scholarly journals The effectiveness on health education to prevent nipple trauma from breastfeeding: a systematic review

2020 ◽  
Vol 20 (2) ◽  
pp. 333-345
Author(s):  
Flávia Silva Oliveira ◽  
Flaviana Vieira ◽  
Jessica Oliveira Cecilio ◽  
Janaína Valadares Guimarães ◽  
Suzanne Hetzel Campbell
Keyword(s):  
Systematic Review ◽  
Health Education ◽  
Literature Review ◽  
Postpartum Period ◽  
Web Of Science ◽  
Educational Approach ◽  
Level Of Evidence ◽  
Assessment Development ◽  
Positive Effects ◽  
High Level

Abstract Objectives: to analyze the effectiveness on health education to prevent nipple trauma in breastfeeding compared to other interventions. Methods: systematic literature review was carried out in January 2019, according to PRISMA recommendations. The searches were conducted in Cinahl, PubMed, Web of Science, Scopus, and in the references cited in the selected articles. The studies were assessed for quality and level of evidence according to the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE). Results: twelve studies were selected, all conducted at the maternities. The interventions were classified in two categories: health education on breastfeeding and the use of nipple covers. Health education on breastfeeding presents a moderate level of evidence on the prevention of nipple trauma. There is a moderate to high level of evidence on the positive effects of guaiazulene, gel or peppermint water applied in the postpartum period to prevent nipple trauma. Conclusion: health education on breastfeeding with clinical demonstration is an important strategy to prevent nipple trauma and requires more than one educational approach. The use of nipple covers requires some consideration, since they must be removed prior to breastfeeding. All interventions were conducted in the postpartum period, which points out for the necessity of clinical research to prevent nipple trauma in prenatal care.

scholarly journals A systematic review and meta-analysis of angiotensin-converting enzyme inhibitor use and psoriasis incidence

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Gonjin Song ◽  
Ji Yea Kim ◽  
Ha Young Yoon ◽  
Jeong Yee ◽  
Hye Sun Gwak
Keyword(s):  
Systematic Review ◽  
Literature Review ◽  
Angiotensin Converting Enzyme ◽  
Subgroup Analysis ◽  
Ace Inhibitor ◽  
Web Of Science ◽  
Enzyme Inhibitor ◽  
Meta Analysis ◽  
Temperate Climate ◽  
Converting Enzyme

AbstractAlthough a considerable volume of data supporting induction or aggravation of psoriasis because of angiotensin-converting enzyme (ACE) inhibitor use exists, it remains insufficient for definitive conclusions. Therefore, we aimed to evaluate the association between ACE inhibitor use and psoriasis incidence through a systematic literature review and meta-analysis. We searched for qualifying studies across PubMed, Web of Science, and Embase. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to evaluate the strength of the association between ACE inhibitor use and psoriasis incidence. Eight studies with a total of 54,509 patients with a psoriasis diagnosis were included in this meta-analysis. The pooled OR for psoriasis incidence among ACE inhibitor users was 1.52 (95% CI, 1.16–2.00) compared to that among non-users. From subgroup analysis by continent, the OR for ACE inhibitor users versus non-users was 2.37 (95% CI 1.28–4.37) in Asia. Per the subgroup analysis by climate, the OR for ACE inhibitor users vs non-users in dry climate was 3.45 (95% CI: 2.05–5.79) vs 1.32 (95% CI 1.01–1.73) in temperate climate. Our results reveal a significant association between ACE inhibitor use and psoriasis incidence.

scholarly journals The Association Between Dental Anxiety And Psychiatric Disorders And Symptoms: A Systematic Review

2018 ◽  
Vol 14 (1) ◽  
pp. 207-222 ◽  
Author(s):  
Harri Halonen ◽  
Jenna Nissinen ◽  
Heli Lehtiniemi ◽  
Tuula Salo ◽  
Pirkko Riipinen ◽  
...  
Keyword(s):  
Systematic Review ◽  
Psychiatric Disorders ◽  
Web Of Science ◽  
Dental Anxiety ◽  
Data Sources ◽  
Inclusion Criteria ◽  
Clinical Interviews ◽  
Specific Phobias ◽  
Axis I ◽  
High Level

