scholarly journals Pharmacological and Non-Pharmacological Intervention to Prevent Preeclampsia: A Systematic Literature Review

2020 ◽  
Vol 8 (3) ◽  
pp. 168
Author(s):  
Fatimatasari - Fatimatasari ◽  
Angela C.B Trude ◽  
Herlin Herlin Fitriana Kurniawati ◽  
Rosmita Nuzuliana
Keyword(s):  
Nitric Oxide ◽  
Literature Review ◽  
Systematic Literature Review ◽  
Pharmacological Intervention ◽  
Isosorbide Mononitrate ◽  
Fetal Mortality ◽  
Nitric Oxide Donors ◽  
Pharmacological Interventions ◽  
Inadequate Sample Size

<p class="TextAbstract"><strong>Background:</strong> Preeclampsia is a disorder of pregnancy that increases risk for long-term health consequences for both mother and child, and if left untreated is one of the main causes of maternal and fetal mortality. However, delivery of the placenta is the only cure, making prevention options for this condition needed but little consensus exist on their effectiveness. Thus, we conducted a systematic review on the effectiveness of pharmacological and non-pharmacological interventions to prevent preeclampsia. <strong>Methods:</strong> We used MEDLINE and ProQuest to conduct a systematic search for peer-review publications on prevention of preeclampsia. We selected studies conducted in human and published in English from 2010 through 2020 on: i) types of interventions; ii) quality of studies and limitations. We selected 22 articles to be reviewed. <strong>Results:</strong> Eleven types of pharmacological and non-pharmacological interventions were identified. Nitric Oxide-donors with Isosorbide Mononitrate (IMN), and aspirin have been shown to be effective, while selenium, calcium, vitamin D, DHA-rich fish oil-concentrate, copper, phytonutrient, Nitric Oxide-donors with Penthaerythrityl Tetranitrate (PETN), folic acid, vitamins C and E and magnesium have not been proved effective to prevent preeclampsia. Although all studies presented good quality of evidence, they had several limitations, the most common limitations are lack of initial therapy, lack of dosage, and inadequate sample size to detect small effect.  <strong>Conclusion:</strong> Despite the growing evidence of treatments to prevent preeclampsia, their effect is not large. More research is needed in the field before prevention treatments are prescribed in clinical settings.</p><p class="TextAbstract"><strong>Keywords</strong><strong>: </strong>prevention; pharmacological; non-pharmacological; Systematic Literature Review; preeclampsia.</p>

scholarly journals AB0602 IMPACT OF SOCIOECONOMIC FACTORS ON PAIN AND FUNCTION IN KNEE OSTEOARTHRITIS: A SYSTEMATIC LITERATURE REVIEW

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1337.2-1337
Author(s):  
T. W. Swinnen ◽  
M. Willems ◽  
I. Jonkers ◽  
F. P. Luyten ◽  
J. Vanrenterghem ◽  
...  
Keyword(s):  
Risk Factors ◽  
Literature Review ◽  
Knee Osteoarthritis ◽  
Socioeconomic Factors ◽  
Systematic Literature Review ◽  
Intervention Effects ◽  
Socioeconomic Outcomes ◽  
And Function ◽  
The Impact

