Anesthesia and intensive care for patients with COVID-19. Russian Federation of anesthesiologists and reanimatologists guidelines. Annals of Critical Care

2020 ◽  
pp. 3-120 ◽  
Author(s):  
I. B Zabolotskikh ◽  
M. Yu Kirov ◽  
K. M Lebedinskii ◽  
D. N Protsenko ◽  
S. N Avdeev ◽  
...  
Keyword(s):  
Intensive Care ◽  
Russian Federation ◽  
Randomized Clinical Trials ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Transportation Of Patients ◽  
Search Query ◽  
Cochrane Reviews ◽  
Central Register ◽  
The Russian Federation

The article provides the main statements of the guidelines for the anesthesia and intensive care of patients with the coronavirus disease (COVID-19), developed by the Federation of Anesthesiologists and Reanimatologists of Russia. In the process of developing the recommendations, the publications of the official websites of the Russian Federation, the electronic databases of the RSCI, PubMed, MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials (CENTRAL) were analyzed by the developers independently of each other. The date of the last search query was June 29, 2020. To develop the Guidelines for the recommendations, were used documents that directly describing the features of the management of patients with coronavirus disease COVID-19 (guidelines and guidelines - 16; randomized clinical trials and Cochrane Reviews - 8; observational and comparative studies - 77; other documents, notes and comments - 54) and describing anesthetic and resuscitation support in the general population of patients. The provisions of the recommendations highlight the specifics of anesthesia, intensive care, resuscitation, manipulation, and prevention of the spread of COVID-19 in the implementation of these activities. Methods of protecting personnel from infection with COVID-19 during manipulations, anesthesia and intensive care are considered. The features of respiratory support, extracorporeal detoxification, extracorporeal membrane oxygenation, thromboprophylaxis are described. The features of the management of pregnant women, children of different age, patients with concomitant diseases, issues of transportation of patients are considered.

scholarly journals Systematic Review of Randomized Clinical Trials of Acupressure Therapy for Primary Dysmenorrhea

2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
Hui-ru Jiang ◽  
Shuang Ni ◽  
Jin-long Li ◽  
Miao-miao Liu ◽  
Ji Li ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Statistical Analysis ◽  
Adverse Events ◽  
Randomized Clinical Trials ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Primary Dysmenorrhea ◽  
Randomized Controlled ◽  
Central Register

The evidence of acupressure is limited in the management of dysmenorrhea. To evaluate the efficacy of acupressure in the treatment of primary dysmenorrhea based on randomized controlled trials (RCTs), we searched MEDLINE, the Chinese Biomedical Database (CBM), and the Cochrane Central Register of Controlled Trials (CENTRAL) databases from inception until March 2012. Two reviewers independently selected articles and extracted data. Statistical analysis was performed with RevMan 5.1 software. Eight RCTs were identified from the retrieved 224 relevant records. Acupressure improved pain measured with VAS (−1.41 cm 95% CI [−1.61, −1.21]), SF-MPQ at the 3-month followup (WMD −2.33, 95% CI [−4.11, −0.54]) and 6-month followup (WMD −4.67, 95% CI [−7.30, −2.04]), and MDQ at the 3-month followup (WMD −2.31, 95% CI [−3.74, −0.87]) and 6-month followup (WMD −4.67, 95% CI [−7.30, −2.04]). All trials did not report adverse events. These results were limited by the methodological flaws of trials.

scholarly journals Protetores de ouvido e olhos na promoção do sono em cuidados intensivos

2018 ◽  
Vol 12 (10) ◽  
pp. 2784 ◽  
Author(s):  
João Vitor Vieira ◽  
Rogério Ferrinho Ferreira ◽  
Margarida Palma Goes
Keyword(s):  
Intensive Care ◽  
Systematic Reviews ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Levels Of Evidence ◽  
Protective Devices ◽  
Quantitative Studies ◽  
Cochrane Database ◽  
Central Register

