scholarly journals Safe investigation of isolated change in bowel habit with a flexible sigmoidoscopy? A systematic review and meta-analysis

2019 ◽  
Vol 101 (6) ◽  
pp. 379-386
Author(s):  
PJJ Herrod ◽  
H Boyd-Carson ◽  
B Doleman ◽  
JEM Blackwell ◽  
EJO Hardy ◽  
...  
Keyword(s):  
Systematic Review ◽  
Rectal Bleeding ◽  
Flexible Sigmoidoscopy ◽  
Public Awareness ◽  
Meta Analysis ◽  
Bowel Cancer ◽  
Bowel Habit ◽  
Presenting Symptoms ◽  
Awareness Campaigns ◽  
Language Restriction

IntroductionPublic awareness campaigns have led to increasing referrals of patients to colorectal surgery for possible cancer. Change in bowel habit, is traditionally described as a symptom of a left sided bowel cancer. If this is the case in practice, it raises the potentially attractive option of investigating such patients with flexible sigmoidoscopy only. This study sought to systematically review the literature describing tumour location of patients with bowel cancer presenting with left-sided symptoms to establish the safety of potential investigation of these patients with flexible sigmoidoscopy alone.MethodsA systematic review of studies reporting both the presenting symptoms of patients with bowel cancer and the location of their cancer in the bowel was prospectively registered (CRD42017072492). MEDLINE, EMBASE and CENTRAL were searched with no date or language restriction.ResultsSeven studies were included. Isolated change in bowel habit (with or without rectal bleeding) was a presenting symptom of 73% (95% CI 41–96%, I2 = 99%) of left-sided cancers but also in 13% (95% CI 2–30%, I2 = 96%) of right-sided cancers. In all patients with cancer who presented with isolated change in bowel habit (with or without rectal bleeding), the cancer was right sided in 8% (95% CI 4–12%, I2 = 69%).ConclusionsThere is a higher than expected risk that if a cancer is diagnosed in a patient presenting with either an isolated change in bowel habit or a combination of change in bowel habit with rectal bleeding, the cancer may be right sided.

scholarly journals Epidemiology of hepatitis E virus infection in animals in Africa: a systematic review and meta-analysis

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Abdou Fatawou Modiyinji ◽  
Jean Joel Bigna ◽  
Sebastien Kenmoe ◽  
Fredy Brice N. Simo ◽  
Marie A. Amougou ◽  
...  
Keyword(s):  
Systematic Review ◽  
Hepatitis E Virus ◽  
Data Extraction ◽  
Meta Analysis ◽  
Hepatitis E ◽  
Epidemiological Studies ◽  
Cross Sectional ◽  
Resource Limited ◽  
Study Selection ◽  
Language Restriction

Abstract Background Hepatitis E virus (HEV) is a major cause of acute hepatitis in humans worldwide and have high burden in the resource-limited countries. Better knowledge of the epidemiology of hepatitis in animals in Africa can help to understand the epidemiology among humans. The objective of this study was to summarize the prevalence of HEV infection and distribution of HEV genotypes among animals in Africa. Methods In this systematic review and meta-analysis, we comprehensively searched PubMed, EMBASE, African Journals Online, and Africa Index Medicus from January 1st, 2000 to March 22th, 2020 without any language restriction. We considered cross-sectional studies of HEV infection in animals in Africa. Study selection, data extraction, and methodological quality of included studies were done independently by two investigators. Prevalence data were pooled using the random-effects meta-analysis. This review was registered in PROSPERO, CRD42018087684. Results Twenty-five studies (13 species and 6983 animals) were included. The prevalence (antibodies or ribonucleic acid [RNA]) of HEV infection in animals varied widely depending on biological markers of HEV infection measured: 23.4% (95% confidence interval; 12.0–37.2) for anti-HEV immunoglobulins G, 13.1% (3.1–28.3) for anti-HEV immunoglobulins M, and 1.8% (0.2–4.3) for RNA; with substantial heterogeneity. In subgroup analysis, the immunoglobulins G seroprevalence was higher among pigs 37.8% (13.9–65.4). The following HEV genotypes were reported in animals: Rat-HEV genotype 1 (rats and horses), HEV-3 (pigs), HEV-7 (dromedaries), and Bat hepeviruses (bats). Conclusions We found a high prevalence of HEV infection in animals in Africa and HEV genotypes close to that of humans. Some animals in Africa could be the reservoir of HEV, highlighting the need of molecular epidemiological studies for investigating zoonotic transmission.

scholarly journals Dengue virus infection in people residing in Africa: a systematic review and meta-analysis of prevalence studies

