scholarly journals Chest CT and rapid antigen testing for reducing the risk of COVID-19 infection among HCWs involved in emergency trauma surgery during the pandemic: a systematic review protocol (Preprint)

2020 ◽  
Author(s):  
Dylan Griswold ◽  
Andres Gempeler ◽  
Gail Rosseau ◽  
Neema Kaseje ◽  
WALTER D JOHNSON ◽  
...  
Keyword(s):  
Health Systems ◽  
Evidence Synthesis ◽  
Meta Analysis ◽  
Trauma Surgery ◽  
Experimental Studies ◽  
Healthcare Services ◽  
Chest Ct ◽  
Flow Diagram ◽  
Cochrane Central Register ◽  
Rapid Testing

UNSTRUCTURED ABSTRACT Introduction: Many healthcare facilities in low-and middle-income countries are inadequately resourced and may lack optimal organization and governance, especially concerning surgical health systems. COVID-19 has the potential to decimate these already strained surgical healthcare services unless health systems take stringent measures to protect healthcare workers (HCWs) from viral exposure and ensure the continuity of specialized care for the patients. The objective of this broad evidence synthesis is to identify and summarize the available literature regarding the efficacy of chest CT and rapid testing for emergency trauma surgery patients to reduce the risk of COVID-19 infection in trauma surgery staff in low-resource environments (LREs). Methods We will conduct several searches in the L·OVE (Living OVerview of Evidence) platform for COVID-19, a system that performs automated regular searches in PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), and over thirty other sources. The search results will be presented according to the PRISMA flow diagram. This review will preferentially consider systematic reviews of experimental and quasi-experimental studies, as well as individual studies of such designs, evaluating the effect of chest CT and rapid testing for emergency trauma surgery patients in preventing COVID-19 infection in emergency trauma surgery staff. Critical appraisal of the eligible studies for methodological quality will be conducted. Data will be extracted using the standardized data extraction tool in Covidence. Studies will, when possible, be pooled in a statistical meta-analysis using JBI SUMARI. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach for grading the certainty of evidence will be followed, and a Summary of Findings (SoF) will be created. Ethics and dissemination Ethical approval is not required for this review. The plan for dissemination is to publish review findings in a peer-reviewed journal and present findings at high-level conferences that engage the most pertinent stakeholders. PROSPERO: CRD42020198267

scholarly journals Personal protective equipment for reducing the risk of COVID-19 infection among healthcare workers involved in emergency trauma surgery during the pandemic: an umbrella review protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e045598
Author(s):  
Dylan P Griswold ◽  
Andres Gempeler ◽  
Angelos G Kolias ◽  
Peter J Hutchinson ◽  
Andres M Rubiano
Keyword(s):  
Health Systems ◽  
Systematic Reviews ◽  
Low Income ◽  
Personal Protective Equipment ◽  
Healthcare Workers ◽  
Evidence Synthesis ◽  
Trauma Surgery ◽  
Experimental Studies ◽  
Protective Equipment ◽  
Cochrane Central Register

IntroductionMany healthcare facilities in low-income and middle-income countries are inadequately resourced and may lack optimal organisation and governance, especially concerning surgical health systems. COVID-19 has the potential to decimate these already strained surgical healthcare services unless health systems take stringent measures to protect healthcare workers (HCWs) from viral exposure and ensure the continuity of specialised care for patients. The objective of this broad evidence synthesis is to identify and summarise the available literature regarding the efficacy of different personal protective equipment (PPE) in reducing the risk of COVID-19 infection in health personnel caring for patients undergoing trauma surgery in low-resource environments.MethodsWe will conduct several searches in the L·OVE (Living OVerview of Evidence) platform for COVID-19, a system that performs automated regular searches in PubMed, Embase, Cochrane Central Register of Controlled Trials and over 30 other sources. The search results will be presented according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow diagram. This review will preferentially consider systematic reviews of experimental and quasi-experimental studies, as well as individual studies of such designs, evaluating the effect of different PPE on the risk of COVID-19 infection in HCWs involved in emergency trauma surgery. Critical appraisal of eligible studies for methodological quality will be conducted. Data will be extracted using the standardised data extraction tool in Covidence. Studies will, when possible, be pooled in a statistical meta-analysis using JBI SUMARI. The Grading of Recommendations, Assessment, Development and Evaluation approach for grading the certainty of evidence will be followed and a summary of findings will be created.Ethics and disseminationEthical approval is not required for this review. The plan for dissemination is to publish review findings in a peer-reviewed journal and present findings at high-level conferences that engage the most pertinent stakeholders.PROSPERO registration numberCRD42020198267.

