-Concussion Scale, Post-Concussion Scale: Revised, Post-Concussion Scale: ImPACT, Post-Concussion Symptom Scale: Vienna, Graded Symptom Checklist [GSC], Head Injury Scale, McGill ACE Post-Concussion Symptoms Scale, and CogState Sport Symptom Checklist), narrowing down to 6 core scales, which the authors discussed further. The 6 core scales were the Pittsburgh Steelers Post-Concussion Scale (17 items), Post-Concussion Symptom Assessment Questionnaire (10 items), Concussion Resolution Index postconcussion questionnaire (15 items), Signs and Symptoms Checklist (34 items), Sport Concussion Assessment Tool (SCAT) postconcussion symptom scale (25 items), and Concussion Symptom Inventory (12 items). Each of the 6 core scales includes symptoms associated with sport-related concussion; however, the number of items on each scale varied. A 7-point Likert scale was used on most scales, with a smaller number using a dichotomous (yes/no) classification. Only 7 of the 20 scales had published psychometric properties, and only 1 scale, the Concussion Symptom Inventory, was empirically driven (Rasch analysis), with development of the scale occurring before its clinical use. Internal consistency (Cronbach α) was reported for the Post-Concussion Scale (.87), Post-Concussion Scale: ImPACT 22-item (.88–.94), Head Injury Scale 9-item (.78), and Head Injury Scale 16-item (.84). Test-retest reliability has been reported only for the Post-Concussion Scale (Spearman r = .55) and the Post-Concussion Scale: ImPACT 21-item (Pearson r = .65). With respect to validity, the SCAT postconcussion scale has demonstrated face and content validity, the Post-Concussion Scale: ImPACT 22-item and Head Injury Scale 9-item have reported construct validity, and the Head Injury Scale 9-item and 16-item have published factorial validity. Sensitivity and specificity have been reported only with the GSC (0.89 and 1.0, respectively) and the Post-Concussion Scale: ImPACT 21-item when combined with the neurocognitive component of ImPACT (0.819 and 0.849, respectively). Meaningful change scores were reported for the Post-Concussion Scale (14.8 points), Post-Concussion Scale: ImPACT 22-item (6.8 points), and Post-Concussion Scale: ImPACT 21-item (standard error of the difference = 7.17; 80% confidence interval = 9.18). Conclusions: Numerous scales exist for measuring the number and severity of concussion-related symptoms, with most evolving from the neuropsychology literature pertaining to head-injured populations. However, very few of these were created in a systematic manner that follows scale development processes and have published psychometric properties. Clinicians need to understand these limitations when choosing and using a symptom scale for inclusion in a concussion assessment battery. Future authors should assess the underlying constructs and measurement properties of currently available scales and use the ever-increasing prospective data pools of concussed athlete information to develop scales following appropriate, systematic processes.


Jurnal NERS ◽  
2019 ◽  
Vol 14 (3) ◽  
pp. 71
Author(s):  
Rizki Agustin Purwaningtyas ◽  
Ardila Lailatul Barik ◽  
Dwi Astuti

Introduction: Obesity and stunting in childhood has become one of the greatest global health challenges. The impact of this issue is serious and lasting for individuals, their families, communities and countries. Most of the studies on child weight status have only focused on the mother as the primary caregiver, whereas the role and influence of the grandparents has received less attention. Grandparent-provided child care has become a trend in many countries, with reported rates of approximately 40% to 58%. The objective of this systematic review was to analyze whether children become stunted or obese when they are cared for by their grandparents.Methods: The methodological search of the literature was conducted using Scopus, Science Direct, PubMed, Pro Quest and ResearchGate, and it was undertaken using PRISMA guidelines. The search identified 1803 papers and 135 full-text articles were screened for eligibility. Finally, 15 met the inclusion criteria. The keyword chain was as follows: ("obesity" OR "stunting") AND (“children”) AND (“grandparents”).Results: As grandparents take on increasingly responsible roles in the lives of their grandchildren, there is an influence on the higher risk of child obesity rather than stunting.Conclusion: In future, nurses should target not only the mother but also the grandparents to control their child’s health, especially when related to their weight status.


2019 ◽  
Vol 1 (Supplement_1) ◽  
pp. i17-i17
Author(s):  
Yosef Ellenbogen ◽  
Karanbir Brar ◽  
Nebras Warsi ◽  
Jetan Badhiwala ◽  
Alireza Mansouri

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.


