scholarly journals Postoperative emergence delirium in children: a narrative review of recent publications

2021 ◽  
Keyword(s):  
Cochrane Library ◽  
Future Research ◽  
Inhalation Anesthetics ◽  
Emergence Delirium ◽  
Treatment And Prevention ◽  
Intervention Measures ◽  
Perioperative Monitoring ◽  
The Cochrane Library ◽  
Mother’S Voice ◽  
The Impact

Background: Emergence delirium is a challenge in pediatric anesthesiology, with important unanswered questions concerning incidence, causation, diagnosis, treatment, and sequelae. In this review, we will present the recent research with a particular focus placed on treatment and prevention options. Methods: A wide literature search was conducted across MEDLINE and other databases using PubMed, Embase, Ovid, and the Cochrane Library (latest access: 23 November 2020). The collected publications were assessed for relevance. Only randomized controlled trials and observational studies on postoperative emergence delirium in children were included. Exclusion criteria were articles published before 2018, and studies comprising children older than 12 years of age, mental retardation, or chronic diseases. Results: The final number of studies included in this review was 44. Risk factors identified for emergence delirium were volatile inhalation anesthetics, young age, child temperament, preoperative anxiety, male gender, and specific surgical procedures. Preventive and/or intervention measures were pharmacological (e.g. TIVA, α2-adrenergic agonists (particularly dexmedetomidine), ketamine, propofol, midazolam, opioids (fentanyl)) and non-pharmacological measures (e.g. video or tablet distraction, familiarization with the operating environment, use of mother’s voice, visual preconditioning in eye surgery). Conclusion: ED should be considered a “vital sign” and recorded and documented in all children in the PACU. There is an urgent need for future research to fill in missing gaps of knowledge regarding ED. Implementation of a standardized and validated screening tool for ED are high priorities as is the impact of perioperative monitoring of children at risk to prevent ED.

scholarly journals Tobacco and bone fractures

2019 ◽  
Vol 8 (6) ◽  
pp. 255-265 ◽  
Author(s):  
J. Hernigou ◽  
F. Schuind
Keyword(s):  
Adverse Effects ◽  
Animal Studies ◽  
English Language ◽  
Bone Fractures ◽  
Cochrane Library ◽  
Treatment And Prevention ◽  
Increased Risk ◽  
Negative Effect ◽  
The Cochrane Library ◽  
The Impact

Objectives The aim of this study was to review the impact of smoking tobacco on the musculoskeletal system, and on bone fractures in particular. Methods English-language publications of human and animal studies categorizing subjects into smokers and nonsmokers were sourced from MEDLINE, The Cochrane Library, and SCOPUS. This review specifically focused on the risk, surgical treatment, and prevention of fracture complications in smokers. Results Smokers have an increased risk of fracture and experience more complications with delayed bone healing, even if they have already stopped smoking, because some adverse effects persist for a prolonged period. Some risks can be reduced during and after surgery by local and general prevention, and smoking cessation is an important factor in lessening this risk. However, if a patient wants to stop smoking at the time of a fracture, the cessation strategies in reducing tobacco use are not easy to implement. The patient should also be warned that using e-cigarettes or other tobaccos does not appear to reduce adverse effects on health. Conclusion The evidence reviewed in this study shows that smoking has a negative effect in terms of the risk and treatment of fractures. Cite this article: J. Hernigou, F. Schuind. Tobacco and bone fractures: A review of the facts and issues that every orthopaedic surgeon should know. Bone Joint Res 2019;8:255–265. DOI: 10.1302/2046-3758.86.BJR-2018-0344.R1.