RESUMOObjetivo: analisar a contribuição dos protetores auriculares e das máscaras oculares para a promoção do sono do doente admitido em cuidados intensivos. Método: revisão integrativa da literatura que conduziu à pesquisa no motor de busca EBSCOHost, nas bases de dados CINAHL Complete, MEDLINE Complete, Cochrane Central Register of Controlled Trials e Cochrane Database of Systematic Reviews, para a identificação de estudos publicados entre 2014 e 2018. Foram selecionados quatro ensaios controlados randomizados. Esta revisão considerou a recomendação PRISMA. Os níveis de evidência foram assegurados pelos níveis de evidência do The Joanna Briggs Institute e a qualidade metodológica foi analisada com recurso ao Clinical Appraisal Skills Programme. Resultados: todos os artigos selecionados apontam para os benefícios da utilização desses dispositivos para a promoção da qualidade do sono do doente em cuidados intensivos. Conclusão: pela segurança e benefícios associados a esses dispositivos, sugere-se a sua utilização para a promoção da qualidade do sono do doente em cuidados intensivos. No entanto, pela escassez de estudos sobre o tema e pelas limitações dos estudos analisados, sugere-se a realização de mais estudos quantitativos com amostras mais representativas. Descritores: Protetores para Ouvido; Dispositivos de Proteção dos Olhos; Sono; Cuidados Críticos; Delírio.ABSTRACT Objective: to analyze the contribution of ear protectors and eye masks to promote the sleep of the patient admitted to intensive care. Method: integrative review of the literature that led to the search in the EBSCOHost search engine, in the databases CINAHL Complete, MEDLINE Complete, Cochrane Central Register of Controlled Trials and Cochrane Database of Systematic Reviews, for the identification of studies published between 2014 and 2018. Four randomized controlled trials were selected. This review considered the PRISMA recommendation. Levels of evidence were secured by the levels of evidence from The Joanna Briggs Institute and methodological quality was analyzed using the Clinical Appraisal Skills Program. Results: all articles selected, point to the benefits of using these devices to promote the quality of sleep of the patient in intensive care. Conclusion: due to the safety and benefits associated with these devices, it is suggested that they be used to promote the quality of the patient's sleep in intensive care. However, due to the scarcity of studies on the subject and the limitations of the studies analyzed, it is suggested that more quantitative studies with more representative samples be carried out. Descritores: Ear Protective Devices; Eye Protective Devices; Sleep; Critical Care; Delirium.RESUMEN Objetivo: analizar la contribución de los protectores auriculares y de las máscaras oculares para la promoción del sueño del enfermo admitido en cuidados intensivos. Método: revisión integrativa de la literatura que condujo a la investigación en el motor de búsqueda EBSCOHost, en las bases de datos CINAHL Complete, MEDLINE Complete, Cochrane Central Register de Controlled Trials y Cochrane Database of Systematic Reviews, para la identificación de estudios publicados entre 2014 y 2018. Se seleccionaron cuatro ensayos controlados aleatorizados. Esta revisión consideró la recomendación PRISMA. Los niveles de evidencia fueron asegurados por los niveles de evidencia del The Joanna Briggs Institute y la calidad metodológica fue analizada con recurso al Clinical Appraisal Skills Programme. Resultados: todos los artículos seleccionados apuntan a los beneficios de la utilización de estos dispositivos para la promoción de la calidad del sueño del enfermo en cuidados intensivos. Conclusión: por la seguridad y los beneficios asociados a estos dispositivos, se sugiere su utilización para la promoción de la calidad del sueño del paciente en cuidados intensivos. Sin embargo, por la escasez de estudios sobre el tema y las limitaciones de los estudios analizados, se sugiere realizar más estudios cuantitativos con muestras más representativas. Descritores: Dispositivos de Protectores de Oídos; Dispositivos de Protección de los Ojos; Sueño; Cuidados Críticos; Delirio.

Reactive Arthritis: Modern Aspects of Diagnosis and Treatment

2020 ◽  
Vol 65 (7-8) ◽  
pp. 63-70
Author(s):  
B. S. Belov ◽  
R. M. Balabanova
Keyword(s):  
Russian Federation ◽  
Clinical Picture ◽  
Reactive Arthritis ◽  
Epidemiological Data ◽  
Controlled Trials ◽  
Antimicrobial Drugs ◽  
Randomized Controlled ◽  
Laboratory Techniques ◽  
High Prevalence ◽  
The Russian Federation

Currently, the problem of reactive arthritis (ReA) retains its importance due to the fairly high prevalence of the disease, primarily in Russia. Analysis of epidemiological data allows us to put forward a number of possible reasons explaining the different frequency of ReA in certain regions of the Russian Federation and in other countries. The lecture describes the clinical picture of the disease, as well as analyzes the significance of various laboratory techniques aimed at identifying the causative agent of ReA. The Russian diagnostic criteria for ReA are presented. The main approaches to the therapy of ReA are outlined with an emphasis on the use of antimicrobial drugs. The effectiveness and safety of drug immunocorrection (inducers of interferon, polyoxidonium, immunofan, etc.) in the treatment of urogenital chlamydia in patients with ReA have not been confirmed by data from randomized controlled trials.