2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Ciaran Judge ◽  
Sarah Mello ◽  
David Bradley ◽  
Joseph Harbison

Introduction. The inadvertent or purposeful introduction of foreign bodies or substances can lead to cerebral infarction if they embolize to the brain. Individual reports of these events are uncommon but may increase with the increased occurrences of their risk factors, for example, intra-arterial procedures.Method. We searched EMBASE and MEDLINE for articles on embolic stroke of nontissue origin. 1889 articles were identified and screened and 216 articles were ultimately reviewed in full text and included in qualitative analysis. Articles deemed relevant were assessed by a second reviewer to confirm compatibility with the inclusion criteria. References of included articles were reviewed for relevant publications. We categorized the pathology of the emboli into the following groups: air embolism (141 reports), other arterial gas embolisms (49 reports), missiles and foreign bodies (16 reports), and others, including drug embolism, cotton wool, and vascular sclerosant agents.Conclusion. Air and gaseous embolism are becoming more common with increased use of interventional medical procedures and increased popularity of sports such as diving. There is increasing evidence for the use of hyperbaric oxygen for such events. Causes of solid emboli are diverse. More commonly reported causes include bullets, missiles, and substances used in medical procedures.


2012 ◽  
Vol 19 (1) ◽  
pp. 15-23 ◽  
Author(s):  
Simon Zhornitsky ◽  
V Wee Yong ◽  
Samuel Weiss ◽  
Luanne M Metz

Multiple sclerosis (MS) is more common among women than men. MS often goes into remission during pregnancy, when prolactin (PRL) levels are known to be high. In an animal model of demyelination, PRL promoted myelin repair, suggesting it has potential as a remyelinating therapy in MS. In this systematic review, we examined the known associations between PRL and MS, in order to elucidate its potential role in the pathophysiology and treatment of MS. A systematic search was performed in the electronic databases PubMed and EMBASE, using the keywords "prolactin" AND “multiple sclerosis.” The inclusion criteria were met by 23 studies. These studies suggested to us that elevated PRL may be more common in MS patients than in controls. Hyperprolactinemia may also be associated with clinical relapse in MS, especially among patients with hypothalamic lesions or optic neuritis; however, it is unknown if this is a cause or consequence of a relapse. Overall, most people with MS have normal PRL levels. The impact of PRL on MS outcomes remains unclear.


Author(s):  
Andrik Hermanto ◽  
Tintin Sukartini ◽  
Esti Yunitasari

Background: Anxiety will affect the cancer patient's physiology and decrease the body's immune system, so that intervention is needed to alleviate anxiety. Objective: To find out various non-pharmacalogical therapies to reduce anxiety in cancer patients with chemotherapy. Method: The database used in this study was scopus, proquest and pubmed were limited to the last 5 years of publication from 2016 to 2020, full-text article and in english. The keywords used were "cancer" and "anxiety". This systematic review uses 10 articles that fit the inclusion criteria. Results: nonpharmacological management of cancer patients to reduce anxiety includes music therapy, autogenic training, mindfulness programs, virtual reality, guided imagery and progressive muscle training. Non-pharmacalogical therapy functions to reduce anxiety in cancer patients with chemotherapy and reduce various kinds of side effects such as anaemia, thrombocytopenia, leucopenia, nausea and vomiting, alopecia (hair loss), stomatitis, allergic reactions, neurotoxic, and extravasation (discharge of vesicle or irritant drugs to the patient) subcutaneous tissue resulting in pain, tissue necrosis, and tissue ulceration). Keywords: cancer; anxiety; nonpharmacologic therapy ABSTRAK Latar belakang: Cemas akan mempengaruhi psikologis pasien kanker dan menurunkan sistem imun tubuh, sehingga dibutuhkan intervensi yang dapat meringankan kecemasan. Tujuan: Untuk mengetahui berbagai macam terapi non farmakalogis untuk mengurangi kecemasan pada pasien kanker dengan kemoterapi. Metode: Database yang digunakan dalam studi ini adalah Scopus, Proquest dan Pubmed terbatas untuk publikasi 5 tahun terakhir dari 2016 hingga 2020, full text article dan berbahasa Inggris. Kata kunci yang digunakan adalah “cancer” AND “anxiety”. Systematic review ini menggunakan 10 artikel yang sesuai dengan kriteria inklusi Hasil: Tatalaksana nonfarmakologi pada pasien kanker untuk mengurangi cemas antara lain meliputi terapi musik, latihan autogenik, minfullnes program, virtual reality, guided imagery dan latihan otot progresif. Terapi non farmakalogis berfungsi untuk mengurangi kecemasan pada pasien kanker dengan kemoterapi dan mengurangi berbagai macam efek samping seperti anemia, trombositopenia, leucopenia, mual dan muntah, alopesia (rambut rontok), stomatitis, reaksialergi, neurotoksik, dan ekstravasasi (keluarnya obat vesikan atau iritan ke jaringan subkutan yang berakibat timbulnya rasa nyeri, nekrosis jaringan, dan ulserasi jaringan). Kata kunci: kanker; kecemasan; terapi nonfarmakologi


