scholarly journals Tehnični dejavniki aplikacije intramuskularne injekcije

2021 ◽  
Vol 55 (4) ◽  
Author(s):  
Aleš Vehar ◽  
Katja Vehar ◽  
Rebeka Lekše ◽  
Melita Peršolja
Keyword(s):  
Injection Site ◽  
Intramuscular Injection ◽  
Critical Appraisal ◽  
Cochrane Library ◽  
Injection Technique ◽  
Skin Disinfection ◽  
Critical Appraisal Skills ◽  
The Cochrane Library

Uvod: Aplikacija intramuskularne injekcije predstavlja najpogosteje uporabljen način aplikacije injekcij. Namen raziskave je bil preučiti najnovejše ugotovitve s področja priprave vbodnega mesta in aplikacije intramuskularne injekcije.Metode: Izveden je bil sistematični pregled znanstvene in strokovne literature v mednarodnih podatkovnih bazah CINAHL, PubMed, The Cochrane Library ter ScienceDirect. Uporabili smo naslednje ključne besede: intramuscular injection, instramuscular vaccination, injection site, skin disinfection, injection technique. Pri iskanju smo uporabili tudi Boolove operatorje AND (IN) in OR (ALI). Iskanje literature je potekalo marca in aprila 2021. Za oceno kakovosti posameznih raziskav smo uporabili orodje Critical Appraisal Skills Programme.Rezultati: Izmed 4.208 identificiranih zadetkov je bilo v končno analizo vključenih 13 člankov. Ugotovitve smo združili v štiri vsebinske kategorije: (1) izbira vbodnega mesta, (2) tehnike intramuskularne injekcije, (3) razkuževanje vbodnega mesta, (4) aspiracija.Diskusija in zaključek: Med zaključki raziskav ni enotnega mnenja glede varne in strokovne aplikacije intramuskularne injekcije. Kot kažejo raziskave, je najprimernejše mesto aplikacije ventroglutealno področje. Razkuževanje vbodnega mesta pred aplikacijo v izvenbolnišničnem okolju ni potrebno, medtem ko je aspiracija priporočljiva zgolj na dorzoglutelnem mestu. Priporoča se aplikacija s tehniko trakcija kože – pritisk – hitro sproščanje mišic, z izbiro igle ob upoštevanju debeline podkožnega maščevja, mesta za aplikacijo in gostote zdravila. Potrebna bi bila izvedba dodatnih raziskav, s katerimi bi lahko oblikovali priporočila za optimalno tehniko intramuskularne injekcije. 

scholarly journals LO072: Fever in the returning traveller: a systematic review and critical appraisal of existing clinical practice guidelines and approaches to returning travellers presenting with fever

CJEM ◽  
2016 ◽  
Vol 18 (S1) ◽  
pp. S54-S55
Author(s):  
A. Collier ◽  
J.J. Perry ◽  
A. Nath
Keyword(s):  
Systematic Review ◽  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Practice Guideline ◽  
Critical Appraisal ◽  
Clinical Information ◽  
Final Analysis ◽  
Cochrane Library ◽  
The Cochrane Library

Introduction: Fever in the returning traveller is a common ED presentation; however approaches and level of comfort with tropical diseases vary widely. This project aimed to conduct a systematic review and critical appraisal of existing clinical practice guidelines and approaches, to guide an ED approach, in Canada, to fever in the returning traveller. Methods: A literature review was conducted of peer reviewed papers, national and international practice guidelines, and practice statements presenting approaches to fever in the returning traveller. A literature search was conducted using MEDLINE and Embase (1947-Dec 2014), with librarian assistance to optimize strategy. The databases of guideline clearing houses, CMA, PHAC, WHO, CDC, and the Cochrane library were searched, along with a google scholar search. References of included articles were hand searched. Article titles and abstracts were reviewed by the author for inclusion. Key elements of the guidelines and approaches were identified and grouped by theme and where appropriate, the quality of guidelines were assessed by two reviewers using the AGREEII tool. Results: The search returned 1598 titles. 72 full manuscripts were reviewed based on inclusion from title and abstract, with 24 manuscripts included for final analysis. Common elements suggested by the guidelines or approaches were identified and grouped within three themes (key historical features, physical exam findings, investigations). Most manuscripts presented tables of important clinical information, but limited guidance on how to approach diagnosis in a focused manner. When evaluated by AGREEII, only one guideline (D’Acremont et al) scored > 50% overall quality rating. Unlike other approaches, this guideline proposes a stepwise approach to diagnosis and treatment based on the presence of key exposures, signs/symptoms, and eosinophilia. Conclusion: The guideline by D’Acremont et al was identified as the most rigorous existing practice guideline. This guideline, combined with other elements identified by thematic review, forms the basis of a suggested ED approach to fever in the returning traveller, which will be further refined using the AGREEII model to propose a practice guideline for Canadian EDs.

