scholarly journals Indicadores de obesidade e resistência à insulina: uma revisão sistemática

2021 ◽  
Vol 14 ((Supl. 1)) ◽  
pp. 1-19
Author(s):  
Hully Cantão dos Santos ◽  
Lara Onofre Ferriani ◽  
José Geraldo Mill
Keyword(s):  
Newcastle Ottawa Scale ◽  
Ottawa Scale

O objetivo deste estudo foi verificar os indicadores de obesidade associados à resistência à insulina, através de uma revisão sistemática. Dois revisores independentes realizaram uma busca nas bases de dados Medline, Pubmed, LILACS, IBECS-ES e MedCarib até abril de 2019, incluindo estudos caso-controle, coorte ou delineamento transversal, em adultos. A qualidade dos artigos foi avaliada por meio do Newcastle-Ottawa Scale. Foram adotadas as normas do PRISMA para a condução da revisão, com protocolo registrado no PROSPERO. Foram incluídos na revisão 12 artigos. Associação positiva entre indicador de obesidade e HOMA-IR foi observada em todos os estudos. O indicador de obesidade que mais esteve positivamente associado ao HOMA-IR foi o IMC, seguido da circunferência da cintura. Os indicadores de obesidade estão associados ao HOMA-IR podendo ser uma ferramenta útil no rastreio da resistência à insulina.

Prevalence of Cognitive Impairment and Dementia in Older Adults Living at High Altitude: A Systematic Review and Meta-Analysis

2021 ◽  
pp. 1-11
Author(s):  
Diego Urrunaga-Pastor ◽  
Diego Chambergo-Michilot ◽  
Fernando M. Runzer-Colmenares ◽  
Josmel Pacheco-Mendoza ◽  
Vicente A. Benites-Zapata
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
High Altitude ◽  
Web Of Science ◽  
Meta Analysis ◽  
Cross Sectional ◽  
Language Restriction ◽  
Newcastle Ottawa Scale ◽  
Meta Analyses ◽  
Ottawa Scale

<b><i>Introduction:</i></b> Dementia is a chronic disease with a variable prevalence throughout the world; however, this could be higher at high-altitude populations. We aimed to summarize the prevalence of cognitive impairment and dementia in older adults living at high altitude. <b><i>Methods:</i></b> We searched in PubMed, Medline, Scopus, Web of Science, and Embase and included the studies published from inception to July 20, 2020, with no language restriction, which reported the frequency of cognitive impairment or dementia in older adults living at high-altitude populations. Random-effects meta-analyses were performed to calculate the overall prevalence and 95% confidence intervals (95% CI) of cognitive impairment and dementia. The risk of bias was evaluated using the Newcastle-Ottawa Scale (NOS) adapted for cross-sectional studies. <b><i>Results:</i></b> Six studies were included (3,724 participants), and 5 of the 6 included studies were carried out in Latin America. The altitude ranged from 1,783 to 3,847 m, the proportion of women included varied from 38.7 to 65.6%, and the proportion of participants with elementary or illiterate educational level ranged from 71.7 to 97.6%. The overall prevalence of cognitive impairment was 22.0% (95% CI: 8–40, <i>I</i><sup>2</sup>: 99%), and the overall prevalence of dementia was 11.0% (95% CI: 6–17, <i>I</i><sup>2</sup>: 92%). In a subgroup analysis according to the instrument used to evaluate cognitive impairment, the prevalence of cognitive impairment was 21.0% (95% CI: 5–42, <i>I</i><sup>2</sup>: 99%) in the MMSE group while the prevalence was 29.0% (95% CI: 0–78) in the non-MMSE group. <b><i>Conclusions:</i></b> The prevalence of cognitive impairment and dementia in older adults living at high altitude is almost twice the number reported in some world regions.

Hydroxychloroquine prophylaxis for preeclampsia, hypertension and prematurity in pregnant patients with systemic lupus erythematosus: A meta-analysis

Lupus ◽  
2021 ◽  
pp. 096120332110071
Author(s):  
Jiaoniu Duan ◽  
Dan Ma ◽  
Xiaoting Wen ◽  
Qianyu Guo ◽  
Jinfang Gao ◽  
...  
Keyword(s):  
Lupus Erythematosus ◽  
English Language ◽  
Gestational Hypertension ◽  
Meta Analysis ◽  
Fetal Outcomes ◽  
Pregnancy Hypertension ◽  
Cochrane Database ◽  
Newcastle Ottawa Scale ◽  
Prospective Cohorts ◽  
Ottawa Scale