scholarly journals Personal protective equipment for reducing the risk of COVID-19 infection among healthcare workers involved in emergency trauma surgery during the pandemic: a systematic review protocol

2020 ◽  
Author(s):  
Dylan P Griswold ◽  
Andres Gempeler ◽  
Angelos Kolias ◽  
Peter J. Hutchinson ◽  
Andres M. Rubiano
Keyword(s):  
Systematic Review ◽  
Health Systems ◽  
Systematic Reviews ◽  
Personal Protective Equipment ◽  
Healthcare Workers ◽  
Evidence Synthesis ◽  
Trauma Surgery ◽  
Experimental Studies ◽  
Protective Equipment ◽  
Cochrane Central Register

ABSTRACTObjectiveThe objective of this broad evidence synthesis is to identify and summarize the available literature regarding the efficacy of different personal protective equipment (PPE) for reducing the risk of COVID-19 infection in health personnel caring for patients undergoing trauma surgery in low-resource environments (LREs).IntroductionMany healthcare facilities in low-and middle-income countries are inadequately resourced and may lack optimal organization and governance, especially concerning surgical health systems. COVID-19 has the potential to decimate these already strained surgical healthcare services unless health systems take stringent measures to protect healthcare workers from viral exposure and ensure the continuity of specialized care for the patients.Inclusion criteriaThis review will preferentially consider systematic reviews of experimental and quasi-experimental studies, as well as individual studies of such designs, evaluating the effect of different PPE on the risk of COVID-19 infection in healthcare workers (HCWs) involved in emergency trauma surgery.MethodsWe will conduct several searches in the L·OVE (Living OVerview of Evidence) platform for COVID-19, a system that performs automated regular searches in PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), and over thirty other sources. The search results will be presented according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow diagram. Critical appraisal of the eligible studies for methodological quality will be conducted. Data will be extracted using the standardized data extraction tool in Covidence. Studies will, when possible, be pooled in a statistical meta-analysis using JBI SUMARI. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach for grading the certainty of evidence will be followed, and a Summary of Findings (SoF) will be created.Systematic review registration numberCRD42020198267

Continuous infusion ketamine as analgesia or sedation in mechanically ventilated adults in the intensive care unit: a scoping review

2021 ◽  
Author(s):  
Nicholas David Richards ◽  
Simon Howell ◽  
Mark Bellamy ◽  
Ruben Mujica-Mota
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Continuous Infusion ◽  
Scoping Review ◽  
Evidence Synthesis ◽  
Meta Analysis ◽  
Flow Diagram ◽  
Mechanically Ventilated ◽  
Scoping Reviews ◽  
Review Protocol

Abstract IntroductionMechanical ventilation (MV) is a common and often live-saving intervention on the Intensive Care Unit (ICU). In order to facilitate this intervention, the majority of patients require medical sedation. Optimising sedation is one of the fundamentals of ICU care, and inadequate sedation (predominantly too deep) has consistently been associated with worse outcomes for patients.This article presents the protocol for a scoping review of published literature on the use of ketamine as a sedative to facilitate MV on ICU.The scoping review has been designed to answer the question ‘What is known about the use of ketamine as a continuous infusion to provide sedation in mechanically ventilated adults in the intensive care unit, and what gaps in the evidence exist?’ MethodsThe scoping review protocol has been designed using the Preferred Reporting Items for Systematic Reviews and Meta-analysis extension for Scoping Reviews (PRISMA-ScR) checklist and the JBI manual for evidence synthesis. Data will be extracted using a dedicated form, and reviewed by 2 reviewers.Results Results will be tabulated and presented along side descriptive summaries. A PRISMA flow diagram will also be generated.Ethics and DisseminationThis scoping review is designed to map out the literature using existing published articles and does not require ethical approval.Results will be submitted for publication in relevant peer-reviewed journals and to international meetings as well as disseminated to relevant professional groups.

scholarly journals Telemedicine in the correctional setting: A scoping review

2018 ◽  
Vol 24 (10) ◽  
pp. 669-675 ◽  
Author(s):  
Buddhika Senanayake ◽  
Sumudu I Wickramasinghe ◽  
Lars Eriksson ◽  
Anthony C Smith ◽  
Sisira Edirippulige
Keyword(s):  
Mental Health ◽  
Health Services ◽  
Experimental Studies ◽  
Healthcare Services ◽  
Current Evidence ◽  
Delivery Mode ◽  
Cochrane Central Register ◽  
Correctional Setting ◽  
The Usa ◽  
Correctional Settings