Background:A growing amount of evidence suggests that dental anxiety is associated with other psychiatric disorders and symptoms. A systematic review was conducted to critically evaluate the studies of comorbidity of dental anxiety with other specific phobias and other Axis I psychiatric disorders.Objective:The aim of the review was to explore how dental anxiety is associated with other psychiatric disorders and to estimate the level of comorbid symptoms in dental anxiety patients.Methods:The review was conducted and reported in accordance with the MOOSE statement. Data sources included PubMed, PsycInfo, Web of Science and Scopus.Results:The search produced 631 hits, of which 16 unique records fulfilled the inclusion criteria. The number of eligible papers was low. Study populations were heterogeneous including 6,486 participants, and a total of 25 tests and in few cases clinical interviews were used in the evaluation processes. The results enhanced the idea about the comorbidity between dental anxiety and other psychiatric disorders. The effect was found strong in several studies.Conclusion:Patients with a high level of dental anxiety are more prone to have a high level of comorbid phobias, depression, mood disorders and other psychiatric disorders and symptoms.

scholarly journals Processed Electroencephalogram-Based Monitoring to Guide Sedation in Critically Ill Patients: A Systematic Review and International Expert Panel-Based Consensus Recommendations

2021 ◽  
Author(s):  
Frank A Rasulo ◽  
Philip Hopkins ◽  
Francisco Almeida Lobo ◽  
Pierre Pandin ◽  
Basil Matta ◽  
...  
Keyword(s):  
Systematic Review ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Level Of Evidence ◽  
Assessment Development ◽  
Modified Delphi ◽  
Delphi Round ◽  
Processed Eeg ◽  
Grade Of Recommendation ◽  
Excessive Sedation

Abstract BackgroundThe literature related to the use of processed EEG (pEEG) for depth of sedation (DOS) monitoring is increasing, however it is unclear how to use this type of monitoring for critical care patients within the intensive care unit (ICU).MethodsWe performed a systematic review of the literature according to the Grade of Recommendation assessment, Development, and Evaluation (GRADE) approach. The modified Delphi method was utilised by a team of experts to produce statements and recommendations derived from study questions. Three separate online rounds discussing 89 statements categorized into four domains were formulated. The panelists rated the appropriateness of each statement and were able to suggest modifications or addition of statements. An analysis of anonymised ratings of the statements by part of the panel followed each Delphi round and previously validated criteria were used to define appropriateness and consensus.ResultsLevel of evidence regarding the four domains was very low. Fourteen panelists participated in the Delphi rounds and consensus was reached for 28 out of 89 statements, from which the reccomendations were created. The main findings were that DOS monitoring should be performed in critically ill patients whenever clinical evaluation is not possible, it should be performed by continuous pEEG techniques and the resulting data depicted with graphical tools to facilitate detection of excessive sedation, a potential cause of burst-suppression, and finally, structured training is suggested to achieve a basic pEEG competency.ConclusionsAlthough evidence on using DOS monitors in ICU is scarce and further research is required in order to better define the benefits of using pEEG, the results of this consensus highlight the general agreement that critically-ill patients would benefit from this type of neuromonitoring.

Unstimulated high-sensitive thyroglobulin is a powerful prognostic predictor in patients with thyroid cancer

2019 ◽  
Vol 58 (1) ◽  
pp. 130-137 ◽  
Author(s):  
Luca Giovanella ◽  
Marco Castellana ◽  
Pierpaolo Trimboli
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Differentiated Thyroid Carcinoma ◽  
Level Of Evidence ◽  
Prognostic Performance ◽  
Clinical Scenarios ◽  
High Level ◽  
Operating Points

Abstract Background Differentiated thyroid carcinoma (DTC) has an excellent prognosis and the role of high-sensitive thyroglobulin measured during levothyroxine (ON-T4 hs-Tg) testing to discriminate patients with structural from not-evidence of disease (SED and NED, respectively) has been investigated. We conducted a systematic review and meta-analysis evaluating the performance of ON-T4 hs-Tg in two clinical scenarios considering its negative predictive value (NPV) as primary outcome: (1) diagnostic performance of Tg when undetectable value and NED status are simultaneously demonstrated; (2) prognostic performance of undetectable Tg in predicting NED in the subsequent follow-up. Methods This systematic review and meta-analysis were registered on PROSPERO (CRD42019125092). PubMed, Scopus, CENTRAL and Web of Science were searched until February 12, 2019. Original articles reporting data on SED/NED in patients with detectable/undetectable ON-T4 hs-Tg were selected. Summary operating points were estimated using a random-effects model. Results Out of 1413 retrieved papers, 10 studies evaluating 1796 patients were included. Participants were outpatients diagnosed with DTC, treated with near-total (NTx) or total thyroidectomy (TTx) with or without radioactive iodine (RAI). The NPV of ON-T4 hs-Tg for diagnostic and prognostic performance was 99.4% (95% CI 98.9–99.9; I2 = 13%) and 99.4% (95% CI 98.8–100; I2 = 0%), respectively. Conclusions Our findings show that ON-T4 hs-Tg is an excellent diagnostic tool and prognostic factor to rule-out SED. A high level of evidence is provided to decrease the intensity and frequency of follow-up in those DTC patients having undetectable high-sensitive Tg.

