Acute clinical manifestations in toxic smoke inhalation victims: systematic review of observational studies

Abstract Introduction: Lung injuries from toxic smoke inhalation are the main causes of death in fire victims; however, information regarding the acute effects on the respiratory system after smoke inhalation and its constituents in closed environments are still scarce in literature. Objective: To investigate the acute clinical manifestations observed in victims of smoke inhalation during enclosed-space fires by means of systematic review. Methods: A systematic search was conducted in the following databases: MEDLINE (via PubMed), Lilacs, Scopus and Web of Science. There were no appliedrestrictions in terms of thepublication date. In addition, a manual search was performed on the references of published studies. Observational studies assessing the prevalence of acute clinical manifestations in victims of toxic smoke inhalation in closed environments were included. Results: Of the 4,603 articles identified, eight were included, comprising a total of 233 patients. The signs and symptoms were identified and ranked according to frequency. Dyspnea (58.80%, six studies), carbonaceous sputum (54.51%, four studies), hoarseness (39.91%, three studies), wheezing (34.33%, five studies) and sore throat (33.90%, two studies) were the most frequent acute clinical manifestations of smoke inhalation. Besides these, chest pain and pulmonary edema were observed, respectively in 13.30%, 5.15% of the studies. Conclusion: The results suggest that dyspnea, carbonaceous sputum, hoarseness, wheezing and sore throat were the most frequent acute clinical manifestations in victims of smoke inhalation. Further studies of a higher level of evidence and greater methodological rigor are required.

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Aspirin and fracture risk: a systematic review and exploratory meta-analysis of observational studies

BMJ Open ◽

10.1136/bmjopen-2018-026876 ◽

2020 ◽

Vol 10 (2) ◽

pp. e026876 ◽

Cited By ~ 2

Author(s):

A L Barker ◽

Sze-Ee Soh ◽

Kerrie M Sanders ◽

Julie Pasco ◽

Sundeep Khosla ◽

...

Keyword(s):

Systematic Review ◽

Fracture Risk ◽

Observational Studies ◽

Meta Analysis ◽

Large Population ◽

Mineral Density ◽

Random Effects Models ◽

Manual Search ◽

Relative Risks ◽

Hip Bmd

ObjectivesThis review provides insights into the potential for aspirin to preserve bone mineral density (BMD) and reduce fracture risk, building knowledge of the risk-benefit profile of aspirin.MethodsWe conducted a systematic review and exploratory meta-analysis of observational studies. Electronic searches of MEDLINE and Embase, and a manual search of bibliographies was undertaken for studies published to 28 March 2018. Studies were included if: participants were men or women aged ≥18 years; the exposure of interest was aspirin; and relative risks, ORs and 95% CIs for the risk of fracture or difference (percentage or absolute) in BMD (measured by dual energy X-ray absorptiometry) between aspirin users and non-users were presented. Risk of bias was assessed using the Joanna Briggs Institute Critical Appraisal Checklists for observational studies. Pooled ORs for any fracture and standardised mean differences (SMDs) for BMD outcomes were calculated using random-effects models.ResultsTwelve studies met the inclusion criteria and were included in the meta-analysis. Aspirin use was associated with a 17% lower odds for any fracture (OR 0.83, 95% CI 0.70 to 0.99; I2=71%; six studies; n=511 390). Aspirin was associated with a higher total hip BMD for women (SMD 0.03, 95% CI −0.02 to 0.07; I2=0%; three studies; n=9686) and men (SMD 0.06, 95% CI −0.02 to 0.13, I2=0%; two studies; n=4137) although these associations were not significant. Similar results were observed for lumbar spine BMD in women (SMD 0.03, 95% CI −0.03 to 0.09; I2=34%; four studies; n=11 330) and men (SMD 0.08; 95% CI −0.01 to 0.18; one study; n=432).ConclusionsWhile the benefits of reduced fracture risk and higher BMD from aspirin use may be modest for individuals, if confirmed in prospective controlled trials, they may confer a large population benefit given the common use of aspirin in older people.