Functional cortical changes associated with shoulder instability – a systematic review

2021 ◽  
pp. 175857322110190
Author(s):  
Morissa F Livett ◽  
Deborah Williams ◽  
Hayley Potter ◽  
Melinda Cairns
Keyword(s):  
Systematic Review ◽  
Joint Instability ◽  
Glenohumeral Joint ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Cortical Function ◽  
High Quality Research ◽  
Central Register ◽  
Rehabilitative Measures ◽  
Randomised Controlled

Background Glenohumeral joint instability is associated with structural deficits and/or alterations in sensory and motor processing; however, a proportion of patients with glenohumeral joint instability fail to respond to surgical and rehabilitative measures. This systematic review aimed to establish if functional cortical changes occur in patients with glenohumeral joint instability. Methods AMED, CINAHL, Cochrane Central Register of Controlled Trials, Embase, Medline, PEDro, Pubmed, PsychINFO and Scopus were searched from inception to 17 March 2021. Randomised controlled trials and non-randomised trials were included and quality was appraised using the Downs and Black tool. Results One thousand two hundred seventy-nine records were identified of which five were included in the review. All studies showed altered cortical function when comparing instability patients with healthy controls and included areas associated with higher cortical functions. Discussion The findings of this systematic review offer some insight as to why interventions addressing peripheral pathoanatomical factors in patients with glenohumeral joint instability may fail in some cases due to functional cortical changes. However, data are of moderate to high risk of bias. Further high-quality research is required to ascertain the degree of functional cortical changes associated with the type and duration of glenohumeral joint instability.

O papel da fisioterapia no tratamento das cefaleias: revisão de literatura

2016 ◽  
pp. 33-42
Author(s):  
Débora Wanderley ◽  
Joaquim José de Souza Costa Neto ◽  
Marcelo Moraes Valença ◽  
Daniella Araújo de Oliveira
Keyword(s):  
Controlled Trials ◽  
Cochrane Central Register ◽  
Central Register

A intolerância aos movimentos, incapacidade do pescoço e alterações nos músculos pericranianos são aspectos que podem interferir durante as crises de migrânea. A presença destes achados tornou a fisioterapia uma modalidade terapêutica alternativa para as cefaleias. Assim, as desordens estruturais e comportamentais musculares podem promover modificações na biomecânica da cabeça e região cervical, bem como limitações na mobilidade cervical no paciente com cefaleia, as quais podem ser tratadas por meio de diferentes modalidades fisioterapêuticas. O objetivo deste estudo foi revisar as publicações mais relevantes sobre o papel da fisioterapia no tratamento das cefaleias, a fim de fundamentar e direcionar o tratamento não farmacológico destes pacientes. Foi feito um levantamento da literatura, entre setembro/2015 e maio/2016, nas bases de dados MEDLINE/ PubMed, LILACS e Cochrane Central Register of Controlled Trials - CENTRAL, buscando ensaios clínicos randomizados e quasi randomizados sobre o tema. Os descritores do MeSH/DeCS utilizados foram: 'cefaleia', 'modalidades de fisioterapia', e seus equivalentes em inglês. Foram identificados 589 artigos, dos quais 19 foram incluídos, segundo os critérios de elegibilidade. De acordo com os resultados dos estudos avaliados, a fisioterapia promove melhora da cefaleia, dos sintomas associados e das disfunções musculoesqueléticas relacionadas. Entre as modalidades utilizadas estão correção postural, mobilização da coluna, alongamento muscular, técnicas de relaxamento, massagem, exercícios ativos ou passivos, entre outras. Devido à baixa qualidade metodológica da maioria dos estudos, são necessários novos ensaios controlados e randomizados, baseados nos critérios diagnósticos da ICHD, utilizando protocolos descritos de maneira mais detalhada e reprodutível, incluindo a avaliação de efeitos adversos.

Reducción de eventos cardiovasculares de Lomitapida versus Estatinas en pacientes con diagnóstico de hipercolesterolemia familiar. Protocolo de revisión sistemática.