scholarly journals The effectiveness of telemedicine on stigmatization and treatment burden in patients with health compromising lifestyles and chronic diseases: A critically appraised topic

2018 ◽  
Vol 3 (1) ◽  
Author(s):  
Ebere Ellison Obisike
Keyword(s):  
Chronic Diseases ◽  
Information And Communication Technologies ◽  
Full Text ◽  
Critical Appraisal ◽  
Patient Empowerment ◽  
Cochrane Library ◽  
Treatment Burden ◽  
Information And Communication ◽  
The Cochrane Library ◽  
Based Medicine

Objectives: To conduct a critical appraisal of peer reviewed articles on the effectiveness of telemedicine on stigmatization and treatment burden in patients with health compromising lifestyles and chronic diseases.Methods: This study critically appraised peer-reviewed article on the effectiveness of telemedicine on stigmatization and treatment burden in patients with health compromising lifestyles and chronic diseases. Treatments included e-health interventions, information and communication technologies used in health care, internet-based interventions for diagnosis and treatments that encouraged collaborative care for patients with chronic diseases.  This paper critically appraised the full text of each relevant peer-reviewed article adapting the Occupational Therapy Critically Appraised Topics (CATs) template while using the Oxford Centre for Evidence-based Medicine- Levels of Evidence (2011) model to assess for best evidence or quality. Results: Initial internet search using Psychinformation; PubMed; Medline; ProQuest; CINAHL; OT seeker and the Cochrane Library generated over 1450 titles/abstracts. Following abstract appraisal, 30 articles were selected for full text assessment. Five of the final articles selected for this critical appraisal alluded to the effectiveness of telemedicine in reducing the treatment burden of stigmatization on patients with chronic diseases. Majority of the appraised articles indicated the effectiveness of telemedicine in changing behaviours.Conclusions: All the appraised articles alluded to the effectiveness of telemedicine in curbing some of the treatment burdens of stigmatization for patients with health compromising lifestyles and chronic diseases. However, it is evident that the use of other intervention methods such as government policy, public education and patient empowerment in conjunction with telemedicine would better reduce the effect of stigmatization and facilitate the medical interventions for patients with chronic diseases.

scholarly journals Systematic review of studies investigating ventilator associated pneumonia diagnostics in intensive care

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Basem Al-Omari ◽  
Peter McMeekin ◽  
A. Joy Allen ◽  
Ahsan R. Akram ◽  
Sara Graziadio ◽  
...  
Keyword(s):  
Standard Test ◽  
Cochrane Library ◽  
Ventilator Associated Pneumonia ◽  
Reference Standard ◽  
Treatment Unit ◽  
Common Reference ◽  
Full Text Review ◽  
Comprehensive Search ◽  
Critical Appraisal Skills ◽  
The Cochrane Library

Abstract Background Ventilator-associated pneumonia (VAP) is an important diagnosis in critical care. VAP research is complicated by the lack of agreed diagnostic criteria and reference standard test criteria. Our aim was to review which reference standard tests are used to evaluate novel index tests for suspected VAP. Methods We conducted a comprehensive search using electronic databases and hand reference checks. The Cochrane Library, MEDLINE, CINHAL, EMBASE, and web of science were searched from 2008 until November 2018. All terms related to VAP diagnostics in the intensive treatment unit were used to conduct the search. We adopted a checklist from the critical appraisal skills programme checklist for diagnostic studies to assess the quality of the included studies. Results We identified 2441 records, of which 178 were selected for full-text review. Following methodological examination and quality assessment, 44 studies were included in narrative data synthesis. Thirty-two (72.7%) studies utilised a sole microbiological reference standard; the remaining 12 studies utilised a composite reference standard, nine of which included a mandatory microbiological criterion. Histopathological criteria were optional in four studies but mandatory in none. Conclusions Nearly all reference standards for VAP used in diagnostic test research required some microbiological confirmation of infection, with BAL culture being the most common reference standard used.

scholarly journals A protocol for a qualitative synthesis exploring people with stroke, family members, caregivers and healthcare professionals experiences of early supported discharge (ESD) after stroke