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Regenerative Endodontic Procedures, Disinfectants and Outcomes: A Systematic Review

Primary Dental Journal ◽

10.1177/2050168420963302 ◽

2020 ◽

Vol 9 (4) ◽

pp. 65-84

Author(s):

Adam S. Kharchi ◽

Nara Tagiyeva-Milne ◽

Shalini Kanagasingam

Keyword(s):

Systematic Review ◽

Observational Studies ◽

Clinical Signs ◽

Signs And Symptoms ◽

Permanent Teeth ◽

Randomised Control Trial ◽

Eligibility Criteria ◽

High Quality Research ◽

Patient Reported ◽

Secondary Outcomes

Aims: This systematic review aims to identify and synthesise available evidence to determine the clinical and radiographic outcomes of REP involving any disinfection irrigant together with a non-antibiotic intracanal medicament. Methods: Experimental and observational studies evaluating the outcomes of REP in immature non-vital permanent teeth in 6-16 year olds, where the protocol used any type of disinfectant irrigant together with a non-antibiotic intracanal medicament (non-setting calcium hydroxide) were included. Data was narratively synthesised and presented in respect to the primary outcome (elimination of symptoms and infection) and secondary outcomes (increase in root length/width; positive response to vitality testing; patient-reported outcomes; adverse effects). Main findings: 1628 studies were identified, of which five met the eligibility criteria for inclusion in the review. Studies included one randomised control trial and four observational studies. All five studies showed an absence of clinical signs and symptoms for all teeth postoperatively with radiographic resolution or absence of pathology following the disinfection stages of the REP used. Choice of secondary outcomes were inconsistent but included further root development, coronal discolouration and root canal calcifications postoperatively. There was a high risk of bias in all five studies and subsequently the quality of the evidence base was judged to be low. Principle conclusions: REP using a non-antibiotic disinfectant approach appears capable of providing satisfactory outcomes for a non-vital immature permanent tooth. Further high-quality research is required before solid recommendations towards clinical practice guidelines for the disinfection portion of REP can be implemented.

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Salivary Biomarkers in Denture Stomatitis: A Systematic Review

JDR Clinical & Translational Research ◽

10.1177/2380084419830941 ◽

2019 ◽

Vol 4 (4) ◽

pp. 312-322 ◽

Cited By ~ 1

Author(s):

M.F. Khiyani ◽

M. Ahmadi ◽

J. Barbeau ◽

J.S. Feine ◽

R.F. de Souza ◽

...

Keyword(s):

Systematic Review ◽

Observational Studies ◽

Methodological Quality ◽

Control Group ◽

Cochrane Central Register ◽

Level Of Evidence ◽

Denture Stomatitis ◽

Salivary Biomarkers ◽

Tnf Α ◽

Significant Difference

Objective Denture stomatitis (DS) is an oral biofilm–associated inflammation of the denture-bearing mucosa. The objective of this review was to identify and evaluate the quality of evidence on the association between the levels of salivary biomarkers and DS among adults with and without palatal DS. Materials and methods: Following the PRISMA guidelines, Medline, PubMed, EMBASE, and the Cochrane Central Register for Controlled Trials were searched for eligible studies from the beginning of the archives until December 2018. Experimental and observational studies with adult participants were included that had a control group or subgroup analysis and provided data on salivary biomarkers and DS. Articles in languages other than English or French were excluded. The level of evidence and grades of recommendation were established with the 2011 scale of the Oxford Centre for Evidence-Based Medicine. Additionally, the assessment of methodological quality was conducted with the STROBE statement (Strengthening the Reporting of Observational Studies in Epidemiology) and graded according to the Olmos scale. Results: From 1,008 citations, 9 studies were included in the systematic review (8 observational, 1 clinical trial). Seven studies suggested a statistically significant difference in the levels of salivary cytokines (IL-6, CCL3, TGF-β, CXCL8, GM-CSF, and TNF-α) between participants with DS and controls ( P < 0.05). In contrast, 2 studies concluded that the difference in the levels of several salivary cytokines (IL2, IL12, IFN-g, IL-4, IL-8, IL-10, IL-17, TNF-α, and ICAM-1) between the groups was not statistically significant. The level of evidence for the majority of studies was 3, while the grade of recommendation for all the studies was B, interpreted as “favorable.” In terms of methodological quality, most studies met 50% to 80% of STROBE criteria and were graded B. Conclusion: Palatal inflammation in DS is significantly associated with the levels of salivary cytokines. Knowledge Transfer Statement: The results of this study identified altered levels of specific salivary biomarkers associated with denture stomatitis, which may aid in the early diagnosis and treatment of this disease.

