scholarly journals Lung ultrasound in the diagnosis and management of acute viral bronchiolitis; a systematic review

2021 ◽  
Author(s):  
Christos Kogias ◽  
Spyridon Prountzos ◽  
Efthymia Alexopoulou ◽  
Konstantinos Douros
Keyword(s):  
Systematic Review ◽  
Chest Radiography ◽  
Viral Infections ◽  
Lung Ultrasound ◽  
Length Of Hospital Stay ◽  
Diagnostic Algorithm ◽  
Main Role ◽  
Eligibility Criteria ◽  
Diagnosis And Management ◽  
Acute Viral Bronchiolitis

Objective: Acute viral bronchiolitis (AVB) is one of the most common viral infections and the most common lower respiratory tract infection in the first year of life. Current guidelines recommend that medical history and physical examination have the main role in the diagnosis of AVB. Lung ultrasound (LUS) has not been included in the diagnostic algorithm so far. The aim of this systematic review is to collect all available studies concerning the role of LUS in the diagnosis and management of AVB. Methods: PubMed - MEDLINE, Scopus and ScienceDirect databases were searched for trials reporting on LUS examination in the diagnosis and management of AVB in paediatric patients. Results: A total of seventeen studies matching our eligibility criteria were analyzed for the purposes of this review and their results were categorized into six major fields each one of them answering to a question. There are several LUS scores that evaluate the severity of sonographic findings in children with AVB. The findings on LUS and chest radiography are comparable and LUS has a significant role in further management of AVB in the Paediatric Emergency Department. LUS score is correlated to the clinical course of AVB and it can predict both the duration of hospitalization and the need for respiratory support. Conclusion: Current literature supports that LUS could have comparable efficiency with chest radiography concerning the diagnosis of AVB and it could predict the length of hospital stay and the need of oxygen supply.

Comparison of the use of lung ultrasound and chest radiography in the diagnosis of rib fractures: a systematic review

2018 ◽  
Vol 36 (3) ◽  
pp. 185-190 ◽  
Author(s):  
Ceri Battle ◽  
Simon Hayward ◽  
Sabine Eggert ◽  
Phillip Adrian Evans
Keyword(s):  
Systematic Review ◽  
Quality Assessment ◽  
Chest Wall ◽  
Chest Radiograph ◽  
Chest Radiography ◽  
Lung Ultrasound ◽  
Grey Literature ◽  
Rib Fractures ◽  
Chest Wall Trauma ◽  
Study Results

IntroductionIt is well-recognised that the detection of rib fractures is unreliable using chest radiograph. The aim of this systematic review was to investigate whether the use of lung ultrasound is superior in accuracy to chest radiography, in the diagnosis of rib fractures following blunt chest wall trauma.MethodsThe search filter was used for international online electronic databases including MEDLINE, EMBASE, Cochrane and ScienceDirect, with no imposed time or language limitations. Grey literature was searched. Two review authors completed study selection, data extraction and data synthesis/analysis process. Quality assessment using the Quality Assessment of Diagnostic Accuracy Studies Tool (QUADAS-2) was completed.Results13 studies were included. Overall, study results demonstrated that the use of lung ultrasound in the diagnosis of rib fractures in blunt chest wall trauma patients appears superior compared with chest radiograph. All studies were small, single centre and considered to be at risk of bias on quality assessment. Meta-analysis was not possible due to high levels of heterogeneity, lack of appropriate reference standard and poor study quality.DiscussionThe results demonstrate that lung ultrasound may be superior to chest radiography, but the low quality of the studies means that no definitive statement can be made.