Introduction The access healthcare services to inmates within correctional settings has generally been low and problematic due to specific nature of the prison setting. Telemedicine has been used as an alternative delivery mode. This study aimed to collate the current evidence related to the use of telemedicine to deliver health services within correctional settings. Methods A comprehensive search of seven databases – PubMed, Embase, CINAHL, Informit, Cochrane Central Register of Controlled Trials, PsycINFO and Scopus, for peer-reviewed publications was conducted in April, 2018. Results Initial search identified 1147 articles. After review of the title and abstract, 36 articles were included in the final review. Of the included articles, 19 (53%) were published during the period of 2010-2018. Articles were predominantly from the USA ( n = 23; 64 %), France and Australia. There were 23 descriptive studies (64%), five costing studies (14%) five experimental studies (14%), two mixed methods (6%) and one qualitative study (3%). The experimental studies were predominantly focused on mental health services ( n = 4, 80%). The commonest telemedicine intervention used was synchronous videoconferencing ( n = 21, 58%), while eight articles (22%) described asynchronous interventions. Telemedicine interventions were mainly used for mental health ( n = 13), and ophthalmology ( n = 4) disciplines. Discussion In the right circumstances, telemedicine interventions within correctional settings seem to be a useful method in connecting inmates with essential health services.

scholarly journals Effect of Resin Infiltration on Enamel: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 12 (3) ◽  
pp. 48
Author(s):  
Madalena Soveral ◽  
Vanessa Machado ◽  
João Botelho ◽  
José João Mendes ◽  
Cristina Manso
Keyword(s):  
Bond Strength ◽  
Penetration Depth ◽  
Shear Bond Strength ◽  
Meta Analysis ◽  
Experimental Studies ◽  
Cochrane Central Register ◽  
Resin Infiltration ◽  
Central Register ◽  
Intact Surface ◽  
Meta Analyses

Subsurface enamel demineralization beneath an intact surface layer or white spots lesions (WSL) can and should be treated with non-invasive procedures to impede the development of a cavitated lesion. We aim to analyze if infiltrative resin improves enamel roughness, microhardness, shear bond strength, and penetration depth. MEDLINE [via Pubmed], Cochrane Central Register of Controlled Trials, Embase, Web of Science, Scholar, and LILACS were searched until May 2021. Methodological quality was assessed using the Joanna Briggs Institute Clinical Appraisal Checklist for Experimental Studies. Pairwise ratio of means (ROM) meta-analyses were carried out to compare the enamel properties after treatment with infiltrative resin on sound enamel and WSLs. From a total of 1604 articles, 48 studies were included. Enamel surface roughness decreased 35% in sound enamel (95%CI: 0.49–0.85, I2 = 98.2%) and 54% in WSLs (95%CI: 0.29–0.74, I2 = 98.5%). Microhardness reduced 24% in sound enamel (95%CI: 0.73–0.80, I2 = 99.1%) and increased by 68% in WSLs (95%CI: 1.51; 1.86, I2 = 99.8%). Shear bond strength reduced of 25% in sound enamel (95%CI: 0.60; 0.95, I2 = 96.9%) and increased by 89% in WSLs (95%CI: 1.28–2.79, I2 = 99.8%). Penetration depth was 65.39% of the WSLs (95%CI: 56.11–74.66, I2 = 100%). Infiltrative resins effectively promote evident changes in enamel properties in sound and WSLs. Future studies with long-term follow-ups are necessary to corroborate these results from experimental studies.

Esophageal defect repair by artificial scaffolds: a systematic review of experimental studies and proportional meta-analysis

2020 ◽  
Author(s):  
Dimitrios Schizas ◽  
Maximos Frountzas ◽  
Emmanouil Sgouromallis ◽  
Eleftherios Spartalis ◽  
Konstantinos S Mylonas ◽  
...  
Keyword(s):  
Tissue Engineering ◽  
Systematic Reviews ◽  
Meta Analysis ◽  
Survival Rates ◽  
Experimental Studies ◽  
Esophageal Replacement ◽  
Measurement Tool ◽  
Cochrane Central Register ◽  
Graft Stenosis ◽  
Meta Analyses