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Management of tympanic membrane retractions: a systematic review

European Archives of Oto-Rhino-Laryngology ◽

10.1007/s00405-021-06719-3 ◽

2021 ◽

Author(s):

Ahmed B. Bayoumy ◽

Christianne C. A. F. M. Veugen ◽

Erwin L. van der Veen ◽

Jan-Willem M. Bok ◽

Jacob A. de Ru ◽

...

Keyword(s):

Systematic Review ◽

Tympanic Membrane ◽

Observational Studies ◽

Tube Placement ◽

Ventilation Tube ◽

Military Population ◽

Level Of Evidence ◽

Surgical Interventions ◽

Wait And See ◽

Tympanic Membrane Retraction

Abstract Importance Tympanic membrane retraction (TMR) is a relatively common otological finding. However, no consensus on its management exists. We are looking especially for a treatment strategy in the military population who are unable to attend frequent follow-up visits, and who experience relatively more barotrauma at great heights and depths and easily suffer from otitis externa from less hygienic circumstances. Objective To assess and summarize the available evidence for the effectiveness of surgical interventions and watchful waiting policy in patients with a tympanic membrane retraction. Evidence review The protocol for this systematic review was published at Prospero (207859). PubMed, Embase, and the Cochrane Database of Systematic Reviews were systematically searched from inception up to September 2020 for published and unpublished studies. We included randomized trials and observational studies that investigated surgical interventions (tympanoplasty, ventilation tube insertion) and wait-and-see policy. The primary outcomes of this study were clinical remission of the tympanic membrane retraction, tympanic membrane perforations and cholesteatoma development. Findings In total, 27 studies were included, consisting of 1566 patients with TMRs. We included data from 2 randomized controlled trials (76 patients) and 25 observational studies (1490 patients). Seven studies (329 patients) investigated excision of the TMR with and without ventilation tube placement, 3 studies (207 patients) investigated the wait-and-see policy and 17 studies (1030 patients) investigated tympanoplasty for the treatment of TMRs. Conclusions and relevance This study provides all the studies that have been published on the surgical management and wait-and-policy for tympanic membrane retractions. No high level of evidence comparative studies has been performed. The evidence for the management of tympanic membrane retractions is heterogenous and depends on many factors such as the patient population, location and severity of the TMR and presence of other ear pathologies (e.g., perforation, risk of cholesteatoma and serous otitis media).

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Clinical features contributing to the sit-to-stand transfer in people with Parkinson’s disease: a systematic review

The Egyptian Journal of Neurology Psychiatry and Neurosurgery ◽

10.1186/s41983-021-00396-z ◽

2021 ◽

Vol 57 (1) ◽

Author(s):

Charmaine Pearl Da Cunha ◽

Pratiksha Tilak Rao ◽

Suruliraj Karthikbabu

Keyword(s):