Lung Ultrasound versus Chest X-Ray for the Detection of Fluid Overload in Critically Ill Children: A Systematic Review

2021 ◽  
Author(s):  
Emily Schapka ◽  
Jerica Gee ◽  
John W. Cyrus ◽  
Gregory Goldstein ◽  
Kara Greenfield ◽  
...  
Keyword(s):  
Systematic Review ◽  
Critically Ill ◽  
Lung Ultrasound ◽  
Fluid Overload ◽  
Volume Overload ◽  
High Sensitivity ◽  
Critically Ill Children ◽  
Eligibility Criteria ◽  
X Ray ◽  
Chest X Ray

AbstractFluid overload is a common complication of critical illness, associated with increased morbidity and mortality. Pulmonary fluid status is difficult to evaluate clinically and many clinicians utilize chest X-ray (CXR) to identify fluid overload. Adult data have shown lung ultrasound (LUS) to be a more sensitive modality. Our objective was to determine the performance of LUS for detecting fluid overload, with comparison to CXR, in critically ill children. We conducted a systematic review using multiple electronic databases and included studies from inception to November 15, 2020. The sensitivity and specificity of each test were evaluated. Out of 1,209 studies screened, 4 met eligibility criteria. Overall, CXR is reported to have low sensitivity (44–58%) and moderate specificity (52–94%) to detect fluid overload, while LUS is reported to have high sensitivity (90–100%) and specificity (94–100%). Overall, the quality of evidence was moderate, and the gold standard was different in each study. Our systematic review suggests LUS is more sensitive and specific than CXR to identify pulmonary fluid overload in critically ill children. Considering the clinical burden of fluid overload and the relative ease of obtaining LUS, further evaluation of LUS to diagnose volume overload is warranted.

Anatomy of Ankle Syndesmotic Ligaments: A Systematic Review of Cadaveric Studies

2020 ◽  
Vol 13 (4) ◽  
pp. 341-350
Author(s):  
Akilesh Anand Prakash
Keyword(s):  
Systematic Review ◽  
Clinical Practice ◽  
Surgical Management ◽  
Systematic Reviews ◽  
Current Understanding ◽  
Study Quality ◽  
Quality Appraisal ◽  
Eligibility Criteria ◽  
Diagnosis And Management ◽  
Meta Analyses

Diagnosis and management of isolated syndesmotic injuries are controversial and highly debated. Hence, the aim of this study is to explore and gain the current understanding pertaining to detailed anatomy of syndesmotic ligaments through a systematic review of published cadaveric studies. A systematic review was conducted online for literature published in English using PubMed and Google Scholar, as per PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, up to April 30, 2019. Predefined eligibility criteria were applied, and the data thus compiled was analyzed. Study quality was assessed based on Quality Appraisal for Cadaveric Studies (QUACS) scale. A total of 12 studies reporting 365 ankles were included in this review. Considerable inconsistency in the naming and description of syndesmotic ligaments was observed, with only 2 studies reporting the vasculature of the ligaments. Hence further investigation of the anatomy of the syndesmotic ligaments is recommended so as to better inform clinical practice, as awareness of anatomy is critical for assessment, healing, and successful surgical management. Levels of Evidence: Level III: Systematic review of anatomical dissections

scholarly journals Latissimus dorsi detrusor myoplasty for bladder acontractility: a systematic review

2021 ◽  
Vol 48 (5) ◽  
pp. 528-533
Author(s):  
Antonio Jorge Forte ◽  
Daniel Boczar ◽  
Maria Tereza Huayllani ◽  
Steven Moran ◽  
Oluwaferanmi O. Okanlami ◽  
...  
Keyword(s):  
Systematic Review ◽  
Latissimus Dorsi ◽  
Therapeutic Option ◽  
Case Series ◽  
Length Of Hospital Stay ◽  
The United States ◽  
Clean Intermittent Catheterization ◽  
Cochrane Central Register ◽  
Eligibility Criteria ◽  
Cord Injury