Appendectomy Does Not Increase the Risk of Future Emergence of Parkinson’s Disease: A Meta-analysis

2021 ◽  
pp. 000313482198903
Author(s):  
Mitsuru Ishizuka ◽  
Norisuke Shibuya ◽  
Kazutoshi Takagi ◽  
Hiroyuki Hachiya ◽  
Kazuma Tago ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Random Effects Models ◽  
Significant Difference ◽  
The Cochrane Library ◽  
The Impact ◽  
The Relationship ◽  
Observation Period

Objective To explore the impact of appendectomy history on emergence of Parkinson’s disease (PD). Background Although there are several studies to investigate the relationship between appendectomy history and emergence of PD, the results are still controversial. Methods We performed a comprehensive electronic search of the literature (the Cochrane Library, PubMed, and the Web of Science) up to April 2020 to identify studies that had employed databases allowing comparison of emergence of PD between patients with and those without appendectomy history. To integrate the impact of appendectomy history on emergence of PD, a meta-analysis was performed using random-effects models to calculate the risk ratio (RR) and 95% confidence interval (CI) for the selected studies, and heterogeneity was analyzed using I2 statistics. Results Four studies involving a total of 6 080 710 patients were included in this meta-analysis. Among 1 470 613 patients with appendectomy history, 1845 (.13%) had emergences of PD during the observation period, whereas among 4 610 097 patients without appendectomy history, 6743 (.15%) had emergences of PD during the observation period. These results revealed that patients with appendectomy history and without appendectomy had almost the same emergence of PD (RR, 1.02; 95% CI, .87-1.20; P = .83; I2 = 87%). Conclusion This meta-analysis has demonstrated that there was no significant difference in emergence of PD between patients with and those without appendectomy history.

scholarly journals Excess weight and dyslipidemia and their complications during pregnancy: a systematic review

2016 ◽  
Vol 16 (2) ◽  
pp. 93-101 ◽  
Author(s):  
Iramar Baptistella do Nascimento ◽  
Willian Barbosa Sales ◽  
Raquel Fleig ◽  
Grazielle Dutra da Silva ◽  
Jean Carl Silva
Keyword(s):  
Systematic Review ◽  
Key Words ◽  
Excess Weight ◽  
Cochrane Library ◽  
Obstetric Outcomes ◽  
Lipid Disorders ◽  
Key Words Lipids ◽  
The Cochrane Library ◽  
The Impact ◽  
In Pregnancy

Abstract Objectives: to identify bibliographically disorders related to excess weight, dyslipidemia and their complication during pregnancy and in the fetus and newborn. Methods: a systematic review including observational and interventional studies and reviews, based on MEDLINE, LILACS, Embase and the Cochrane Library between 2000 and 2015. The key-words "lipids, pregnancy, obesity and newborn" were used to establish a selective stage for inclusion/exclusion of titles, repeated studies, key-words, abstracts, methodological incompatibility and correlation with objectives. Results: 58 studies were selected, of which 36 (62%) addressed prevention and the risk in pregnancy of excess weight and lipid disorders and 19 (32.7%) suggestions and/or consequences for the fetus and newborn. Conclusions: excess weight and lipidemic disorders in pregnancy are causes for concern in scientific studies, posing risks both for the mother and the newborn. Higher prevalence of caesarian and pre-eclampsia were the two most noteworthy complications for gestational outcomes. In short, the impact on care of maternal habits and excess weight during pregnancy is highly significant, owing to the different degrees of complication in obstetric outcomes and their influence on the clinical characteristics of the newborn.

scholarly journals Hygienic assessment of the impact of 5G/IMT-2020 communication networks on public health (literature review)

2021 ◽  
Vol 100 (9) ◽  
pp. 929-932
Author(s):  
Anna M. Egorova ◽  
Lydiya A. Lutsenko ◽  
Anna V. Sukhova ◽  
Vyacheslav V. Kolyuka ◽  
Rustam V. Turdyev
Keyword(s):  
Public Health ◽  
Radio Frequency ◽  
Electromagnetic Radiation ◽  
Communication Networks ◽  
Biological Effects ◽  
Three Dimensional ◽  
Cochrane Library ◽  
Pubmed Search ◽  
The Cochrane Library ◽  
The Impact