Systematic Review ◽

Parkinson’S Disease ◽

Parkinson's Disease ◽

Observational Studies ◽

Trunk Flexion ◽

Case Control Studies ◽

Level Of Evidence ◽

Cross Sectional ◽

Joint Torques ◽

Sit To Stand

Abstract Introduction The aim of this systematic review is to present the existing literature on the clinical motor, and non-motor factors contributing to sit-to-stand transfer in individuals with Parkinson's disease. Data synthesis Five databases (PubMed, PEDro, Cochrane, SCOPUS, and Ovid) were searched for literature on the contributing factors to sit-to-stand performance in Parkinson's disease. A quality check of these observational studies was done using the 'strengthening the reporting of observational studies in epidemiology' (STROBE) statement and the tool of the 'National Heart, Lung, and Blood Institute' (NHLBI). Descriptive and quantitative data were extracted and compiled, and a meta-analysis was performed to compute the standardised mean difference. Results Thirteen studies were selected; a majority of them provided a high-to-moderate level of evidence. Ten were cross-sectional, while the other three were case–control studies. Collectively, individuals with Parkinson's disease had a prolonged transfer time than those of age-matched healthy peers, particularly from peak horizontal velocity phase to seat-off phase, implying bradykinesia. A reduction in peak and rate to peak joint torques was also related to the decreased pace and stability of the sit-to-stand movement in individuals with Parkinson's disease. Additionally, they demonstrated exaggerated trunk flexion as a postural stabilisation strategy, allowing them to maintain and manoeuvre the relative positions of their centre of mass through the transitional phase of the transfer. Conclusion As per the existing literature, an alteration in strength, overall body bradykinesia, balance, posture, as well as cognition may result in an impaired sit-to-stand transfer in individuals with Parkinson's disease.

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Face Masks Use to Avoid Airborne Contamination during COVID-19 Pandemic and Related Conditions: A Systematic Review

Iranian Journal of Public Health ◽

10.18502/ijph.v50i12.7920 ◽

2021 ◽

Author(s):

Danúbia da Cunha De Sá-Caputo ◽

Ana Carolina Coelho-Oliveira ◽

Anelise Sonza ◽

Laisa Liane Paineiras-Domingos ◽

Redha Taiar ◽

...

Keyword(s):

Systematic Review ◽

Observational Studies ◽

English Language ◽

Face Mask ◽

Risk Of Bias ◽

Bacterial Suspension ◽

Level Of Evidence ◽

Airborne Contamination ◽

Different Types ◽

The Face

Background: The facemasks use has been discussed to prevent respiratory disease due airborne contamination. The aim of this study was to perform a systematic review about the face masks use to avoid airborne contamination during COVID-19 pandemic and related conditions, registered (PROSPERO-CRD42020198347) and performed according PRISMA. Methods: PubMed, Embase and Scopus databases were used to collect data. Observational studies, published in 2020, and English language, were included. Two reviewers independently identified records through database search and reference screening and disagreements were resolved by a third reviewer. Six studies were included. Results: The works investigated about the use of masks (different types) to prevent droplets dissemination with virus or bacterial suspension and decrease COVID-19 transmission routes, comfort, or temperature. The studies have moderate to critical risk of bias and the level of evidence is III-2. Conclusion: It is recommended facemask use to prevent droplets from escaping airborne and infecting other people, although there are different percentages of protection and can be possible a discomfort related the use. Further clinical trials to the effectiveness of face mask to avoid airborne contamination during the COVID-19 pandemic and the factors interfering with their effectiveness should be conducted.

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Do Sideline Tests of Vestibular and Oculomotor Function Accurately Diagnose Sports-Related Concussion in Adults? A Systematic Review and Meta-analysis

The American Journal of Sports Medicine ◽

10.1177/03635465211027946 ◽

2021 ◽

pp. 036354652110279

Author(s):

Sarah A. Harris ◽

Alasdair R. Dempsey ◽

Katherine Mackie ◽

Doug King ◽

Mark Hecimovich ◽

...