10.52011/0097 ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Maritza Auxiliadora Torres Valdez ◽  
Lorena Alexandra Muñoz Avila ◽  
Carlos Enrique Ortega Espinoza ◽  
Franklin Geovany Mora Bravo ◽  
Diego Fernando Barzallo Zeas
Keyword(s):  
Controlled Trials ◽  
Cochrane Central Register ◽  
Electronic Library ◽  
Central Register ◽  
Revisión Sistemática

Introducción: La hipercolesterolemia familiar (HF) un trastorno genético autosómico dominante que produce hipercolesterolemia y desarrollo prematuro de enfermedades cardiovasculares. Las estatinas han sido el medicamento de elección en estos pacientes, sin embargo, un buen porcentaje de pacientes no pueden alcanzar sus objetivos terapéuticas con las dosis máximas recomendadas por lo que la Lomitapida se podría establecer como una nueva alternativa de tratamiento. Objetivo: El objetivo de esta revisión sistemática es determinar si la Lomitapida reduce los eventos cardiovasculares en pacientes con diagnóstico de Hipercolesterolemia familiar comparado con estatinas. Métodos: Se incluirán ensayos controlados aleatorios (ECA) y cuasialeatorios de pacientes con diagnóstico de HF. Las medidas de resultado primarias: 1. Niveles de LDL, HDL pos tratamiento. 2. Presencia de eventos cardiovasculares. Las búsquedas electrónicas se realizarán en PUBMED, The Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE y Scientific electronic library (Scielo). La evaluación del riesgo de sesgo se utilizará la herramienta de Cochrane. Las medidas del efecto del tratamiento serán las diferencias de medias (DM) y los intervalos de confianza (IC) del 95%. La evaluación de heterogeneidad se realizará mediante la inspección visual del diagrama de embudo. La evaluación de la calidad de la evidencia se realizará usando la evaluación GRADE.

scholarly journals Meta-Analysis: Randomized Trials of Lactobacillus plantarum on Immune Regulation Over the Last Decades

2021 ◽  
Vol 12 ◽  
Author(s):  
Wei Zhao ◽  
Chuantao Peng ◽  
Hafiz Arbab Sakandar ◽  
Lai-Yu Kwok ◽  
Wenyi Zhang
Keyword(s):  
Meta Analysis ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Central Register ◽  
Tnf Α ◽  
Ifn Γ ◽  
The Mean ◽  
Regulatory Effects ◽  
Mean Differences ◽  
Necrosis Factor

Lactobacillus (L.) plantarum strains, belong to lactic acid bacteria group, are considered indispensable probiotics. Here, we performed meta-analysis to evaluate the regulatory effects of L. plantarum on the immunity during clinical trials. This meta-analysis was conducted by searching across four most common literature databases, namely, Cochrane Central Register of Controlled Trials, Web of Science, Embase, and PubMed. Clinical trial articles that met the inclusion and exclusion criteria were analyzed by Review Manager (version 5.3). p-value < 0.05 of the total effect was considered statistically significant. Finally, total of 677 references were retrieved, among which six references and 18 randomized controlled trials were included in the meta-analysis. The mean differences observed at 95% confidence interval: interleukin (IL)-4, −0.48 pg/mL (−0.79 to −0.17; p < 0.05); IL-10, 9.88 pg/mL (6.52 to 13.2; p < 0.05); tumor necrosis factor (TNF)-α, −2.34 pg/mL (−3.5 to −1.19; p < 0.05); interferon (IFN)-γ, −0.99 pg/mL (−1.56 to −0.41; p < 0.05). Therefore, meta-analysis results suggested that L. plantarum could promote host immunity by regulating pro-inflammatory and anti-inflammatory cytokines.

scholarly journals Cognitive Behavioral Therapy combined with physical exercise for depression, anxiety, fatigue and pain in adults with chronic diseases: systematic review and meta-analysis

2018 ◽  
Author(s):  
Paquito Bernard ◽  
Romain Ahmed Jérôme ◽  
Johan Caudroit ◽  
Guillaume Chevance ◽  
Carayol Marion ◽  
...  
Keyword(s):  
Physical Exercise ◽  
Methodological Quality ◽  
Randomized Clinical Trials ◽  
Behavioral Therapy ◽  
Meta Analysis ◽  
Effect Sizes ◽  
Cognitive Behavior ◽  
Cochrane Central Register ◽  
Depression And Anxiety ◽  
Central Register