The program “Digital Economy of the Russian Federation” approved the Concept for the creation and development of 5G / IMT-2020 networks. The development of 5G communications will significantly impact the implementation of many innovative projects and initiatives: the Smart City project, Unmanned Transport, etc. Along with significant technical advantages compared to previous generations of communication (2G, 3G, 4G), 5G technology has completely different emitting characteristics: more emitting elements, signal modulation, three-dimensional beam, the ability to control the beam, SHF (ultra-high) and EHF (extremely high) radio frequency ranges and centimetre and millimetre wavelengths of electromagnetic radiation. Therefore, it is becoming an especially urgent problem to ensure exposure to the human body of non-ionizing electromagnetic fields of the radio frequency range (30 kHz-300 GHz). The authors searched the literature on the biological effects of 5G cellular communications and electromagnetic radiation in the centimetre and millimetre ranges using the appropriate keywords in PubMed search engines, Scopus, Web of Science, Medline, The Cochrane Library, EMBASE, Global Health, CyberLeninka, RSCI and others. There is currently tentative and conflicting evidence on the impact of 5G. The rapidly growing density of wireless devices and antennas (considering future 5G networks) increases the public health risk from exposure to RF EMFs as the penetration depth for 5G EHF radiation is only a few millimetres. At these wavelengths, resonance phenomena are possible at the cellular and molecular levels, particularly concerning stimulating SHF and EHF oxidative processes and damaging DNA. The influence of the millimetre range of RF-EMF is poorly understood; oncological and non-oncological (impact on the reproductive, immune systems, etc.) effects are possible. Using numerical simulation methods of EMF radiation resonances on insects, Thielens A et al., 2018, found a significant overall increase in the absorbed RF power at a frequency of 6 GHz and higher than a frequency below 6 GHz.

Outcomes of digital biomarker-based interventions: protocol for a systematic review of systematic reviews (Preprint)

2021 ◽  
Author(s):  
Hossein Motahari-Nezhad ◽  
Márta Péntek ◽  
László Gulácsi ◽  
Zsombor Zrubka
Keyword(s):  
Clinical Outcomes ◽  
Systematic Reviews ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Level Of Evidence ◽  
Clinical Benefits ◽  
The Cochrane Library ◽  
The Impact ◽  
Digital Biomarkers

BACKGROUND Digital biomarkers are defined as objective, quantifiable physiological and behavioral data that are collected and measured by means of digital devices such as portables, wearables, implantables or digestibles. For their widespread adoption in publicly financed healthcare systems, it is important to understand how their benefits translate into improved patient outcomes, which is essential for demonstrating their value. OBJECTIVE To assess the quality and strength of evidence of the impact of digital biomarkers on clinical outcomes compared to interventions without digital biomarkers, reported in systematic reviews. METHODS A comprehensive search for 2019-2020 will be conducted in the PubMed and the Cochrane Library using keywords related to digital biomarkers and a filter for systematic reviews. Original full-text English publications of systematic reviews comparing clinical outcomes of interventions with and without digital biomarkers via meta-analysis will be included. The AMSTAR-2 tool will be used to assess the methodological quality of reviews. To assess the quality of evidence, we will evaluate systematic reviews using the GRADE tool. To detect the possible presence of reporting bias, we will record whether the protocol of the systematic reviews was published before the start of the study. A qualitative summary of results by digital biomarker technology and outcome will be provided. RESULTS This protocol was submitted before data collection. The next steps in this review will be initiated after the protocol is accepted for publication. CONCLUSIONS Our study will provide a comprehensive summary of the highest level of evidence available on digital biomarker interventions. Our results will help identify clinical areas where the use of digital biomarkers leads to favorable clinical outcomes. In addition, our findings will highlight areas of evidence gaps where the clinical benefits of digital biomarkers have not yet been demonstrated.

Improvement of Acupuncture Therapy on Relapse of P atients with G outy A rthritis: A Pairwise and Bayesian Network Meta analysis

2021 ◽  
Author(s):  
Zhihui Li ◽  
Min Chen ◽  
Chunzhi Tang
Keyword(s):  
Acupuncture Therapy ◽  
Bayesian Network ◽  
Meta Analysis ◽  
Gouty Arthritis ◽  
Serum Urate ◽  
Cochrane Library ◽  
Future Research ◽  
Fire Needle ◽  
The Impact