Objectives This meta-analysis aimed to evaluate the effectiveness of HCQ in improving the maternal and fetal outcomes in pregnancies with SLE. Methods A literature search was conducted using PubMed, MEDLINE, EMBASE, and the Cochrane database for relevant English language articles, and Wanfang, CNKI and VIP for Chinese articles, from the databases’ inception to April 30, 2020. These studies compared the maternal and/or fetal outcomes between pregnant patients with SLE who were administered HCQ during pregnancy (HCQ+ group) and those who were not administered HCQ (HCQ− group). Two investigators extracted the data and assessed the quality using the Newcastle-Ottawa Scale (NOS) and GRADE criteria independently. Odds ratio (OR) and 95% confidence intervals (CIs) were calculated. All statistical analyses were conducted using the Stata 12.0 software. Results Nine studies involving 1132 pregnancies were included in the study (3 case controls, 2 prospective cohorts, 4 retrospective cohorts). Preeclampsia, gestational hypertension, and prematurity were significantly lower in the HCQ+ group than in the HCQ− group (OR 0.35, 95% CI 0.21–0.59), (OR 0.41, 95% CI 0.19–0.89) and (OR 0.55, 95% CI 0.36–0.86), respectively. There were no significant differences in the rates of HELLP Syndrome (OR 0.88, 95% CI 0.19–3.96), gestational diabetes (OR 2.3, 95% CI 0.44–12.12), thrombotic events (OR 0.26, 95% CI 0.05–1.51), spontaneous abortion (OR 1.77, 95% CI 0.96–3.26), premature rupture of membranes (OR 0.58, 95% CI 0.24–1.39), oligohydramnios (OR 0.90, 95% CI 0.38–2.14), live birth (OR 1.22, 95% CI 0.60–2.47), stillbirth (OR 1.00, 95% CI 0.50–2.00), congenital malformation (OR 0.53, 95% CI 0.14–2.04), low birth weight (OR 0.77, 95% CI 0.43–1.39), intrauterine distress (OR 1.07, 95% CI 0.41–2.76,), intrauterine growth restriction (OR 0.57, 95% CI 0.06–5.43), or five-minute APGAR score <7 (OR 0.72, 95% CI 0.20–2.58) between the two groups. Conclusions HCQ treatment during pregnancy could reduce the risk of preeclampsia, pregnancy hypertension and prematurity in SLE patients. The certainty of evidence is high but majority of the studies included are retrospective studies and not randomized controlled trials. Therefore, the multidisciplinary management of pregnant patients with SLE should promote HCQ use, irrespective of disease activity or severity.

scholarly journals Safety of Systemic Medications Among Older Adults With Psoriasis and Atopic Dermatitis: A Systematic Review of Observational Studies

2021 ◽  
pp. 120347542199377
Author(s):  
Evan Tang ◽  
Talha Maqbool ◽  
Megan Lam ◽  
Gaelen P. Adam ◽  
Mina Tadrous ◽  
...  
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Atopic Dermatitis ◽  
Observational Studies ◽  
Relative Effect ◽  
Emergency Department Visits ◽  
Major Cardiovascular Events ◽  
Quantitative Synthesis ◽  
Newcastle Ottawa Scale ◽  
Ottawa Scale

Background Psoriasis and atopic dermatitis are common among older adults (≥65 years old), but clinical trials often exclude that population. Objective To synthesize evidence from observational studies on the safety of systemic therapies (conventional or biologic) for psoriasis and atopic dermatitis among older adults in a systematic review. Methods We searched MEDLINE and EMBASE (inception to October 31, 2019) and included observational studies reporting adverse events among older people treated with systemic therapy for psoriasis or atopic dermatitis. Outcomes were death, hospitalization, emergency department visits, infections, major cardiovascular events, renal toxicity, hepatotoxicity, and cytopenias. We assessed study quality using the Newcastle-Ottawa Scale. Results We included 22 studies on treatment for psoriasis and 2 for atopic dermatitis. Most studies were small and non-comparative and 20 of 24 were low quality. Studies comparing safety between medications or medication classes or between older and younger adults did not show apparent differences but had wide confidence intervals around relative effect estimates. Heterogeneity of study design and reporting precluded quantitative synthesis. Conclusions There is scant evidence on the safety of conventional systemic and biologic medications for older adults with psoriasis or atopic dermatitis; older adults and their clinicians should be aware of this evidence gap.