2020 ◽  
Vol 3 ◽  
pp. 79
Author(s):  
Elaine O Connor ◽  
Eamon Dolan ◽  
Frances Horgan ◽  
Katie Robinson ◽  
Rose Galvin
Keyword(s):  
Healthcare Professionals ◽  
Family Members ◽  
Cost Savings ◽  
Hospital Environment ◽  
Cochrane Library ◽  
Qualitative Synthesis ◽  
Open Access Journals ◽  
Early Supported Discharge ◽  
Critical Appraisal Skills ◽  
The Cochrane Library

Early supported discharge (ESD) facilitates a person with a stroke to be discharged from the acute hospital environment earlier than conventional care to continue their rehabilitation within the home with members of the multi-disciplinary team. A number of quantitative studies have highlighted benefits of ESD including a reduction in the length of inpatient stay, cost savings, as well as reducing long term dependency. This systematic review and qualitative synthesis explores the perspectives and experiences of those involved in ESD including people with stroke, family members, caregivers as well as the healthcare professionals involved in the delivery of the service. A comprehensive literature search will be completed in the following databases CINAHL, PubMed Central, Embase, Medline, PsycINFO, Sage, Academic Search Complete, Directory of Open Access Journals, The Cochrane Library, PsycARTICLES and Scopus. Qualitative or mixed methods studies that include qualitative data on the perspectives and experiences of people with stroke, family members, caregivers and healthcare professionals of an ESD service will be included. Methodological quality will be appraised using the ten-item Critical Appraisal Skills Programme checklist for qualitative research by two independent reviewers with a third reviewer involved should differences of opinion arise. Findings will be synthesised using thematic synthesis.    It is anticipated that the qualitative synthesis will provide a deeper understanding of the experiences of ESD which may serve to inform practice as well as assist in the development of new ESD services. PROSPERO registration: CRD42020135197 – 28/04/2020

scholarly journals The effect of intramuscular injection technique on injection associated pain; a systematic review and meta-analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (5) ◽  
pp. e0250883
Author(s):  
Oluseyi Ayinde ◽  
Rachel S. Hayward ◽  
Jonathan D. C. Ross
Keyword(s):  
Systematic Review ◽  
Injection Site ◽  
Intramuscular Injection ◽  
Meta Analysis ◽  
Injection Pain ◽  
Injection Technique ◽  
Local Pressure ◽  
Needle Technique ◽  
Pain Intervention ◽  
Manual Pressure

Aim To review the effect of different intramuscular injection (IMI) techniques on injection associated pain, in adults. Methods The review protocol was registered on PROSPERO (CRD42019136097). MEDLINE, EMBASE, British Nursing Index and CINAHL were searched up to June 2020. Included studies were appraised and a meta-analysis, where appropriate, was conducted with a random effects model and test for heterogeneity. Standardised mean difference (SMD) with a 95% confidence interval in reported injection pain (intervention cf. control) was reported. Results 29 studies were included in the systematic review and 20 studies in the meta-analysis. 13 IMI techniques were identified. 10 studies applied local pressure to the injection site. Of these, applying manual pressure (4 studies, SMD = -0.85[-1.36,-0.33]) and Helfer (rhythmic) tapping (3 studies, SMD = -2.95[-5.51,-0.39]) to the injection site reduced injection pain, whereas the use of a plastic device to apply local pressure to the skin (ShotBlocker) did not significantly reduce pain (2 studies, SMD = -0.51[-1.58,0.56]). Acupressure techniques which mostly involved applying sustained pressure followed by intermittent pressure (tapping) to acupressure points local to the injection site reduced pain (4 studies: SMD = -1.62[-2.80,-0.44]), as did injections to the ventrogluteal site compared to the dorsogluteal site (2 studies, SMD = -0.43[-0.81,-0.06]). There was insufficient evidence on the benefits of the ‘Z track technique’ (2 studies, SMD = -0.20[-0.41,0.01]) and the cold needle technique (2 studies, SMD = -0.73[-1.83,0.37]) on injection pain. The effect of changing the needle after drawing up the injectate on injection pain was conflicting and warming the injectate did not reduce pain. Limitations included considerable heterogeneity, poor reporting of randomisation, and possible bias in outcome measures from unblinding of assessors or participants. Conclusions Manual pressure or rhythmic tapping over the injection site and applying local pressure around the injection site reduced IMI pain. However, there was very high unexplained heterogeneity between studies and risk of significant bias within small studies.