Keyword(s):

Systematic Review ◽

Sensitivity And Specificity ◽

Assessment Tool ◽

Meta Analysis ◽

Clinical Signs ◽

Signs And Symptoms ◽

Assessment Tools ◽

Emotional Symptoms ◽

Level Of Evidence ◽

Clinical Signs And Symptoms

Background: Sports-related concussion (SRC) assessment tools are primarily based on subjective assessments of somatic, cognitive, and psychosocial/emotional symptoms. SRC symptoms remain underreported, and objective measures of SRC impairments would be valuable to assist diagnosis. Measurable impairments to vestibular and oculomotor processing have been shown to occur after SRC and may provide valid objective assessments. Purpose: Determine the diagnostic accuracy of sideline tests of vestibular and oculomotor dysfunction to identify SRC in adults. Study Design: Systematic review; Level of evidence, 4. Methods: Electronic databases and gray literature were searched from inception until February 12, 2020. Physically active individuals (>16 years of age) who participated in sports were included. The reference standard for SRC was a combination of clinical signs and symptoms (eg, the Sport Concussion Assessment Tool [SCAT]), and index tests included any oculomotor assessment tool. The QUADAS tool was used to assess risk of bias, with the credibility of the evidence being rated according to GRADE. Results: A total of 8 studies were included in this review. All included studies used the King-Devick test, with no other measures being identified. Meta-analysis was performed on 4 studies with a summary sensitivity and specificity of 0.77 and 0.82, respectively. The overall credibility of the evidence was rated as very low. Conclusion: Caution must be taken when interpreting these results given the very low credibility of the evidence, and the true summary sensitivity and specificity may substantially differ from the values calculated within this systematic review. Therefore, we recommend that clinicians using the King-Devick test to diagnose SRC in adults do so in conjunction with other tools such as the SCAT. PROSPERO Registration: CRD42018106632.

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SEDENTARY BEHAVIOR AND NUTRITIONAL STATUS AMONG OLDER ADULTS: A META-ANALYSIS

Revista Brasileira de Medicina do Esporte ◽

10.1590/1517-869220182404183390 ◽

2018 ◽

Vol 24 (4) ◽

pp. 310-315 ◽

Cited By ~ 1

Author(s):

Bruno de Freitas Camilo ◽

Talita Inácio Martins Resende ◽

Édimo Fernando Alves Moreira ◽

Renata Damião

Keyword(s):

Systematic Review ◽

Nutritional Status ◽

Sedentary Behavior ◽

Exposure Time ◽

Observational Studies ◽

Web Of Science ◽

Meta Analysis ◽

Level Of Evidence ◽

Level Ii ◽

Modernization Process

ABSTRACT The accelerated modernization process has entailed changes in the lifestyle of people, such as exposure to sedentary behavior, and this in turn may affect the nutritional status. The aim of this systematic review with meta-analysis was to analyze observational studies that assessed the association between exposure time to sedentary behavior and nutritional status (overweight/malnutrition) in individuals aged ≥60 years. BVS, PubMed and Web of Science were the databases used in the search for observational studies, published until November 28, 2017, which have examined the association between exposure time to sedentary behavior and nutritional status. Two authors undertook the reading of titles and abstracts and applied the STROBE checklist independently. The Odds Ratio was calculated using the random effects model. Eight studies were included in this meta-analysis and involved 21415 individuals. All the studies covered most of the items suggested by the STROBE checklist. Of the total, four studies showed association between sedentary behavior and nutritional status. Longer exposure to sedentary behavior did not increase the odds of overweight and/or obesity (OR 1.32; 95%; CI 0.95-1.84). It is suggested that further studies with standardized criteria for measuring sedentary behavior and nutritional status are undertaken. Level of Evidence II; Systematic review of level II studies.