Objective: The aim of this study is to investigate the impact of acupuncturetherapy on relapse of patients with gouty arthritis (GA). Methods: “gout ORgouty arthritis” AND “a cupuncture therapy OR acupuncture OR moxibustionOR electroacupuncture OR fire needle OR acupotomology OR blood lettingpuncture OR plum blossom needle” were used as search strategies forsearching related studies. Twenty two studies involving 2394 patient s wereenrolled in this research through the analysis of databases of CNKI, Wanfang,VIP, PubMed, Embase and Cochrane Library. Results: The results of pairwise metaanalysis and network meta analysis (NMA) indicated that patients withacupuncture therapy had a significantly lower relapse rate (RR) compared withthose without acupuncture therapy (OR = 0.21, 95% CI: 0.16 0.26, P <0.00001); the follow up time (TFU) and serum urate concentration (SUA)before treatment had no significant effect on the reductio n of RR caused byacupuncture therapy (P > 0.05); and patients treated with acupuncture plusWestern medicine (WM) had the lowest RR (surface under the cumulativeranking [SUCRA] = 85.0%), followed by acupuncture plus traditional Chinesemedicine (TCM, SUC RA = 73.5%), acupuncture only (SUCRA = 72.8%),fourthly acupuncture plus TCM and WM (SUCRA = 33.0%), then TCM(SUCRA = 28.7%), finally WM (SUCRA = 7.0%). Conclusion: Our findingmay facilitate the application of acupuncture therapy in patients with GA. Ourresearch also offered some information for the future research.

What is the impact of physicians in prehospital treatment for patients in need of acute critical care? – An overview of reviews

2019 ◽  
Vol 35 (1) ◽  
pp. 27-35 ◽  
Author(s):  
Gitte Valentin ◽  
Lotte Groth Jensen
Keyword(s):  
Cardiac Arrest ◽  
Systematic Reviews ◽  
Critical Conditions ◽  
Current Evidence ◽  
Cochrane Library ◽  
Future Research ◽  
Success Rates ◽  
Prehospital Treatment ◽  
The Impact ◽  
Hospital Cardiac Arrest

AbstractObjectivesThe aim of this overview was to systematically identify and synthesize existing evidence from systematic reviews on the impact of prehospital physician involvement.MethodsThe Medline, Embase, and Cochrane library were searched from 1 January 2000 to 17 November 2017. We included systematic reviews comparing physician-based with non–physician-based prehospital treatment in patients with one of five critical conditions requiring a rapid response.ResultsTen reviews published from 2009 to 2017 were included. Physician treatment was associated with increased survival in patients with out-of-hospital cardiac arrest and patients with severe trauma; in the latter group, the result was based on more limited evidence. The success rate of prehospital endotracheal intubation (ETI) has improved over the years, but ETI by physicians is still associated with higher success rates than intubation by paramedics. In patients with severe traumatic brain injury, intubation by paramedics who were not well skilled to do so markedly increased mortality.ConclusionsCurrent evidence is hinting at a benefit of physicians in selected aspects of prehospital emergency services, including treatment of patients with out-of-hospital cardiac arrest and critically ill or injured patients in need of prehospital intubation. Evidence is, however, limited by confounding and bias, and comparison is hampered by differences in case mix and the organization of emergency medical services. Future research should strive to design studies that enable appropriate control of baseline confounding and obtain follow-up data for the proportion of patients who die in the prehospital setting.

Facilitators of Attendance and Adherence to Group-Based Physical Activity for Older Adults: A Literature Synthesis

2018 ◽  
Vol 26 (1) ◽  
pp. 155-167 ◽  
Author(s):  
Cassandra J. de Lacy-Vawdon ◽  
Ruth Klein ◽  
Joanna Schwarzman ◽  
Genevieve Nolan ◽  
Renee de Silva ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Social Factors ◽  
Best Practice ◽  
Qualitative Studies ◽  
Cochrane Library ◽  
Future Research ◽  
Literature Synthesis ◽  
Instructor Characteristics ◽  
The Cochrane Library