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Fredy Brice N. Simo ◽  
Jean Joel Bigna ◽  
Sebastien Kenmoe ◽  
Marie S. Ndangang ◽  
Elvis Temfack ◽  
...  
Keyword(s):  
Systematic Review ◽  
Dengue Virus ◽  
Dengue Fever ◽  
Meta Analysis ◽  
Denv Infection ◽  
Risk Of Bias ◽  
Prevalence Studies ◽  
Language Restriction ◽  
The Face ◽  
Apparently Healthy

Abstract Better knowledge of the face of the current dengue virus (DENV) epidemiology in Africa can help to implement efficient strategies to curb the burden of dengue fever. We conducted this systematic review and meta-analysis to determine the prevalence of DENV infection in Africa. We searched PubMed, EMBASE, African Journals Online, and Africa Index Medicus from January 1st, 2000 to June 10th, 2019 without any language restriction. We used a random-effects model to pool studies. A total of 76 studies (80,977 participants; 24 countries) were included. No study had high risk of bias. Twenty-two (29%) had moderate and 54 (71%) had low risk of bias. In apparently healthy individuals, the pooled prevalence of DENV was 15.6% (95% confidence interval 9.9–22.2), 3.5% (0.8–7.8), and 0.0% (0.0–0.5) respectively for immunoglobulins (Ig) G, IgM, and for ribonucleic acid (RNA) in apparently healthy populations. In populations presenting with fever, the prevalence was 24.8% (13.8–37.8), 10.8% (3.8–20.6k) and 8.4% (3.7–14.4) for IgG, IgM, and for RNA respectively. There was heterogeneity in the distribution between different regions of Africa. The prevalence of DENV infection is high in the African continent. Dengue fever therefore deserves more attention from healthcare workers, researchers, and health policy makers.

scholarly journals Zinc supplementation combined with antidepressant drugs for treatment of patients with depression: a systematic review and meta-analysis

2020 ◽  
Vol 79 (1) ◽  
pp. 1-12
Author(s):  
Laís Eloy Machado da Silva ◽  
Mônica Leila Portela de Santana ◽  
Priscila Ribas de Farias Costa ◽  
Emile Miranda Pereira ◽  
Carina Márcia Magalhães Nepomuceno ◽  
...  
Keyword(s):  
Systematic Review ◽  
Placebo Group ◽  
Depressive Symptoms ◽  
Zinc Supplementation ◽  
Data Extraction ◽  
Meta Analysis ◽  
Intervention Group ◽  
Antidepressant Drugs ◽  
Language Restriction ◽  
Registration Number

Abstract Context Zinc is an essential trace mineral required for the function of brain and neural structures. The role of zinc supplementation in the prevention and treatment of depression has been suggested in clinical studies that reported a reduction in depressive symptoms. Objective The aim of this review was to determine whether zinc supplementation vs placebo can prevent or improve depressive symptoms in children, adolescents, or adults. Data Sources Five electronic databases were searched, and studies published until September 2019 were included without language restriction. Study Selection Randomized, controlled, crossover trials that evaluated the effect of zinc supplementation vs a comparator for prevention or improvement of depressive symptoms in children, adolescents, or adults were eligible for inclusion. Data Extraction Two authors independently performed data extraction and risk-of-bias assessment. Results The initial search identified 12 322 studies, 5 of which were eligible for meta-analysis. The standardized mean difference (SMD) showed an average reduction of 0.36 point (95%CI, −0.67 to −0.04) in the intervention group compared with the placebo group. Forstudies in which the mean age of participants was ≥ 40 years, the SMD was reduced by 0.61 point (95%CI, −1.12 to −0.09) in the intervention group vs the placebo group. The meta-analysis by sample size (< 60 individuals and  ≥ 60 individuals) did not show an effect of zinc supplementation in reducing depressive symptoms (SMD −0.28; 95%CI, −0.67 to −0.10; and SMD −0.52; 95%CI, −1.10 to 0.06). Conclusion Zinc supplementation may reduce depressive symptoms in individuals treated with antidepressant drugs for clinical depression. Systematic Review Registration PROSPERO registration number CRD42018081691.

scholarly journals Initiatives to shorten duration of untreated psychosis: systematic review

2011 ◽  
Vol 198 (4) ◽  
pp. 256-263 ◽  
Author(s):  
Brynmor Lloyd-Evans ◽  
Michelle Crosby ◽  
Sarah Stockton ◽  
Stephen Pilling ◽  
Lorna Hobbs ◽  
...  
Keyword(s):  
Systematic Review ◽  
Early Detection ◽  
Public Awareness ◽  
National Level ◽  
First Episode ◽  
Duration Of Untreated Psychosis ◽  
Early Intervention Services ◽  
Awareness Campaigns ◽  
Poor Outcomes ◽  
Practitioner Education