Bladder acontractility affects several thousand patients in the United States, but the available therapies are limited. Latissimus dorsi detrusor myoplasty (LDDM) is a therapeutic option that allows patients with bladder acontractility to void voluntarily. Our goal was to conduct a systematic review of the literature to determine whether LDDM is a better option than clean intermittent catheterization (CIC) (standard treatment) in patients with bladder acontractility. On January 17, 2020, we conducted a systematic review of the PubMed/MEDLINE, Cochrane Clinical Answers, Cochrane Central Register of Controlled Trials, Embase, and ClinicalTrials.gov databases, without time frame limitations, to identify articles on the use of LDDM for bladder acontractility. Of 75 potential articles, 4 fulfilled the eligibility criteria. The use of LDDM to treat patients with bladder acontractility was reported in four case series by the same group in Europe. Fifty-eight patients were included, and no comparison groups were included. The most common cause of bladder acontractility was spinal cord injury (n=36). The mean (±standard deviation) operative time was 536 (±22) minutes, postoperative length of hospital stay ranged from 10 to 13 days, and follow-up ranged from 9 to 68 months. Most patients had complete response, were able to void voluntarily, and had post-void residual volume less than 100 mL. Although promising outcomes have been obtained, evidence is still weak regarding whether LDDM is better than CIC to avoid impairment of the urinary tract among patients with bladder acontractility. Further prospective studies with control groups are necessary.

scholarly journals The effect of pre-anaesthetic assessment clinic: a systematic review of randomised and non-randomised prospective controlled studies

2021 ◽  
Author(s):  
Eirunn Kristoffersen ◽  
Anne Opsal ◽  
Tor Tveit ◽  
Rigmor Berg ◽  
Mariann Fossum
Keyword(s):  
Systematic Review ◽  
Hospital Stay ◽  
Quantitative Methods ◽  
Data Extraction ◽  
Experimental Studies ◽  
Length Of Hospital Stay ◽  
Risk Of Bias ◽  
Eligibility Criteria ◽  
Quasi Experimental ◽  
Anaesthetic Assessment

ABSTRACT Objectives: The aim of this systematic review was to examine the effectiveness of pre-anaesthetic assessment clinics (PACs) implemented to improve quality and patient safety in perioperative care. Design: Systematic review. Data sources: The electronic databases CINAHL Plus with Full Text (EBSCOhost), Medline, and Embase (OvidSP) were systematically searched from 1st April, 1996 to 4th February, 2021. Eligibility criteria: The main inclusion criterion was that the study, using empirical quantitative methods, addressed the effectiveness of PACs. Data extraction and synthesis: Titles, abstracts, and full texts were screened in duplicate by two authors. Risk of bias assessment, using the Joanna Briggs Institute critical appraisal checklist for quasi-experimental studies, and data extraction were performed by one author and checked by the other author. Results were synthesised narratively owing to the heterogeneity of the included studies. Results: Seven prospective controlled studies were conducted. Most studies had a high risk of bias. Three studies reported a significant reduction in the length of the hospital stay, and two studies reported a significant reduction in cancellation of surgery for medical reasons when patients were seen in the PAC. In addition, the included studies presented mixed results regarding anxiety in patients. Conclusion: This systematic review demonstrated a reduction in the length of hospital stay and cancellation of surgery when the patients had been assessed in the PAC. There is a need for high-quality prospective studies to gain a deeper understanding of the effectiveness of PACs. PROSPERO registration number: CRD42019137724

scholarly journals Magnitude and modifiers of the weekend effect in hospital admissions: a systematic review and meta-analysis

BMJ Open ◽  
2019 ◽  
Vol 9 (6) ◽  
pp. e025764 ◽  
Author(s):  
Yen-Fu Chen ◽  
Xavier Armoiry ◽  
Caroline Higenbottam ◽  
Nicholas Cowley ◽  
Ranjna Basra ◽  
...  
Keyword(s):  
Systematic Review ◽  
Patient Satisfaction ◽  
Adverse Events ◽  
Hospital Admissions ◽  
Length Of Hospital Stay ◽  
Care Quality ◽  
Weekend Effect ◽  
Eligibility Criteria ◽  
Medline Search ◽  
Mortality Effect