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Prevalence Of, and Factors Associated with, Obesity among the Oldest Old. A Study Protocol for a Systematic Review

Healthcare ◽

10.3390/healthcare8030319 ◽

2020 ◽

Vol 8 (3) ◽

pp. 319

Author(s):

André Hajek ◽

Benedikt Kretzler ◽

Hans-Helmut König

Keyword(s):

Systematic Review ◽

Observational Studies ◽

Data Extraction ◽

Oldest Old ◽

Empirical Studies ◽

Cochrane Library ◽

Cross Sectional ◽

Design Assessment ◽

Factors Associated ◽

Manual Search

Some empirical studies have identified the prevalence of, and factors associated with, obesity among the oldest old. However, there is a lack of a systematic review synthesizing the existing evidence. Therefore, the purpose of our upcoming systematic review is to provide an overview of the evidence provided by observational studies. The current paper presents the protocol for this systematic review. We will search four electronic databases (Medline, PsycINFO, CINAHL, and Cochrane Library). Furthermore, we will perform a manual search (searching reference lists of included studies). Cross-sectional and longitudinal observational studies identifying the prevalence and preferably the factors associated with obesity among the oldest old (80 years and over) will be included. Data extraction will concentrate on study design, assessment of obesity and its associated factors, statistical analysis, sample characteristics, and key findings. We will evaluate the quality of the included studies. Two individuals will perform study selection, data extraction, and evaluation of study quality. We will present the results in figures, summary tables and narrative summaries. If data permits, a meta-analysis will be conducted.

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Systematic Review of the Effectiveness of Thermal Annular Procedures in Treating Discogenic Low Back Pain

January 2018 - Pain Physician ◽

10.36076/ppj.2009/12/207 ◽

2009 ◽

Vol 1;12 (1;1) ◽

pp. 207-232 ◽

Cited By ~ 1

Author(s):

Standiford Helm II

Keyword(s):

Systematic Review ◽

Low Back Pain ◽

Back Pain ◽

Outcome Measures ◽

Observational Studies ◽

Low Back ◽

Level Of Evidence ◽

Level Ii ◽

Discogenic Low Back Pain ◽

One Year

Background: Chronic discogenic low back pain is a common problem with significant personal and societal costs. Thermal annular procedures (TAPs) have been developed in an effort to provide a minimally invasive treatment for this disorder. Multiple techniques utilized are intradiscal electrothermal therapy (IDET), radiofrequency annuloplasty, and intradiscal biacuplasty (IDB). However, these treatments continue to be controversial, coupled with a paucity of evidence. Study Design: A systematic review of the literature evaluating the efficacy or effectiveness of TAPs. Objective: To determine the effectiveness of TAPs in reducing low back pain in patients with intradiscal disorders. Methods: A comprehensive evaluation of the literature relating to TAPs was performed. The literature was evaluated according to Cochrane Review criteria for randomized controlled trials (RCTs) and according to the Agency for Healthcare Research and Quality (AHRQ) criteria for observational studies. The level of evidence was classified as Level I, II, or III based on the quality of evidence developed by the U.S. Preventive Services Task Force (USPSTF). Pain relief was the primary outcome measure. Other outcome measures were functional improvement, improvement of psychological status, and return to work. Data sources included relevant literature of the English language identified through searches of PubMed, EMBASE, the Cochrane Library, and the Database of Reviews of Effectiveness (DARE). Outcome Measures: Short-term effectiveness was defined as one-year or less and long-term effectiveness was defined as greater than one-year. Results: Systematic review of IDET identified 2 RCTs and 16 observational studies with an indicated evidence of Level II-2. Systematic review of radiofrequency annuloplasty identified no RCTs but 2 observational studies with an uncertain evidence of Level II-3. Systematic review of IDB identified one pilot study. The level of evidence is lacking with Level III. Limitations: The limitations of this review include paucity of the literature and lack of evidence with internal validity and generalizability. Conclusion: IDET offers functionally significant relief in approximately one-half of appropriately chosen chronic discogenic low back pain patients. There is minimal evidence supporting the use of radiofrequency annuloplasty and IDB. Key words: Chronic low back pain, degenerative disc disease, internal disc disruption, intervertebral disc, thermal annular procedures, intradiscal electrothermal therapy, radiofrequency ablation, intradiscal biacuplasty, radiofrequency annuloplasty

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