The promise of Telemedicine in Pakistan: A Systematic Review (Preprint)

2021 ◽  
Author(s):  
Syed Sarosh Mahdi ◽  
Franceso Amenta ◽  
Raheel Allana ◽  
Gopi Battineni 3rd ◽  
Tamsal Khalid ◽  
...  
Keyword(s):  
Systematic Review ◽  
Rural Areas ◽  
Urban Region ◽  
Middle Income ◽  
Web Based ◽  
Study Characteristics ◽  
Implementation Costs ◽  
Newcastle Ottawa Scale ◽  
Good Support ◽  
Ottawa Scale

BACKGROUND Telemedicine is a medical practice of assisting remote patients and it has great potential in developing countries like Pakistan. Telemedicine solves the logistical barriers, deliver good support to weak health systems and unite worldwide networks of healthcare personals. Because of high implementation costs, yet it is not possible to adopt telehealth systems for low and middle-income nations. OBJECTIVE In this systematic review, we aim to present an update revision of region-based telemedical services in Pakistan. METHODS Libraries such as PubMed (Medline), CINAHL (Cumulative Index to Nursing and Allied Health Literature), Scopus (EMBASE) and Google Scholar were used for document search. Newcastle Ottawa Scale (NOS) is adopted to conduct study quality. Majority of the studies (n-8) included in the review were of high quality as assessed through the Newcastle Ottawa scale. Selected study characteristics further analyzed based on different parameters such as publication year, sample size, study design, methods, motivation and outcomes. RESULTS Search produced 955 articles and 11 items were ultimately selected to conduct the review. These studies further characterized as region-based telemedicine implementation. Out of 11, eight studies were conducted in the urban region and three studies were conducted in the rural areas of Pakistan. Majority of studies produced evidence on telehealth interventions by smartphone services like SMS, apps and web-based telemedicine. CONCLUSIONS Telehealth interventions like mHealth, eHealth, telemedicine, and telepharmacy are starting to evaluate for the last two decades but certainly needs to become an integral part of Pakistan's current health infrastructure.

scholarly journals Sleep in youth with autism spectrum disorders: systematic review and meta-analysis of subjective and objective studies

2018 ◽  
Vol 21 (4) ◽  
pp. 146-154 ◽  
Author(s):  
Amparo Díaz-Román ◽  
Junhua Zhang ◽  
Richard Delorme ◽  
Anita Beggiato ◽  
Samuele Cortese
Keyword(s):  
Systematic Review ◽  
Autism Spectrum Disorders ◽  
Evidence Synthesis ◽  
Meta Analysis ◽  
Autism Spectrum ◽  
Newcastle Ottawa Scale ◽  
Spectrum Disorders ◽  
Sleep Alterations ◽  
The Impact ◽  
Ottawa Scale

BackgroundSleep problems are common and impairing in individuals with autism spectrum disorders (ASD). Evidence synthesis including both subjective (ie, measured with questionnaires) and objective (ie, quantified with neurophysiological tools) sleep alterations in youth with ASD is currently lacking.ObjectiveWe conducted a systematic review and meta-analysis of subjective and objective studies sleep studies in youth with ASD.MethodsWe searched the following electronic databases with no language, date or type of document restriction up to 23 May 2018: PubMed, PsycInfo, Embase+Embase Classic, Ovid Medline and Web of Knowledge. Random-effects models were used. Heterogeneity was assessed with Cochran’s Q and I2 statistics. Publication (small studies) bias was assessed with final plots and the Egger’s test. Study quality was evaluated with the Newcastle Ottawa Scale. Analyses were conducted using Review Manager and Comprehensive Meta-Analysis.FindingsFrom a pool of 3359 non-duplicate potentially relevant references, 47 datasets were included in the meta-analyses. Subjective and objective sleep outcome measures were extracted from 37 and 15 studies, respectively. Only five studies were based on comorbidity free, medication-naïve participants. Compared with typically developing controls, youth with ASD significantly differed in 10/14 subjective parameters and in 7/14 objective sleep parameters. The average quality score in the Newcastle-Ottawa Scale was 5.9/9.Discussion and clinical implicationsA number of subjective and, to a less extent, objective sleep alterations might characterise youth with ASD, but future studies should assess the impact of pharmacological treatment and psychiatric comorbidities.