Background:The personal and societal burden of knee osteoarthritis (KOA) urges the research community to identify factors that predict its onset and progression. A mechanistic understanding of disease is currently lacking but needed to develop targeted interventions. Traditionally, risk factors for KOA are termed ‘local’ to the joint or ‘systemic’ referring to whole-body systems. There are however clear indications in the scientific literature that contextual factors such as socioeconomic position merit further scientific scrutiny, in order to justify a more biopsychosocial view on risk factors in KOA.Objectives:The aims of this systematic literature review were to assess the inclusion of socioeconomic factors in KOA research and to identify the impact of socioeconomic factors on pain and function in KOA.Methods:Major bibliographic databases, namely Medline, Embase, CINAHL, Web of Science and Cochrane, were independently screened by two reviewers (plus one to resolve conflicts) to identify research articles dealing with socioeconomic factors in the KOA population without arthroplasty. Included studies had to quantify the relationship between socioeconomic factors and pain or function. Main exclusion criteria were: a qualitative design, subject age below 16 years and articles not written in English or Dutch. Methodological quality was assessed via the Cochrane risk of bias tools for randomized (ROB-II) and non-randomized intervention studies (ROBIN-I) and the Newcastle-Ottawa Scale for assessing the quality of non-randomised studies. Due to heterogeneity of studies with respect to outcomes assessed and analyses performed, no meta-analysis was performed.Results:Following de-duplication, 7639 articles were available for screening (120 conflicts resolved without a third reader). In 4112 articles, the KOA population was confirmed. 1906 (25%) were excluded because of knee arthroplasty and 1621 (21%) because of other issues related to the population definition. Socioeconomic factors could not be identified in 4058 (53%) papers and were adjusted for in 211 (3%) articles. In the remaining papers covering pain (n=110) and/or function (n=81), education (62%) and race (37%) were most frequently assessed as socioeconomic factors. A huge variety of mainly dichotomous or ordinal socioeconomic outcomes was found without further methodological justification nor sensitivity analysis to unravel the impact of selected categories. Although the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) was the most popular instrument to assess pain and function, data pooling was not possible as socioeconomic factors estimates were part of multilevel models in most studies. Overall results showed that lower education and African American race were consistent predictors of pain and poor function, but those effects diminished or disappeared when psychological aspects (e.g. discrimination) or poverty estimates were taken into account. When function was assessed using self-reported outcomes, the impact of socioeconomic factors was more clear versus performance-based instruments. Quality of research was low to moderate and the moderating or mediating impact of socioeconomic factors on intervention effects in KOA is understudied.Conclusion:Research on contextual socioeconomic factors in KOA is insufficiently addressed and their assessment is highly variable methodologically. Following this systematic literature review, we can highlight the importance of implementing a standardised and feasible set of socioeconomic outcomes in KOA trials1, as well as the importance of public availability of research databases including these factors. Future research should prioritise the underlying mechanisms in the effect of especially education and race on pain and function and assess its impact on intervention effects to fuel novel (non-)pharmacological approaches in KOA.References:[1]Smith TO et al. The OMERACT-OARSI Core Domain Set for Measurement in Clinical Trials of Hip and/or Knee Osteoarthritis J Rheumatol 2019. 46:981–9.Disclosure of Interests:None declared.

scholarly journals 593 Quality of life following a road traffic injury: a systematic literature review

2016 ◽  
Vol 22 (Suppl 2) ◽  
pp. A213.1-A213
Author(s):  
Ritva Rissanen ◽  
Hans-Yngve Berg ◽  
Marie Hasselberg
Keyword(s):  
Quality Of Life ◽  
Literature Review ◽  
Systematic Literature Review ◽  
Road Traffic ◽  
Road Traffic Injury ◽  
Traffic Injury

scholarly journals Quality of care indicators for schizophrenia: determinants of observed variations among Italian Departments of Mental Health. Results from the ETAS DSM study

2016 ◽  
Vol 26 (3) ◽  
pp. 299-313 ◽  
Author(s):  
G. Fantini ◽  
G. Tibaldi ◽  
P. Rucci ◽  
D. Gibertoni ◽  
M. Vezzoli ◽  
...  
Keyword(s):  
Mental Health ◽  
Quality Of Care ◽  
Health Care Professionals ◽  
Treatment Guidelines ◽  
Psychosocial Rehabilitation ◽  
Metabolic Effects ◽  
Administrative Databases ◽  
Pharmacological Intervention ◽  
Pharmacological Interventions

Aims.The primary aim of this study is to analyse the conformance of usual care patterns for persons with schizophrenia to treatment guidelines in three Italian Departments of Mental Health (DMHs). The secondary aim is to examine possible organisational and structural reasons accounting for variations among DMHs.Methods.Within the framework of the Evaluation of Treatment Appropriateness in Schizophrenia (ETAS) project, 20 consensus quality of care indicators were developed. Ten concerned pharmacological treatment and ten encompassed general care and psychosocial rehabilitation interventions. Indicators were calculated using data from a stratified random sample of 458 patients treated at three DMHs located in North-Eastern, North-Western and Southern Italy. Patients’ data were collected by combining information from medical charts and from a survey carried out by the health care professionals in charge of the patients. Data on the structural and organisational characteristics of the DMHs were retrieved from administrative databases. For each indicator, the number and percentage of appropriate interventions with and without moderators were calculated. Appropriateness was defined as the percentage of eligible patients receiving an intervention conformant with guidelines. Moderators, i.e., reasons justifying a discrepancy between the interventions actually provided and that recommended by guidelines were recorded. Indicators based on a sufficient number of eligible patients were further explored in a statistical analysis to compare the performance of the DMHs.Results.In the overall sample, the percentage of inappropriate interventions ranged from 11.1 to 59.3% for non-pharmacological interventions and from 5.9 to 66.8% for pharmacological interventions. Comparisons among DMHs revealed significant variability in appropriateness for the indicators ‘prevention and monitoring of metabolic effects’, ‘psychiatric visits’, ‘psychosocial rehabilitation’, ‘family involvement’ and ‘work’. After adjusting the patient's gender, age and functioning, only the indicators ‘Prevention and monitoring of metabolic effects’, ‘psychiatric visits’ and ‘work’ continued to differ significantly among DMHs. The percentage of patients receiving appropriate integrated care (at least one appropriate non-pharmacological intervention and one pharmacological intervention) was significantly different among the three DMHs and lower than expected.Conclusions.Our results underscore discrepancies among Italian DMHs in indicators that explore key aspects of care of patients with schizophrenia. The use of quality indicators and improved guideline adherence can address suboptimal clinical outcomes, and has the potential to reduce practice variations and narrow the gap between optimal and routine care.