Efficacy of compression stockings in preventing post-thrombotic syndrome in patients with deep venous thrombosis: a systematic review and metaanalysis

VASA ◽  
2016 ◽  
Vol 45 (2) ◽  
pp. 141-147 ◽  
Author(s):  
Jakob Martin Burgstaller ◽  
Johann Steurer ◽  
Ulrike Held ◽  
Beatrice Amann-Vesti
Keyword(s):  
Systematic Review ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Cochrane Library ◽  
Compression Stockings ◽  
Post Thrombotic Syndrome ◽  
Study Results ◽  
Preventive Efficacy ◽  
One Year ◽  
The Cochrane Library

Abstract. Background: Here, we update an earlier systematic review on the preventive efficacy of active compression stockings in patients with diagnosed proximal deep venous thrombosis (DVT) by including the results of recently published trials. The aims are to synthesize the results of the original studies, and to identify details to explain heterogeneous results. Methods: We searched the Cochrane Library, PubMed, Scopus, and Medline for original studies that compared the preventive efficacy of active compression stockings with placebo or no compression stockings in patients with diagnosed proximal DVT. Only randomized controlled trials (RCTs) were included. Results: Five eligible RCTs with a total of 1393 patients (sample sizes ranged from 47 to 803 patients) were included. In three RCTs, patients started to wear compression stockings, placebo stockings or no stockings within the first three weeks after the diagnosis of DVT. The results of two RCTs indicate a statistically significant reduction in post-thrombotic syndrome (PTS) of 50% or more after two or more years. The result of one RCT shows no preventive effect of compression stockings at all. Due to the heterogeneity of the study results, we refrained from pooling the results of the RCTs. In a further RCT, randomization to groups with and without compression stockings took place six months after the diagnosis of DVT, and in another RCT, only patients with the absence of PTS one year after the diagnosis of DVT were analyzed. One RCT revealed a significant reduction in symptoms, whereas another RCT failed to show any benefit of using compression stockings. Conclusions: At this time, it does not seem to be justifiable to entirely abandon the recommendations regarding compression stockings to prevent PTS in patients with DVT. There is evidence favoring compression stockings, but there is also evidence showing no benefit of compression stockings.

Barriers and facilitators to conducting research by early career psychiatrists: a literature review

2019 ◽  
Vol 2 (2) ◽  
pp. 135-154
Author(s):  
Katja Koelkebeck ◽  
Maja Pantovic Stefanovic ◽  
Dorota Frydecka ◽  
Claudia Palumbo ◽  
Olivier Andlauer ◽  
...  
Keyword(s):  
Research Participation ◽  
Early Career ◽  
Cochrane Library ◽  
Inclusion Criteria ◽  
Research Career ◽  
Hand Search ◽  
Electronic Search ◽  
Conducting Research ◽  
The Cochrane Library ◽  
To Receive

AbstractObjectivesTo understand and identify factors that promote and prevent research participation among early career psychiatrists (ECPs), in order to understand what would encourage more ECPs to pursue a research career.MethodsWe conducted an electronic search of databases (PubMed and the Cochrane library) using the keywords ‘doctors’, ‘trainees’, ‘residents’, ‘physicians’ and ‘psychiatric trainees’ as well as ‘research’ (MeSH) and ‘publishing’ (MeSH). This search was complemented by a secondary hand search.ResultsWe identified 524 articles, of which 16 fulfilled inclusion criteria for this review. The main barriers included lack of dedicated time for research, lack of mentoring and lack of funding. The main facilitators were opportunities to receive mentorship and access to research funding.ConclusionsAction is needed to counteract the lack of ECPs interested in a career in research. Specific programs encouraging ECPs to pursue research careers and having access to mentors could help increase the current numbers of researching clinicians in the field.