The experience of conducting a Cochrane systematic review of the impact of clinical pathways on professional practice, patient outcomes, length of stay and hospital costs

2009 ◽  
Vol 13 (2) ◽  
pp. 62-66 ◽  
Author(s):  
Thomas Rotter ◽  
Leigh Kinsman ◽  
Erica James ◽  
Andreas Machotta ◽  
Holger Gothe ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Pathways ◽  
Hospital Costs ◽  
Evidence Base ◽  
Care Group ◽  
Level Of Evidence ◽  
Organisation Of Care ◽  
High Level ◽  
Meta Analyses ◽  
The Impact

Despite the high prevalence of clinical pathways (CPWs), the results from published studies are inconsistent and contradictory. The plethora of study designs, settings and lack of an agreed definition of a CPW make the relevance of individual studies difficult to apply to clinical settings. It was timely to catalogue and analyse the existing evidence base for CPWs via a rigorous systematic review. Systematic reviews and meta-analyses provide a high level of evidence for the effectiveness of interventions and are commonly employed reviewing strategies for addressing scientific questions in health-related research. This method is especially useful when research results are known to be inconsistent. Instead of conducting another primary evaluation, a detailed review is needed that reflects a summation of available research. This paper reports and discusses methodological and technical issues of a systematic review of the effectiveness of CPWs in hospitals, based on our experience with the Cochrane Effective Practice and Organisation of Care Group.

Lactoferrin Supplementation to Prevent Late-Onset Sepsis in Preterm Infants: A Meta-Analysis

2019 ◽  
Author(s):  
Abdul Razak ◽  
Asif Hussain
Keyword(s):  
Preterm Infants ◽  
Web Of Science ◽  
Late Onset ◽  
Meta Analysis ◽  
Evaluation Methodology ◽  
Level Of Evidence ◽  
Assessment Development ◽  
Late Onset Sepsis ◽  
All Cause Mortality

Abstract Objective To systematically review and meta-analyze the role of lactoferrin supplementation to prevent late-onset sepsis (LOS) in preterm infants. Study Design Database search include PubMed, Web of Science, and Cochrane central for randomized clinical trial (RCTs). The Cochrane Grading of Recommendations Assessment, Development, and Evaluation methodology was used for summarizing the results. Results Ten RCTs involving 3,679 infants were included. Lactoferrin supplementation with or without probiotics decreased all LOS (relative risk [RR]: 0.56; 95% confidence interval [CI]: 0.36–0.86; I 2 = 58%; 10 studies; 3,470 subjects; level of evidence [LOE]: low) significantly. Similarly, lactoferrin supplementation without probiotics decreased all LOS (RR: 0.43; 95% CI: 0.29–0.62; I 2 = 0%; 8 studies; 1,209 subjects; LOE: moderate) significantly. Lactoferrin supplementation did not significantly reduce necrotizing enterocolitis (RR: 0.62; 95% CI: 0.29–1.33; I 2 = 43%; 6 studies; 3,079 subjects; LOE: low), all-cause mortality (RR: 0.74; 95% CI: 0.36–1.53; I 2 = 53%; 8 studies; 3,395 subjects; LOE: very low), bronchopulmonary dysplasia (RR: 1; 95% CI: 0.90–1.13; I 2 = 0%; 4 studies; 2,570 subjects; LOE: moderate), and threshold retinopathy of prematurity eligible for surgical treatment (RR: 0.61; 95% CI: 0.25–1.51; I 2 = 74%; 2 studies; 2,481 subjects; LOE: very low). Conclusion Low to moderate quality evidence suggests that lactoferrin supplementation reduces LOS in preterm infants. Further research is needed to improve the certainty in the evidence.

scholarly journals Salvage of the Failed Total Wrist Arthroplasty: A Systematic Review