BackgroundLong duration of untreated psychosis (DUP) is common and associated with poor outcomes. Strategies to enhance early detection of first-episode psychosis have been advocated.AimsTo evaluate initiatives for early detection of psychosis.MethodSystematic review of available evidence on the effectiveness of early detection initiatives to reduce the DUP.ResultsThe review included 11 studies which evaluated 8 early detection initiatives. Evidence suggests that general practitioner education campaigns and dedicated early intervention services do not by themselves reduce DUP or generate more treated cases. Evidence for multifocus initiatives is mixed: intensive campaigns targeting the general public as well as relevant professionals may be needed. No studies evaluated initiatives targeting young people or professionals from non-health organisations.ConclusionsHow early detection can be achieved is not clear. Evidence is most promising for intensive public awareness campaigns: these require organisation and resourcing at a regional or national level. More good-quality studies are needed to address gaps in knowledge.

scholarly journals Effect of Dexmedetomidine on Duration of Mechanical Ventilation in Septic Patients: A Systematic Review and Meta-Analysis

2019 ◽  
Author(s):  
peifen chen(Former Corresponding Author) ◽  
Jihong Jiang ◽  
Yunhe Zhang ◽  
Guobao Li ◽  
Zhihui Qiu ◽  
...  
Keyword(s):  
Systematic Review ◽  
Mechanical Ventilation ◽  
Adrenergic Receptor ◽  
Receptor Agonist ◽  
Meta Analysis ◽  
Extant Literature ◽  
Searching Strategy ◽  
Language Restriction ◽  
Review Manager ◽  
Adrenergic Receptor Agonist

Abstract Background: Because of its analgesic and light sedative properties, the highly selective alpha-2 adrenergic receptor agonist dexmedetomidine (DEX) has been suggested for the treatment of septic patients, but its effect on the duration of mechanical ventilation remains unclear. The present study was conducted to review the extant literature in DEX and determine its influence on ventilation time in adult septic patients. Methods: Databases of PubMed, Cochrane, and EMBASE were applied till 20th January 2019 without language restriction. The searching strategy as following: sepsis OR septic AND mechanical ventilation AND dexmedetomidine. Two authors screened titles, abstracts, and even articles to meet the including criterion independently. In addition, references of related articles or reviews were also referred. Data was recorded in a table and analyzed using the software of Review Manager 5.0. Results: Four studies with a total of 349 patients were included. Three trials with 267 patients revealed the effect of DEX on duration of mechanical ventilation, two trials with 264 patients on ventilator-free days and four trials with 334 patients on 28-day mortality. The analyzed results indicated that DEX was not associated with significantly different durations of mechanical ventilation (MD 0.65, 95% CI, -0.13 to 1.42, P = 0.10). However, there were significant differences in ventilator-free days (MD 3.57, 95% CI, 0.26 to 6.89, P = 0.03) and 28-day mortality (RR 0.61, 95% CI, 0.49 to 0.94, P = 0.02) in the septic patients. Conclusion: Administration of DEX for sedation in septic patients was not associated with the duration of mechanical ventilation, but it increased the ventilator-free days and reduced 28-day mortality.

scholarly journals Maternal and neonatal outcomes of preeclamptic and normotensive women who underwent cesarean section under spinal Anesthesia: Systematic review and Meta-Analysis

2020 ◽  
Author(s):  
semagn Abate ◽  
Getachew Mergia ◽  
Bivash Basu
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Experimental Studies ◽  
Open Science ◽  
Neonatal Outcomes ◽  
Forest Plot ◽  
Language Restriction ◽  
Maternal And Neonatal Outcomes ◽  
Risk Of Aspiration

Abstract Background: preeclampsia is very challenging for anesthetists due to the heterogeneous clinical spectrum of the disease characterized by hypertension, risk of hypotension, high risk of aspiration, and difficult airway. Therefore, the Meta-Analysis is intended to provide evidence on maternal and neonatal outcomes of preeclamptic parturient. Methods: A comprehensive strategy was conducted in PubMed/Medline, Science Direct, and Cochrane from January 2000 to May 2020 without language restriction. The Heterogeneity among the included studies was checked with forest plot and I2 test. Observational and experimental studies reporting maternal and neonatal outcomes among preeclamptic and normotensive women were included. Results: The Meta-Analysis revealed that pooled incidence of hypotension was reduced by thirty-eight percent in preeclamptic as compared to normotensive parturient, RR=0.62(95% confidence interval (CI): 0.52 to 0.75)Conclusion: The Meta-Analysis revealed that the incidence of hypotension was lower in preeclamptic women when compared to normotensive women. The included studies were low to a very low quality of evidence which entails further randomized controlled trials.Registration: This systematic review and meta-analysis was registered in Open science Network on June 6, 2020, and the registration is available at https://osf.io/jcedt/.