Abstract Background The traditional technique of gastrointestinal reconstruction of the esophagus after esophagectomy presents plenty of complications. Hence, tissue engineering has been introduced as an effective artificial alternative with potentially fewer complications. Three types of esophageal scaffolds have been used in experimental studies so far. The aim of our meta-analysis is to present the postoperative outcomes after esophageal replacement with artificial scaffolds and the investigation of possible factors that affect these outcomes. Methods The present proportional meta-analysis was designed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and A MeaSurement Tool to Assess systematic Reviews guidelines. We searched Medline, Scopus, Clinicaltrials.gov, EMBASE, Cochrane Central Register of Controlled Trials CENTRAL, and Google Scholar databases from inception until February 2020. Results Overall, 32 studies were included that recruited 587 animals. The pooled morbidity after esophageal scaffold implantation was 53.4% (95% CI = 36.6–70.0%). The pooled survival interval was 111.1 days (95% CI = 65.5–156.8 days). Graft stenosis (46%), postoperative dysphagia (15%), and anastomotic leak (12%) were the most common complications after esophageal scaffold implantation. Animals that underwent an implantation of an artificial scaffold in the thoracic part of their esophagus presented higher survival rates than animals that underwent scaffold implantation in the cervical or abdominal part of their esophagus (P < 0.001 and P = 0.011, respectively). Conclusion Tissue engineering seems to offer an effective alternative for the repair of esophageal defects in animal models. Nevertheless, issues like graft stenosis and lack of motility of the esophageal scaffolds need to be addressed in future experimental studies before scaffolds can be tested in human trials.

scholarly journals Chest CT versus RT-PCR for the detection of COVID-19: systematic review and meta-analysis of comparative studies

JRSM Open ◽  
2021 ◽  
Vol 12 (5) ◽  
pp. 205427042110118
Author(s):  
Mohammad Karam ◽  
Sulaiman Althuwaikh ◽  
Mohammad Alazemi ◽  
Ahmad Abul ◽  
Amrit Hayre ◽  
...  
Keyword(s):  
Systematic Review ◽  
Ct Scan ◽  
Outcome Measures ◽  
Test Performance ◽  
Meta Analysis ◽  
False Positive Rate ◽  
Chest Ct ◽  
Cochrane Central Register ◽  
Rt Pcr ◽  
Sensitivity Specificity

Objectives To compare the performance of chest computed tomography (CT) scan versus reverse transcription polymerase chain reaction (RT-PCR) as the reference standard in the initial diagnostic assessment of coronavirus disease 2019 (COVID-19) patients. Design A systematic review and meta-analysis were performed as per the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. A search of electronic information was conducted using the following databases: MEDLINE, EMBASE, EMCARE, CINAHL and the Cochrane Central Register of Controlled Trials. Setting Studies that compared the diagnostic performance within the same patient cohort of chest CT scan versus RT-PCR in COVID-19 suspected patients. Participants Thirteen non-randomised studies enrolling 4092 patients were identified. Main outcome measures Sensitivity, specificity and accuracy were primary outcome measures. Secondary outcomes included other test performance characteristics and discrepant findings between both investigations. Results Chest CT had a median sensitivity, specificity and accuracy of 0.91 (range 0.82–0.98), 0.775 (0.25–1.00) and 0.87 (0.68–0.99), respectively, with RT-PCR as the reference. Importantly, early small, China-based studies tended to favour chest CT versus later larger, non-China studies. Conclusions A relatively high false positive rate can be expected with chest CT. It is possible it may still be useful to provide circumstantial evidence, however, in some patients with a suspicious clinical presentation of COVID-19 and negative initial Severe Acute Respiratory Syndrome Coronavirus 2 RT-PCR tests, but more evidence is required in this context. In acute cardiorespiratory presentations, negative CT scan and RT-PCR tests is likely to be reassuring.

scholarly journals Social Media and mHealth Technology for Cancer Screening: Systematic Review and Meta-analysis (Preprint)

2020 ◽  
Author(s):  
Arlinda Ruco ◽  
Fahima Dossa ◽  
Jill Tinmouth ◽  
Diego Llovet ◽  
Jenna Jacobson ◽  
...  
Keyword(s):  
Systematic Review ◽  
Social Media ◽  
Cancer Screening ◽  
Meta Analysis ◽  
Experimental Studies ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Screening Programs ◽  
Screening Participation ◽  
Quasi Experimental