Surgical treatment of rectovaginal fistulas (systematic literature review)

2021 ◽  
pp. 30-48
Author(s):  
Andrei Anatolevich Mudrov ◽  
Aleksandr Yur’evich Titov ◽  
Mariyam Magomedovna Omarova ◽  
Sergei Alekseevich Frolov ◽  
Ivan Vasilevich Kostarev ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Literature Review ◽  
Systematic Literature Review ◽  
Meta Analysis ◽  
High Recurrence Rate ◽  
Surgical Interventions ◽  
Rectovaginal Fistulas ◽  
Surgical Treatments

Despite the large number of available surgical interventions aimed at the treatment of rectovaginal fistulas, the results of their use remain extremely disappointing, associated with the high recurrence rate of the disease reaching 80 %, as well as the lack of a single tactic to minimize the risk of anal incontinence and the need for colostomy. Objective: to conduct a systematic literature review in order to summarize information related to the rectovaginal fistulas surgery. The systematic review includes the results of an analysis of 97 clinical trials selected from 756 publications found in databases. Inclusion criteria: a full-text article, the presence of at least 5 patients in the study, as well as data on the outcome of surgery. Clinical trials with different surgical treatments were identified and classified into the following categories: elimination of the rectovaginal septal defect with a displaced flap (rectal and vaginal); Martius surgery; gracilis muscle transposition; transperineal procedure; abdominal procedure including endoscopic and laparoscopic methods; use of biological or biocompatible materials. Treatment outcomes vary significantly from 0 % to > 80 %. None of the studies were randomized. Due to the low quality of the identified studies, comparison of results and meta-analysis conduction were not possible. Conclusion: as a result of the systematic review, data for the analysis and development of any strategic and tactical algorithms for the treatment of RVF were not obtained. The most important questions still remain open: what and when surgical method to choose, is it necessary to form a disconnecting stoma?

Alternatives to solve SDG trade-offs and to enforce SDG synergies: a systematic literature review

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Andrei Boar ◽  
Erola Palau Pinyana ◽  
Marc Oliveras-Villanueva
Keyword(s):  
Sustainable Development ◽  
Developing Countries ◽  
Literature Review ◽  
Systematic Literature Review ◽  
Business Models ◽  
Economic Models ◽  
Clean Energy ◽  
Content Type ◽  
Trade Offs

PurposeThis paper takes a critical view of synergies and trade-offs and discloses the practices that countries and companies should apply to achieve sustainable development.Design/methodology/approachThis paper offers a systematic literature review of 408 papers to find models of sustainable development goals (SDGs) interaction with the aim of shedding light on the existing synergies and trade-offs and finding solutions to enhance these synergies and minimize the trade-offs.FindingsBoth rich and developing countries should follow multiple strategies to improve the quality of life of their citizens. Developing countries should focus on eradicating poverty. Rich countries should apply new economic models that are more likely to be environmental-friendly. Finally, the topic of SDGs should be revisited by the United Nations.Practical implicationsBoosting the quality of education and providing clean energy are two of the most relevant actions that should to be taken by countries, as they will accelerate the fulfilment of all the other SDGs. The use of circular economic models or new business models, such as the sharing economy, is essential to the achievement of sustained economic growth without negative environmental impact.Originality/valueThe paper analyzes SDG interactions and offers a critical vision of practices that countries and companies should adhere to for achieving sustainable development.

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