scholarly journals Effect of Dexmedetomidine on Duration of Mechanical Ventilation in Septic Patients: A Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Peifen Chen ◽  
Jihong Jiang ◽  
Yunhe Zhang ◽  
Guobao Li ◽  
Zhihui Qiu ◽  
...  
Keyword(s):  
Systematic Review ◽  
Mechanical Ventilation ◽  
Adrenergic Receptor ◽  
Receptor Agonist ◽  
Meta Analysis ◽  
Extant Literature ◽  
Searching Strategy ◽  
Language Restriction ◽  
Review Manager ◽  
Adrenergic Receptor Agonist

Abstract Background: Because of its analgesic and light sedative properties, the highly selective alpha-2 adrenergic receptor agonist dexmedetomidine (DEX) has been suggested for the treatment of septic patients, but its effect on the duration of mechanical ventilation remains unclear. The present study was conducted to review the extant literature in DEX and determine its influence on ventilation time in adult septic patients. Methods: Databases of PubMed, Cochrane, and EMBASE were applied till 20th January 2019 without language restriction. The searching strategy as following: sepsis OR septic AND mechanical ventilation AND dexmedetomidine. Two authors screened titles, abstracts, and even articles to meet the including criterion independently. In addition, references of related articles or reviews were also referred. Data was recorded in a table and analyzed using the software of Review Manager 5.0. Results: Four studies with a total of 349 patients were included. Three trials with 267 patients revealed the effect of DEX on duration of mechanical ventilation, two trials with 264 patients on ventilator-free days and four trials with 334 patients on 28-day mortality. The analyzed results indicated that DEX was not associated with significantly different durations of mechanical ventilation (MD 0.65, 95% CI, -0.13 to 1.42, P = 0.10). However, there were significant differences in ventilator-free days (MD 3.57, 95% CI, 0.26 to 6.89, P = 0.03) and 28-day mortality (RR 0.61, 95% CI, 0.49 to 0.94, P = 0.02) in the septic patients. Conclusion: Administration of DEX for sedation in septic patients was not associated with the duration of mechanical ventilation, but it increased the ventilator-free days and reduced 28-day mortality.

scholarly journals Social marketing interventions for neglected tropical diseases (NTDs): A systematic review protocol

2017 ◽  
Author(s):  
Nathaly Aya Pastrana ◽  
J Jaime Miranda ◽  
Claire Somerville ◽  
David Beran ◽  
L Suzanne Suggs
Keyword(s):  
Systematic Review ◽  
Social Marketing ◽  
Hierarchical Model ◽  
Assessment Tool ◽  
Neglected Tropical Diseases ◽  
Meta Analysis ◽  
World Health ◽  
Tropical Diseases ◽  
Behavioral Determinants ◽  
Language Restriction

Background. Social marketing influences behaviors to improve the health and wellbeing of individuals and society, and this approach could be used in the field of public health for the prevention and control Neglected Tropical Diseases (NTDs). NTDs are diseases of poverty that place a burden in individuals, communities and health systems, and that exacerbate the cycle of poverty. Differences in risk and socio-cultural factors make women and children differently vulnerable. Guided by the Hierarchical Model of Social Marketing, this systematic review will assess the breadth of coverage of social marketing interventions about the 17 World Health Organization’s priority NTDs. Additionally, it will use the WHO Gender Assessment Tool (GAT) to assess the gender responsiveness of the included interventions. Methods. This protocol follows the guidelines of the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). Searches will be conducted in the databases of PubMed, EbscoHost, ProQuest, Web of Science (WOS), Global Index Medicus and Virtual Health Library (VHL) Regional Portal, and there will be no language restriction. Social marketing interventions implemented at the community, health facility and public policy settings will be included if they target an NTD; it applies at least 1 of the 4 core social marketing concepts, and 1 of the 5 social marketing techniques as described in the Hierarchical Model of Social Marketing. Data management of records will be done in Covidence, a Cochrane systematic review platform, and of data extracted in Excel. The QATSDD Critical Appraisal Tool will be used to assess the quality of individual studies in terms of how they report their research processes. Discussion. The results of this review will contribute to understand the social marketing concepts and techniques that have been used to address NTDs, and their behavioral determinants and behavioral outcomes. Furthermore, the results of this review will bring together the strengths from multidisciplinary fields by integrating gender, social marketing and NTDs in a systematic manner. Systematic review registration. PROSPERO CRD42017063858

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