ObjectiveTo examine the magnitude of the weekend effect, defined as differences in patient outcomes between weekend and weekday hospital admissions, and factors influencing it.DesignA systematic review incorporating Bayesian meta-analyses and meta-regression.Data sourcesWe searched seven databases including MEDLINE and EMBASE from January 2000 to April 2015, and updated the MEDLINE search up to November 2017. Eligibility criteria: primary research studies published in peer-reviewed journals of unselected admissions (not focusing on specific conditions) investigating the weekend effect on mortality, adverse events, length of hospital stay (LoS) or patient satisfaction.ResultsFor the systematic review, we included 68 studies (70 articles) covering over 640 million admissions. Of these, two-thirds were conducted in the UK (n=24) or USA (n=22). The pooled odds ratio (OR) for weekend mortality effect across admission types was 1.16 (95% credible interval 1.10 to 1.23). The weekend effect appeared greater for elective (1.70, 1.08 to 2.52) than emergency (1.11, 1.06 to 1.16) or maternity (1.06, 0.89 to 1.29) admissions. Further examination of the literature shows that these estimates are influenced by methodological, clinical and service factors: at weekends, fewer patients are admitted to hospital, those who are admitted are more severely ill and there are differences in care pathways before and after admission. Evidence regarding the weekend effect on adverse events and LoS is weak and inconsistent, and that on patient satisfaction is sparse. The overall quality of evidence for inferring weekend/weekday difference in hospital care quality from the observed weekend effect was rated as ‘very low’ based on the Grading of Recommendations, Assessment, Development and Evaluations framework.ConclusionsThe weekend effect is unlikely to have a single cause, or to be a reliable indicator of care quality at weekends. Further work should focus on underlying mechanisms and examine care processes in both hospital and community.Prospero registration numberCRD42016036487

scholarly journals P031: Naltrexone initiation for alcohol use disorder in the emergency department: A systematic review

CJEM ◽  
2019 ◽  
Vol 21 (S1) ◽  
pp. S74
Author(s):  
E. Deschner ◽  
C. Walsh ◽  
S. Spithoff ◽  
S. McLeod ◽  
B. Borgundvaag ◽  
...  
Keyword(s):  
Systematic Review ◽  
Emergency Department ◽  
Alcohol Use ◽  
Full Text ◽  
Alcohol Use Disorder ◽  
Length Of Hospital Stay ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Eligibility Criteria

Introduction: Alcohol use disorder (AUD) is a chronic relapsing and highly comorbid disease. Patients suffering from AUD are frequently seen in the emergency department (ED) presenting intoxicated or in withdrawal. Brief interactions in the ED are often the only portal of entry to the healthcare system for many of these patients. Oral naltrexone and long acting injectable naltrexone are effective treatment options for AUD associated with decreased cravings, shorter length of hospital stay, and lower cost of healthcare utilization. This study's objective was to perform a systematic review of the literature evaluating initiation of naltrexone in the ED. Methods: Electronic searches of Medline, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews and CINAHL were conducted and reference lists were hand-searched. Randomized controlled trials (RCTs) comparing initiation of naltrexone in patients (≥18 years) to standard care in the ED were included. Two reviewers independently screened titles and abstracts, reviewed full text articles for inclusion, assessed quality of the studies, and extracted data. Results: The search strategy yielded 183 potentially relevant citations. After eliminating duplicate citations and studies that did not meet eligibility criteria, 10 articles were retrieved for full text review. There were no published RCTs that examined naltrexone initiation in the ED. There is one ongoing study being conducted in New York, which aims to assess naltrexone initiation in the ED and measure health outcomes and quality of life of study participants, as well as potential healthcare cost savings. Conclusion: The lack of published research in this area demonstrates a significant gap in knowledge. It is clear that well-designed RCTs are needed to evaluate the effectiveness of initiating naltrexone for those with AUD at the ED visit.