BACKGROUND Cancer is a leading cause of death, and although screening can reduce cancer morbidity and mortality, participation in screening remains suboptimal. OBJECTIVE This systematic review and meta-analysis aims to evaluate the effectiveness of social media and mobile health (mHealth) interventions for cancer screening. METHODS We searched for randomized controlled trials and quasi-experimental studies of social media and mHealth interventions promoting cancer screening (breast, cervical, colorectal, lung, and prostate cancers) in adults in MEDLINE, Embase, PsycINFO, Scopus, CINAHL, Cochrane Central Register of Controlled Trials, and Communication & Mass Media Complete from January 1, 2000, to July 17, 2020. Two independent reviewers screened the titles, abstracts, and full-text articles and completed the risk of bias assessments. We pooled odds ratios for screening participation using the Mantel-Haenszel method in a random-effects model. RESULTS We screened 18,008 records identifying 39 studies (35 mHealth and 4 social media). The types of interventions included peer support (n=1), education or awareness (n=6), reminders (n=13), or mixed (n=19). The overall pooled odds ratio was 1.49 (95% CI 1.31-1.70), with similar effect sizes across cancer types. CONCLUSIONS Screening programs should consider mHealth interventions because of their promising role in promoting cancer screening participation. Given the limited number of studies identified, further research is needed for social media interventions. CLINICALTRIAL PROSPERO International Prospective Register of Systematic Reviews CRD42019139615; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=139615 INTERNATIONAL REGISTERED REPORT RR2-10.1136/bmjopen-2019-035411

scholarly journals The Effectiveness of Educational Training or Multicomponent Programs to Prevent the Use of Physical Restraints in Nursing Home Settings: A Systematic Review and Meta-Analysis of Experimental Studies

2020 ◽  
Vol 17 (18) ◽  
pp. 6738
Author(s):  
Anna Brugnolli ◽  
Federica Canzan ◽  
Luigina Mortari ◽  
Luisa Saiani ◽  
Elisa Ambrosi ◽  
...  
Keyword(s):  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Physical Restraint ◽  
Experimental Studies ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Physical Restraints ◽  
Educational Training ◽  
Qualitative Synthesis ◽  
Randomized Controlled

This review assesses the effectiveness of interventions to reduce physical restraint (PR) use in older people living in nursing homes or residential care facilities. A systematic search of studies published in four electronic databases (MEDLINE, CINHAL, PsycINFO, Cochrane Central Register of Controlled Trials). The review included individual and cluster randomized controlled trials that compared educational training and multicomponent programs to avoid PR use. Risk bias of randomized controlled trials (RCTs) was assessed according to the Cochrane Handbook for Systematic Reviews of Interventions. This review includes 16 studies in a qualitative synthesis that met the inclusion criteria, nine of them offered a multicomponent program and seven offered only educational training. The results of the 12 studies included in the meta-analysis showed a significant trend in favor of intervention over time and intensity of PR use tends to decrease. The review indicates that educational programs and other supplementary interventions should be effective, but the heterogeneous operative definition of physical restraints can make difficult data generalization.

scholarly journals Pin vs plate fixation for metacarpal fractures: a meta-analysis

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Xiangting Zhu ◽  
Hongwei Zhang ◽  
Jingying Wu ◽  
Shiwei Wang ◽  
Lin Miao
Keyword(s):  
Functional Outcomes ◽  
Plate Fixation ◽  
Meta Analysis ◽  
Experimental Studies ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Dash Score ◽  
Range Of Movement ◽  
Pin Fixation

Abstract Background The differences in the clinical and functional outcomes of closed reduction and percutaneous pin fixation and open reduction with internal fixation (ORIF) using plate and screws have been systematically synthesized by one meta-analysis. With newer studies being published, an effort to update the earlier meta-analysis is necessary. Methods Comprehensive searches were done systematically through PubMed, Scopus, CENTRAL (Cochrane Central Register of Controlled Trials), and Google scholar databases. Randomized controlled trials, quasi-experimental studies, prospective comparative non-randomized studies, and even studies reporting findings from retrospective chart review were eligible to be included. Statistical analysis was done using STATA version 13.0. GRADE assessment was done to assess the quality of pooled evidence. Results A total of 9 studies were included. The pooled estimates did not suggest any significant differences in the disabilities of the arm, shoulder, and hand (DASH) score [WMD − 0.77; 95% CI, − 3.55, 2.00; I2 = 75.5%], range of movement (ROM) of the metacarpophalangeal joint (o) [WMD 4.44; 95% CI, − 4.19, 13.07; I2 = 86.0%], and grip strength [WMD − 4.63; 95% CI, − 14.52, 5.26; I2 = 86.9%] among the two intervention modalities. No difference was seen in the risk of complications between the two interventions (RR 0.93; 95% CI, 0.57, 1.53; I2 = 31.2%). For all the outcomes, the quality of pooled evidence was judged as low to very low. Conclusion No significant long-term differences were noted in the functional outcomes suggesting that both these techniques are comparable. The choice of modality should be made based on the skills and preference of the surgeon and availability of resources.

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