2021 ◽  
Vol 8 ◽  
Author(s):  
Houda Neani ◽  
Youssef Oualalou ◽  
Ahlam Assali ◽  
Fatima Zaoui

Background: Surgically assisted maxillary expansion has been used for the treatment of transverse maxillary deficiency in adult patients. The aim of this study is to evaluate, through a systematic review, the effect of this therapy on the dimensions of the aeropharyngeal dimensions and on the improvement of nasal ventilation. Materiel and method: 5 databases have been explored from 2010 (Pubmed, Scopus, Embase, Cochrane and Web of Science) using keywords expansion AND airway AND volum. After evaluating title, abstract and full text of articles found from databases, only 11 matching the inclusion criteria were included in the systematic review. Results: All the studies have shown that, in addition to its action on the maxillary bone, surgically-assisted maxillary expansion induces also an enlargement of the nasal floor and a reduction in airflow resistance, which promotes an improvement in nasal breathing. Conclusion: this surgical approach may lead to a modification in upper airway’s dimension and improvement of nasal ventilation.


2018 ◽  
Author(s):  
Ashley Brook McGar ◽  
Christine Kindler ◽  
Meghan Marsac

BACKGROUND Pediatric medical conditions have the potential to result in challenging psychological symptoms (eg, anxiety, depression, and posttraumatic stress symptoms [PTSS]) and impaired health-related quality of life in youth. Thus, effective and accessible interventions are needed to prevent and treat psychological sequelae associated with pediatric medical conditions. Electronic health (eHealth) interventions may help to meet this need, with the capacity to reach more children and families than in-person interventions. Many of these interventions are in their infancy, and we do not yet know what key components contribute to successful eHealth interventions. OBJECTIVE The primary objective of this study was to conduct a systematic review to summarize current evidence on the efficacy of eHealth interventions designed to prevent or treat psychological sequelae in youth with medical conditions. METHODS MEDLINE (PubMed) and PsycINFO databases were searched for studies published between January 1, 1998, and March 1, 2019, using predefined search terms. A total of 2 authors independently reviewed titles and abstracts of search results to determine which studies were eligible for full-text review. Reference lists of studies meeting eligibility criteria were reviewed. If the title of a reference suggested that it might be relevant for this review, the full manuscript was reviewed for inclusion. Inclusion criteria required that eligible studies (1) had conducted empirical research on the efficacy of a Web-based intervention for youth with a medical condition, (2) had included a randomized trial as part of the study method, (3) had assessed the outcomes of psychological sequelae (ie, PTSS, anxiety, depression, internalizing symptoms, or quality of life) in youth (aged 0-18 years), their caregivers, or both, (4) had included assessments at 2 or more time points, and (5) were available in English language. RESULTS A total of 1512 studies were reviewed for inclusion based on their title and abstracts; 39 articles qualified for full-text review. Moreover, 22 studies met inclusion criteria for the systematic review. Of the 22 included studies, 13 reported results indicating that eHealth interventions significantly improved at least one component of psychological sequelae in participants. Common characteristics among interventions that showed an effect included content on problem solving, education, communication, and behavior management. Studies most commonly reported on child and caregiver depression, followed by child PTSS and caregiver anxiety. CONCLUSIONS Previous research is mixed but suggests that eHealth interventions may be helpful in alleviating or preventing problematic psychological sequelae in youth with medical conditions and their caregivers. Additional research is needed to advance understanding of the most powerful intervention components and to determine when and how to best disseminate eHealth interventions, with the goal of extending the current reach of psychological interventions.


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