Objective. The present meta-analysis aimed to determine the overall effect of cognitive behavior therapy combined with physical exercise (CBTEx) interventions on depression, anxiety, fatigue, and pain in adults with chronic illness; to identify the potential moderators of efficacy; and to compare the efficacy of CBTEx versus each condition alone (CBT and physical exercise). Methods. Relevant randomized clinical trials, published before July 2017, were identified through database searches in Pubmed, PsycArticles, CINAHL, SportDiscus and the Cochrane Central Register for Controlled Trials.Results. A total of 30 studies were identified. CBTEx interventions yielded small-to-large effect sizes for depression (SMC = -0.34, 95% CI [-0.53; -0.14]), anxiety (SMC = -0.18, 95% CI [-0.34; -0.03]) and fatigue (SMC = -0.96, 95% CI [-1.43; -0.49]). Moderation analyses revealed that longer intervention was associated with greater effect sizes for depression and anxiety outcomes. Low methodological quality was also associated with increased CBTEx efficacy for depression. When compared directly, CBTEx interventions did not show greater efficacy than CBT alone or physical exercise alone for any of the outcomes. Conclusion. The current literature suggests that CBTEx interventions are effective for decreasing depression, anxiety, and fatigue symptoms, but not pain. However, the findings do not support an additive effect of CBT and exercise on any of the four outcomes compared to each condition alone.

scholarly journals Azithromycin in patients with Covid-19; a systematic review and metanalysis

2021 ◽  
Author(s):  
Luis Ayerbe ◽  
Ivo Forgnone ◽  
Carlos Risco-Risco ◽  
Maria Perez-Pinar ◽  
Salma Ayis
Keyword(s):  
Systematic Review ◽  
Clinical Severity ◽  
Future Research ◽  
Controlled Trials ◽  
Clinical Settings ◽  
Cochrane Central Register ◽  
Random Effects Models ◽  
Central Register ◽  
Significant Difference ◽  
Observational Design

Background: Azithromycin (AZM) has been widely used in the management of Covid-19. However, the evidence on its actual effects remains disperse and difficult to apply in clinical settings. This systematic review and metanalysis summarizes the studies on the beneficial and adverse effect of AZM in patients with Covid-19. Methods: The PRISMA 2020 statement criteria were followed. Randomized controlled trials (RCTs) and observational studies comparing clinical outcomes of patients treated, and not treated, with AZM, indexed until the 5th of July 2021, were searched in PubMed, Embase, The Web of Science, Scopus, The Cochrane Central Register of Controlled Trials, and MedRXivs. We used Random-effects models to estimate pooled effect size from aggregate data. Results: The initial search produced 4950 results. Finally, 16 studies, five RCTs and 11 with an observational design, with a total of 22984 patients, were included. The metanalysis showed no difference in mortality for those treated, or not, with AZM, OR: 0.95 (0.79-1.13). There was also no significant difference for those treated, and not, with AZM in need for hospital admission or time to admission from ambulatory settings, clinical severity, need for intensive care, or adverse effects. Conclusions: These results presented in this review do not support the use of AZM in the management of Covid-19. They also show that any harm caused to the patient who received it is unlikely. Future research on treatment for patients with Covid-19 may need to focus on other drugs

scholarly journals Desenvolvimento de transtornos mentais relacionados à úlcera venosa: revisão sistemática

2019 ◽  
Vol 11 (16) ◽  
pp. e1417
Author(s):  
Adriana Souza Szpalher
Keyword(s):  
Controlled Trials ◽  
Cochrane Central Register ◽  
National Library ◽  
Electronic Library ◽  
Central Register

Objetivo: Avaliar o desenvolvimento de transtornos psicológicos relacionados à presença de úlcera venosa de perna (UVP). Métodos: revisão sistemática em julho de 2019 com metodologia de Donato H e Donato M (2019) e Recomendação PRISMA para responder à questão: há desenvolvimento de transtornos psicológicos relacionados à UVP? Incluídos estudos originais, sem delimitação temporal, em português, inglês e espanhol, nas Bases US National Library of Medicine (PubMed), Biblioteca Virtual de Saúde (BVS), The Cochrane Central Register of Controlled Trials (CENTRAL) abrangendo a Base eletrônica editora Elsevier (EMBASE), Scientific Electronic Library Online (SciELO) e Health Evidence. Resultados: A busca retornou 256 estudos, após análise completa foram excluídos 248 por não atenderem a metodologia e objetivo, resultando em 8 estudos, prevalecendo em inglês. 816 indivíduos foram avaliados, predominando como transtorno mental a depressão. Houve diversidade quanto ao Tipo de estudo. Considerações finais: há pouca produção relacionada à temática e não foi encontrada revisão sistemática. Sugerem-se estudos que aprofundem o impacto dos transtornos psicológicos na UVP, enfatizando os níveis citológico e histológico. Acredita-se que pesquisas futuras trarão reflexões acerca da importância do atendimento psicológico e psiquiátrico, associado à promoção de atividades de bem-estar e do convívio social.

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