Chasing the Anchor: A Systematic Review and Meta-analysis of Perceptual Anchoring Deficits in Developmental Dyslexia

2020 ◽  
Author(s):  
Kurt D Shulver ◽  
Nicholas A Badcock
Keyword(s):  
Systematic Review ◽  
Reading Ability ◽  
English Language ◽  
Prediction Interval ◽  
Meta Analysis ◽  
Visual Assessment ◽  
Individual Performance ◽  
Future Research ◽  
Significant Heterogeneity ◽  
Eligibility Criteria

We report the results of a systematic review and meta-analysis investigating the relationship between perceptual anchoring and dyslexia. Our goal was to assess the direction and degree of effect between perceptual anchoring and reading ability in typical and atypical (dyslexic) readers. We performed a literature search of experiments explicitly assessing perceptual anchoring and reading ability using PsycInfo (Ovid, 1860 to 2020), MEDLINE (Ovid, 1860 to 2019), EMBASE (Ovid, 1883 to 2019), and PubMed for all available years up to June (2020). Our eligibility criteria consisted of English-language articles and, at minimum, one experimental group identified as dyslexic - either by reading assessment at the time, or by previous diagnosis. We assessed for risk of bias using an adapted version of the Newcastle-Ottawa scale. Six studies were included in this review, but only five (n = 280 participants) were included in the meta-analysis (we were unable to access the necessary data for one study).The overall effect was negative, large and statistically significant; g = -0.87, 95% CI [-1.47, 0.27]: a negative effect size indicating less perceptual anchoring in dyslexic versus non-dyslexic groups. Visual assessment of funnel plot and Egger’s test suggest minimal bias but with significant heterogeneity; Q (4) = 9.70, PI (prediction interval) [-2.32, -0.58]. The primary limitation of the current review is the small number of included studies. We discuss methodological limitations, such as limited power, and how future research may redress these concerns. The variability of effect sizes appears consistent with the inherent variability within subtypes of dyslexia. This level of dispersion seems indicative of the how we define cut-off thresholds between typical reading and dyslexia populations, but also the methodological tools we use to investigate individual performance.

Covid-19 and Autoimmune Diseases: A Systematic Review of Reported Cases

2020 ◽  
Vol 16 ◽  
Author(s):  
Mariam Ahmed Saad ◽  
Mostafa Alfishawy ◽  
Mahmoud Nassar ◽  
Mahmoud Mohamed ◽  
Ignatius N Esene ◽  
...  
Keyword(s):  
Systematic Review ◽  
Autoimmune Disease ◽  
Kawasaki Disease ◽  
Autoimmune Diseases ◽  
English Language ◽  
Clinical Evidence ◽  
Eligibility Criteria ◽  
Thrombocytopenic Purpura ◽  
Pubmed Database ◽  
Viral Illness

Introduction: Over 4.9 million cases of Coronavirus disease 2019 (COVID-19) have been confirmed since the worldwide pandemic began. Since the emergence of COVID-19, a number of confirmed cases reported autoimmune manifestations. Herein, we reviewed the reported COVID-19 cases with associated autoimmune manifestations. Methods: We searched PubMed database using all available keyword for COVID-19. All related studies between January 1st, 2020 to May 22nd, 2020 were reviewed. Only studies published in English language were considered. Articles were screened based on titles and abstract. All reports of confirmed COVID-19 patients who have associated clinical evidence of autoimmune disease were selected. Results: Among 10006 articles, searches yielded, Thirty-two relevant articles for full-text assessment. Twenty studies meet the eligibility criteria. The twenty eligible articles reported 33 cases of confirmed COVID-19 diagnosis who developed an autoimmune disease after the onset of covid-19 symptoms. Ages of patients varied from a 6 months old infant to 89 years old female (Mean=53.9 years of 28 cases); five cases had no information regarding their age. The time between symptoms of viral illness and onset of autoimmune symptoms ranged from 2 days to 33 days (Mean of the 33 cases=9.8 days). Autoimmune diseases were one case of subacute thyroiditis (3%), two cases of Kawasaki Disease (6.1%), three cases of coagulopathy and antiphospholipid syndrome (9.1%), three cases of immune thrombocytopenic purpura (9.1%), eight cases of autoimmune hemolytic anemia (24.2%), and sixteen cases of Guillain–Barré syndrome (48.5%). Conclusions: COVID-19 has been implicated in the development in a range of autoimmune diseases which may shed a light on the association between autoimmune diseases and infections.

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