Intervención multi-componente en la prevención de la obesidad infantil como medida de salud pública

2017 ◽  
Vol 42 (2) ◽  
pp. 149-161
Author(s):  
Henry Cuevas Casa ◽  
Gabriela Aguinaga Romero ◽  
Fabricio González-Andrade
Keyword(s):  
Cochrane Library ◽  
Controlled Trials ◽  
The Cochrane Library

Objetivos: se propone identificar y revisar aquellas estrategias potenciales que incluyan un enfoque multifacético a la hora de hacer frente a la obesidad en niños escolarizados. De acuerdo a la evidencia más reciente, las intervenciones más efectivas para combatir la obesidad infantil son aquellas que involucranactividad física, educación nutricional y entornos de apoyo. Así, en esta revisión nos centramos en buscar dichas intervenciones, que además incluyan seguimientos a medio y largo plazo, monitoreo y evaluación, que son críticos para mantener una acción efectiva.Material y métodos: se incluyó una revisión de artículos científicos publicados en bases de datos especializadas como Pubmed (Medline), the Cochrane Library, The Cochrane Controlled Trials Register (CCTR), ScienceDirect, Scielo, La Biblioteca Cochrane Plus y la página web de la Organización Mundial de la Salud (http://www.who.int).Resultados: de 199 artículos potenciales, sólo 8 fueron incluidos en esta revisión. Los resultados mostraron que aquellas intervenciones multi-componente y de largo plazo tienen beneficios sobre IMC, actividad física y elecciones alimentarias. Sin embargo, pocos estudios mostraron cambios significativos sobrelos hábitos alimentarios generales y sobre la prevalencia de la obesidad. También, se observó que las intervenciones multicomponente que se llevaron a cabo tanto en países en desarrollo de Latinoamérica, como en países desarrollados tuvieron resultados similares.Conclusión: esta revisión demuestra que pueden ocurrir cambios sobre las medidas antropométricas, la actividad física y las elecciones alimentarias cuando se llevan a cabo intervenciones multicomponente en ambientes a nivel de la educación académica primaria, sin importar la localización geográfica, peromanteniendo similar metodología y materiales

BREAST CANCER SCREENING: CURRENT ACHIEVEMENTS, FUTURE PERSPECTIVES AND NEW TECHNOLOGIES

2019 ◽  
Vol 65 (5) ◽  
pp. 664-671
Author(s):  
Ilya Pyatnitskiy ◽  
O. Puchkova ◽  
Viktor Gombolevskiy ◽  
Lyudmila Nizovtsova ◽  
Natalya Vetsheva ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
New Technologies ◽  
Screening Program ◽  
Cochrane Library ◽  
Future Perspectives ◽  
Pubmed Database ◽  
The World ◽  
The Cochrane Library

The article presents a literature review of the PubMed database and the Cochrane library, aimed at analyzing the current situation and problems in the field of breast cancer screening in the world and Russia to form an idea of the key elements in organizing an effective screening program in the Russian healthcare system, as well as the possibilities of using new technologies when organizing such programs.

Neuroimaging Outcomes in Studies of Cognitive Training in Mild Cognitive Impairment and Early Alzheimer’s Disease: A Systematic Review

2020 ◽  
Vol 17 (5) ◽  
pp. 472-486
Author(s):  
Lucy Beishon ◽  
Kannakorn Intharakham ◽  
David Swienton ◽  
Ronney B. Panerai ◽  
Thompson G. Robinson ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Cognitive Impairment ◽  
Search Strategy ◽  
Web Of Science ◽  
Cochrane Library ◽  
Functional Magnetic Resonance ◽  
Resonance Imaging ◽  
Early Alzheimer’S Disease ◽  
Magnetic Resonance Imaging Mri ◽  
The Cochrane Library

Background: Cognitive Training (CT) has demonstrated some benefits to cognitive and psychosocial function in Mild Cognitive Impairment (MCI) and early dementia, but the certainty related to those findings remains unclear. Therefore, understanding the mechanisms by which CT improves cognitive functioning may help to understand the relationships between CT and cognitive function. The purpose of this review was to identify the evidence for neuroimaging outcomes in studies of CT in MCI and early Alzheimer’s Disease (AD). Methods: Medline, Embase, Web of Science, PsycINFO, CINAHL, and The Cochrane Library were searched with a predefined search strategy, which yielded 1778 articles. Studies were suitable for inclusion where a CT program was used in patients with MCI or AD, with a structural or functional Magnetic Resonance Imaging (MRI) outcome. Studies were assessed for quality using the Downs and Black criteria. Results: Medline, Embase, Web of Science, PsycINFO, CINAHL, and The Cochrane Library were searched with a predefined search strategy, which yielded 1778 articles. Studies were suitable for inclusion where a CT program was used in patients with MCI or AD, with a structural or functional Magnetic Resonance Imaging (MRI) outcome. Studies were assessed for quality using the Downs and Black criteria. Conclusions: CT resulted in variable functional and structural changes in dementia, and conclusions are limited by heterogeneity and study quality. Larger, more robust studies are required to correlate these findings with clinical benefits from CT.

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