This review examines program features that influence attendance and adherence to group-based physical activity (PA) by older adults. Medline, PubMed, CINAHL plus, PsycINFO, and the Cochrane Library were searched for studies published from 1995–2016. Quantitative and qualitative studies investigating factors related to PA group attendance or adherence by persons aged 55 years and over were included. Searching yielded eight quantitative and 13 qualitative studies, from 2,044 titles. Quantitative findings identified social factors, instructor characteristics, PA types, class duration and frequency, and perceived PA outcomes as important for attendance and adherence, whilst qualitative studies identified settings, leadership, PA types, observable benefits, and social support factors. Studies were predominantly low- to moderate-quality. This review identified design and delivery considerations for group-based PA programs to inform best-practice frameworks and industry capacity building. Future research should use longitudinal and mixed-methods designs to strengthen evidence about facilitators of program reach and engagement.

scholarly journals Itch in Chronic Wounds: Pathophysiology, Impact, and Management

Medicines ◽  
2019 ◽  
Vol 6 (4) ◽  
pp. 112 ◽  
Author(s):  
Michela Iannone ◽  
Agata Janowska ◽  
Valentina Dini ◽  
Giulia Tonini ◽  
Teresa Oranges ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Chronic Wounds ◽  
Management Strategies ◽  
Relevant Information ◽  
Cochrane Library ◽  
Tissue Edema ◽  
Practical Guidelines ◽  
The Cochrane Library ◽  
The Impact

Background: The aims of this review are to analyze the current literature regarding the characteristics and pathophysiological mechanisms of itch in chronic wounds, to assess the impact on quality of life and delayed-healing, to focus on the best strategies of prevention and treatment, to highlight the importance of on-going research in order to fully understand the pathophysiology, and to improve the management of target therapies. Methods: A systematic literature review was performed using MEDLINE, PubMed, Embase, Scopus, ScienceDirect, and the Cochrane Library. We included a total of 11 articles written in English with relevant information on the pathophysiology of itch in chronic wounds and on management strategies. Results: Itch in chronic wounds was found to be correlated with xerosis, larger wound areas, necrotic tissue and amount of exudate, peripheral tissue edema, sclerosis, granulation tissue, contact dermatitis, and bacterial burden, as well as with lower quality of life. Conclusions: Although there are several aspecific pharmacological and non-pharmacological approaches, there appears to be no validated prevention or management strategy for itch in chronic wounds. Further studies are needed to clarify the association and pathophysiology of itch in chronic wounds, to evaluate the safety and efficacy of topical treatments on perilesional skin to reduce itch, to characterize multidimensional sensations of itch in chronic wounds, to identify specific cytokine and chemokine expressions that are correlated to a tailored-based approach, and to develop practical guidelines.

A Systematic Review: Dexmedetomidine Versus Placebo to Decrease the Incidence of Emergence Delirium/Emergence Agitation (ED/EA) in Pediatric Patients

2008 ◽  
Vol 1 (2) ◽  
pp. 89-94
Author(s):  
William M. Enlow ◽  
Laura L. Ardizzone
Keyword(s):  
Systematic Review ◽  
Hospital Costs ◽  
Cost Benefit ◽  
Cochrane Library ◽  
Primary Study ◽  
Emergence Agitation ◽  
Emergence Delirium ◽  
Comprehensive Search ◽  
Randomized Control ◽  
The Cochrane Library

Background: Emergence delirium/emergence agitation (ED/EA) has a reported incidence of up to 73% after general anesthesia (GA) in children. The implications of ED/EA are broad and include patient complications, increased nursing care intensity, and increased hospital costs. Objective: The objective of this systematic review is to appraise available randomized control trials (RCTs) comparing intravenous dexmedetomidine to placebo in decreasing the incidence of ED/EA among children after GA. Method: We conducted a comprehensive search of the literature using Medline from 1950 through September 2007 and CINHAL from 1982 through September 2007, as well as PubMed and The Cochrane Library. Four RCTs were included in the review and were appraised for methodological quality by each author. Results: Evaluation of the primary study outcomes showed an overall decreased incidence of ED/EA in those groups that received dexmedetomidine versus placebo. Conclusion: Though these RCTs demonstrate statistically significant reduction of ED/EA after GA among children who receive dexmedetomidine, the clinical significance of this pharmacologic intervention is not clear. Further research is necessary to determine cost–benefit of dexmedetomidine to prevent ED/EA in children after GA and the effect of dexmedetomidine on ED/EA compared to other agents.

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