Reduction of ileocolic intussusception under sedation or anaesthesia: a systematic review of complications

2021 ◽  
pp. archdischild-2021-322706
Author(s):  
Moran Gal ◽  
Shirly Gamsu ◽  
Ron Jacob ◽  
Daniel M Cohen ◽  
Itai Shavit
Keyword(s):  
Systematic Review ◽  
Intestinal Perforation ◽  
English Language ◽  
Data Extraction ◽  
Current Data ◽  
Pulmonary Aspiration ◽  
Ileocolic Intussusception ◽  
Newcastle Ottawa Scale ◽  
Permanent Neurological Deficit ◽  
Ottawa Scale

BackgroundDespite the increased use of sedation in children undergoing stressful procedures, reduction of ileocolic intussusception (RII) is usually performed on awake children without any form of sedation.ObjectiveTo evaluate the incidence of severe complications of RII under sedation or anaesthesia.DesignA systematic review including English language original articles of any date.PatientsChildren undergoing RII (pneumatic or hydrostatic) under sedation or anaesthesia.Data sourcesOvid Embase, Scopus, PubMed, the Cochrane Database of Systematic Reviews and the internet search engine Google Scholar.Data extractionThree authors independently reviewed each article for eligibility. The Newcastle-Ottawa Scale was used to assess the quality of included studies.Main outcome measuresThe primary outcome was the incidence of intestinal perforation during RII. The secondary outcomes were the incidence of sentinel adverse events defined as death, cardiopulmonary resuscitation, permanent neurological deficit and pulmonary aspiration syndrome.ResultsThe search yielded 368 articles. Nine studies with 1391 cases were included in the analysis. Of the nine studies, six had a score of ≤6 stars in the Newcastle-Ottawa Scale assessment, indicating low-to-moderate quality. Propofol-based sedation was used in 849 (59.2%) cases; 5 (0.6%) had intestinal perforation. Intestinal perforation was not reported in patients who were sedated with other sedatives. One patient had pulmonary aspiration syndrome.ConclusionsAlthough caution remains warranted, current data suggest that the incidence of severe complications due to RII under sedation or anaesthesia is low. Due to the lack of prospective data, it is difficult to ascertain the exact incidence of severe complications.

scholarly journals Does the Animal Model Influence in Vertical Alveolar Distraction? A Systematic Review of the Literature

Animals ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. 2347
Author(s):  
Mario García-González ◽  
Fernando Muñoz ◽  
Antonio González-Cantalapiedra ◽  
Mónica López-Peña ◽  
Nikola Saulacic
Keyword(s):  
Systematic Review ◽  
Animal Model ◽  
Quality Score ◽  
Inclusion Criteria ◽  
Animal Trials ◽  
Mongrel Dog ◽  
Medium Quality ◽  
Newcastle Ottawa Scale ◽  
High Quality Score ◽  
Ottawa Scale

This study is aimed at synthesizing all available evidence on vertical alveolar osteogenesis distraction (VAOD) in animal trials to determine whether the animal model used and its handling influence or not, and find which is the most appropriate animal model for this specific technique. This systematic review has been carried out following the PRISMA statements. Bibliographic sources have been consulted manually by two reviewers. Risk of bias was assessed using a version of the Newcastle-Ottawa-Scale (NOS). The selection criteria established by expert researchers were applied in order to decide which studies should be included in the review. Twenty-six studies met the inclusion criteria and were included in the review. Twenty-four of them had a high quality (score between 7 and 9), two medium quality (score between 4 and 6), and none low quality (score between 1 and 3). The highest possible score was 9 (using the NOS). Six studies complied with all NOS criteria. The animal model has been seen to influence the results, leading to failure in some cases. The most used animal model on VAOD, with fewer complications, was the Mongrel dog. The use of the pig and minipig is not recommended, due to the difficulties in handling and complications encountered.

scholarly journals Policies and Challenges on the Distribution of Specialists and Subspecialists in Rural Areas of Iran

Medicina ◽  
2019 ◽  
Vol 55 (12) ◽  
pp. 783
Author(s):  
Mirmoeini ◽  
Marashi Shooshtari ◽  
Battineni ◽  
Amenta ◽  
Tayebati
Keyword(s):  
Rural Areas ◽  
Mesh Term ◽  
Medical Subject Headings ◽  
Study Selection ◽  
Study Results ◽  
Medical Facilities ◽  
The Status ◽  
Newcastle Ottawa Scale ◽  
Ottawa Scale

Background and objectives: Having fair access to medical services may probably be a standard feature and indisputable right of all health policies. The health policy of Iran enunciates this right. Unfortunately, as may happen in many countries, the execution of this policy depends on different factors. Among these parameters, the suitable distribution of professionals, hospitals, and medical facilities should be quoted. On the other hand, in Iran, there are many other problems linked to accessing areas with natural hindrances. Materials and methods: A literature search was conducted in PubMed and CINAHL libraries, specifically studies from 2010 to 2019. A Boolean operated medical subject headings (MeSH) term was used for the search. Newcastle–Ottawa Scale (NOS) scoring was adopted to assess the quality of each study. Results: A total of 118 studies were displayed, and among them, 102 were excluded due to duplication and study relevance. Study selection was made based on content classified into two groups: (1) shortage and unsuitable distribution of specialist and subspecialist physicians in Iran and (2) studies that explained the status of degradation in different areas of Iran. Outcomes demonstrated that Iran is generally suffering a shortage and unsuitable distribution of specialists and subspecialists. This lack is particularly crucial in deprived and areas far away from the cities. Conclusions: The present study analyzed in detail research studies regarding policies and challenges that reflect on the provision of specialists and subspecialists in Iranian rural areas