2020 ◽  
Vol 09 (05) ◽  
pp. 446-456
Author(s):  
Onur Berber ◽  
Sam Gidwani ◽  
Lorenzo Garagnani ◽  
Michelle Spiteri ◽  
Nicholas Riley ◽  
...  
Keyword(s):  
Systematic Review ◽  
Revision Surgery ◽  
Revision Arthroplasty ◽  
Postoperative Outcome ◽  
Secondary Outcome ◽  
Level Of Evidence ◽  
Total Wrist Arthroplasty ◽  
High Level ◽  
Meta Analyses ◽  
Wrist Arthroplasty

Abstract Background Although the performance of total wrist arthroplasty systems has improved, failure is encountered and is a major challenge to manage. Questions Does physical function improve with surgical management of the failed wrist arthroplasty? Is there an improvement in secondary outcome measures including pain, grip strength, and range of motion? What are the reasons for failure in primary total wrist arthroplasty? What are the complications associated with revision of the failed total wrist arthroplasty? What are the survival profiles of the different revision strategies? Methods A systematic review of available literature was performed. Studies were systematically assessed, and data extracted from suitable studies for review. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guidelines were adhered to. The study protocol was modified from a previous protocol published on the PROSPERO database. Results Fourteen studies were identified considering 218 patients/214 index operations with a follow-up duration following revision surgery of 2 months to 21 years (silicone wrist arthroplasty—42 cases; nonsilicone wrist arthroplasty—172 cases). The functional outcome of revision surgery was infrequently recorded and documented with only short-term assessments undertaken. Complications were seen in 1:2 revision procedures, with re-revision surgeries required in 21.6% of revised primary nonsilicone arthroplasties. Re-revision rate following a revision arthrodesis was 21.4% (15/70 cases) compared with revision arthroplasty of 34.8% (32/92 cases). Revision arthrodesis nonunion rate was 17.5% (22 cases). Conclusion This review has confirmed the high level of surgical complexity and the likelihood of a complicated postoperative outcome when salvaging a failed wrist replacement. Level of Evidence This is a Level 3, systematic review study.

High versus standard dose caffeine for apnoea: a systematic review

2018 ◽  
Vol 103 (6) ◽  
pp. F523-F529 ◽  
Author(s):  
Roos Vliegenthart ◽  
Martijn Miedema ◽  
Gerard J Hutten ◽  
Anton H van Kaam ◽  
Wes Onland
Keyword(s):  
Systematic Review ◽  
Standard Dose ◽  
Meta Analysis ◽  
Neurodevelopmental Outcome ◽  
Optimal Dose ◽  
Controlled Trials ◽  
Level Of Evidence ◽  
Assessment Development ◽  
Postmenstrual Age ◽  
Randomised Controlled

BackgroundPlacebo-controlled trials have shown that caffeine is highly effective in treating apnoea of prematurity and reduces the risk of bronchopulmonary dysplasia (BPD) and neurodevelopmental impairment (NDI).ObjectiveTo identify, appraise and summarise studies investigating the modulating effect of different caffeine dosages.MethodsA systematic review identified all randomised controlled trials (RCTs) comparing a high versus a standard caffeine treatment regimen in infants with a gestational age <32 weeks, by searching the main electronic databases and abstracts of the Pediatric Academic Societies. Studies comparing caffeine to placebo or theophylline only were excluded. Primary outcomes were BPD and mortality at 36 weeks postmenstrual age. Secondary key-outcome was neurodevelopmental outcome at 12 and 24 months corrected age. Meta-analysis was performed using RevMan 5.3.ResultsSix RCTs including 620 infants were identified. Meta-analysis showed a significant decrease in BPD, the combined outcome BPD or mortality, and failure to extubate in infants allocated to a higher caffeine dose. No differences were found in mortality alone and NDI. The quality of the outcome measures were deemed low to very low according to the Grading of Recommendations Assessment, Development and Evaluation guidelines.ConclusionsAlthough this review suggests that administering a higher dose of caffeine might enhance its beneficial effect on death or BPD, firm recommendations on the optimal caffeine dose cannot be given due to the low level of evidence. A large RCT is urgently needed to confirm or refute these findings and determine the optimal dose of caffeine.

scholarly journals Evaluación de la superficie del esmalte luego de la descementación de brackets metálicos. Revisión sistemática / Enamel Surface Assessment after Metallic Bracket Debonding. A Systematic Review

2018 ◽  
Vol 36 (77) ◽  
Author(s):  
Nicolás Arboleda Ariza ◽  
Isaac Wasserman Milhem ◽  
Diana Katherina Reina Velosa ◽  
Ingrid Quintero Quinche
Keyword(s):  
Systematic Review ◽  
High Speed ◽  
Control Group ◽  
Level Of Evidence ◽  
Double Blind ◽  
Adhesive Resin ◽  
Published Evidence ◽  
Revisión Sistemática ◽  
High Level ◽  
Surface Assessment

RESUMEN. Antecedentes: A través del tiempo se han propuesto diferentes técnicas para realizar la remoción del adhesivo y resina remanentes luego de retirar los brackets, pero no existe un consenso entre los diferentes autores. Objetivo: el propósito de esta revisión sistemática fue identificar cuál es la técnica más adecuada para evitar injuria al esmalte durante la remoción de la resina remanente después de retirados los brackets. Métodos: Esta revisión sistemática se basó en los lineamientos de PRISMA, Para recolectar la evidencia publicada se realizó una búsqueda electrónica en diferentes bases de datos. Resultados: Se encontraron 8 artículos con una evidencia media (> de 9) los cuales fueron considerados en esta revisión sistemática. Al parecer la remoción de resina y adhesivo remanentes con ultrasonido, fresa de carburo de tungsteno de alta velocidad y piedras blancas generan la mayor pérdida de esmalte, mientras que 6 artículos proponen la fresa de tungsteno de baja velocidad como la mejor técnica. Conclusiones: Se requieren estudios aleatorizados, con grupo control, doble-ciego y una técnica de análisis del esmalte estandarizada para poder generar un nivel de evidencia alto y dar recomendaciones más acertadas para el clínico.ABSTRACT. Background: Over time different techniques have been proposed for the removal of the remaining adhesive and resin after the removal of brackets, but there is no consensus among authors. Objective: Evaluate the most appropriate technique to prevent injury to the enamel during the removal of the remaining resin after the brackets are removed. Methods: This systematic review is based on the guidelines of PRISMA, to collect the published evidence there was a various electronic databases search. Results: There were only 8 items with medium evidence (> 9) which were considered in this systematic review. Apparently removing remaining adhesive resin with ultrasound, tungsten carbide cutter high speed and white stones generate the greatest loss of enamel, while 6 articles propose the tungsten bur at low speed as the best technique. Conclusions: Randomized studies with control group, double-blind and a standardized technique of enamel analysis are required to generate a high level of evidence and give more accurate recommendations for clinicians.

scholarly journals Deconstructing AMO framework: a systematic review

2016 ◽  
Vol 12 (4) ◽  
pp. 1040 ◽  
Author(s):  
Juan A. Marin-Garcia ◽  
Juan Martinez Tomas
Keyword(s):  
Social Sciences ◽  
Systematic Review ◽  
Web Of Science ◽  
Social Sciences And Humanities ◽  
Positive Effects ◽  
Scientific Papers ◽  
And Performance ◽  
The Relationship ◽  
Measures Of Performance ◽  
Shed Light

Purpose: The AMO framework has been widely accepted in HRM literature for explaining the linkage between human resources practices and performance. However, it remains unclear whether this model has been fully demonstrated or not. Hence, we propose a systematic review that aims at identifying those investigations that have thoroughly tested the model, as well as the approaches used by them.Design/methodology/approach: Systematic literature review, filtering scientific papers published in journals indexed in Scopus, Web of Science or Google Scholar, from the year 1993 to 2016, in the field of Social Sciences and Humanities with research that indirectly apply the AMO model in their analysis.Findings: AMO model is an excellent and structured framework that provides a better understanding of the relationship between HRM and performance. Moreover, the effectiveness of the model's proposal appears to be beyond doubt. In fact, a well trained and skilled employee will perform better, and a motivated worker will be ready to "go the extra mile". Likewise, if the work environment does not provide adequate opportunities, both abilities and motivation might become meaningless. However, we consider that many other factors could influence the positive effects of HPWS. As a matter of fact, not only contextual factors, but also individual beliefs, personal affinities, or personal circumstances (among others) might affect the implementation of these practices and the subsequent outcomes. For this reason, we consider that developing an HRM model that perfectly fit any situation is a very complicated, if not impossible, task.Research limitations/implications: The results show a significant variability in both research approaches and variables taken into consideration. In addition, it seems that little research has been conducted to verify the AMO model directly. Therefore, we consider that there is a great need to study the model from a more systematic perspective. A thorough understanding of the model could lead to a better understanding of the problems that organizations face when implementing human resource practices.Originality/value: Our study shed light on some aspects of the AMO framework within the HRM context. Specifically, we aimed to identify whether or not it is possible to confirm the model as it was originally proposed. We also find out which HR practices and measures of performance were considered across investigations, to define a standard approach.

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