Advantages of virtual reality in the rehabilitation of balance and gait

Neurology ◽  
2018 ◽  
Vol 90 (22) ◽  
pp. 1017-1025 ◽  
Author(s):  
Desiderio Cano Porras ◽  
Petra Siemonsma ◽  
Rivka Inzelberg ◽  
Gabriel Zeilig ◽  
Meir Plotnik
Keyword(s):  
Virtual Reality ◽  
Motor Learning ◽  
Cochrane Collaboration ◽  
Intervention Programs ◽  
Randomized Controlled ◽  
Methodologic Quality ◽  
Newcastle Ottawa Scale ◽  
Meta Analyses ◽  
Learning Principles ◽  
Ottawa Scale

BackgroundVirtual reality (VR) has emerged as a therapeutic tool facilitating motor learning for balance and gait rehabilitation. The evidence, however, has not yet resulted in standardized guidelines. The aim of this study was to systematically review the application of VR-based rehabilitation of balance and gait in 6 neurologic cohorts, describing methodologic quality, intervention programs, and reported efficacy.MethodsThis study follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. VR-based treatments of Parkinson disease, multiple sclerosis, acute and chronic poststroke, traumatic brain injury, and cerebral palsy were researched in PubMed and Scopus, including earliest available records. Therapeutic validity (CONTENT scale) and risk of bias in randomized controlled trials (RCT) (Cochrane Collaboration tool) and non-RCT (Newcastle-Ottawa scale) were assessed.ResultsNinety-seven articles were included, 68 published in 2013 or later. VR improved balance and gait in all cohorts, especially when combined with conventional rehabilitation. Most studies presented poor methodologic quality, lacked a clear rationale for intervention programs, and did not utilize motor learning principles meticulously. RCTs with more robust methodologic designs were widely recommended.ConclusionOur results suggest that VR-based rehabilitation is developing rapidly, has the potential to improve balance and gait in neurologic patients, and brings additional benefits when combined with conventional rehabilitation. This systematic review provides detailed information for developing theory-driven protocols that may assist overcoming the observed lack of argued choices for intervention programs and motor learning implementation and serves as a reference for the design and planning of personalized VR-based treatments.RegistrationPROSPERO CRD42016042051.

scholarly journals Depression, anthropometric parameters, and body image in adults: a systematic review

2019 ◽  
Vol 65 (5) ◽  
pp. 731-738 ◽  
Author(s):  
Daniela Silva ◽  
Lara Ferriani ◽  
Maria Carmen Viana
Keyword(s):  
Systematic Review ◽  
Body Image ◽  
Anthropometric Parameters ◽  
Cross Sectional ◽  
Employed Women ◽  
Language Restriction ◽  
Newcastle Ottawa Scale ◽  
The Relationship ◽  
Ottawa Scale

SUMMARY OBJECTIVE: To evaluate the association between depression, anthropometric parameters and body image in adults through a systematic review of the literature. METHOD: Medline, Lilacs and PsycInfo databases were searched by two independent reviewers up to August 2018, without language restriction, including cross-sectional, case-control, and cohort studies in adults (18-65 years), of both genders. The quality of the studies was assessed using the Newcastle-Ottawa Scale instrument. The PRISMA standards were adopted for the conduct of this review, whose protocol is registered in PROSPERO, number CRD42018105248. RESULTS: The search resulted in 1,770 articles; however, a total of 5 articles were included in this review, whose designs were transversal. Quality scores ranged from 8 to 9 points. The association between depression, anthropometric parameters, and body image was found in all included studies, regardless of the different statistical methods employed. Women perceived their body larger than it really was by idealizing a lean body, whereas in men the perception of being underweight or dissatisfaction was observed by idealizing a larger body, both conditions were associated with the presence of depression or depressive symptoms and body mass index in the same time. CONCLUSION: Depression, anthropometric parameters and body image were associated. It is necessary to conduct other studies, especially longitudinal studies to elucidate the relationship among depression, weight, body image, and other associated factors.

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