Ultrasonido para la valoración del contenido gástrico: revisión sistemática de la literatura

Pneumonic aspiration of gastric contents is an important complication of anesthetic practice. : To determine the applicability of ultrasound for the assessment of the qualitative and quantitative characteristics of gastric contents. : A systematic review was carried out, based on a structured search of the literature published in the databases: Pubmed, EMBASE, SciELO, Cochrane Library, OVID and Google Scholar, from the foundation of these until December 2018 Boolean connectors were used to locate information from the terms: anesthesiology, ultrasonography, gastrointestinal Contents. The quality of the information was assessed using different tools according to each type of study. : We found 23 relevant studies for inclusion in the systematic review. The overall risk of bias was low. : Gastric ultrasound seems to correspond to a tool that is easy to perform at the patient’s bedside, but there is uncertainty about its applicability in uncontrolled settings, different from those applied in the studies described in this review. More research is needed with different populations and scenarios, in favor of establishing the behavior in these, of the variables that can be determined by ultrasound. The implications for clinical practice and long-term outcomes may have the measurements achieved by ultrasound are still uncertain.

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Long-Term Outcomes after Early Neonatal Hyperglycemia in VLBW Infants: A Systematic Review

Neonatology ◽

10.1159/000517951 ◽

2021 ◽

pp. 1-13

Author(s):

Megan E. Paulsen ◽

Sarah Jane Brown ◽

Katherine M. Satrom ◽

Johannah M. Scheurer ◽

Sara E. Ramel ◽

...

Keyword(s):

Systematic Review ◽

Preterm Infants ◽

Metabolic Health ◽

Cochrane Library ◽

Long Term Outcomes ◽

Neurodevelopmental Outcomes ◽

Vlbw Infants ◽

Quality Of Evidence

Introduction: Long-term effects of early hyperglycemia in VLBW infants are poorly characterized. The objective of this study was to systematically review the effect of early hyperglycemia on growth, metabolic health, and neurodevelopment after neonatal intensive care unit discharge in VLBW infants. Methods: The systematic review was conducted in accordance with the PRISMA guidelines. A study protocol was registered in PROSPERO (CRD42019123335). Data sources included Ovid MEDLINE, Embase, Cochrane Library, CINAHL, and Scopus. Selected studies included infants with a blood glucose concentration >150 mg/dL (8.3 mmol/L) during the first 28 days of life, a gestational age (GA) <32 weeks, and/or a birth weight <1,500 g and longitudinal data on growth, metabolic health, or neurodevelopment outcomes. The GRADE system was used to assess quality of evidence. Results: Eight studies (n = 987 infants) reported long-term outcomes from 4-month corrected GA to 7 years old. Most studies compared long-term outcomes of preterm infants with and without hyperglycemia. Two studies addressed outcomes related to interventions following early hyperglycemia. Some studies found differences in growth, metabolic health, and neurodevelopment outcomes between VLBW preterm infants with hyperglycemia and without hyperglycemia, while other studies found no differences between groups. The overall graded quality of evidence was low. Conclusions: Well-designed randomized controlled and prospective studies are necessary to determine the effect of early hyperglycemia and its treatment on later metabolic and neurodevelopmental outcomes in VLBW infants. Authors propose a potential study design for standardizing the assessment of long-term metabolic and neurodevelopmental outcomes following early hyperglycemia in preterm infants.

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Efficacy of antiepileptic drugs in neonatal seizures: a systematic review protocol

BMJ Paediatrics Open ◽

10.1136/bmjpo-2020-000683 ◽

2020 ◽

Vol 4 (1) ◽

pp. e000683

Author(s):

Yang He ◽

Jun Tang ◽

Meng Zhang ◽

Tao Xiong ◽

Shalini Ojha ◽

...

Keyword(s):

Systematic Review ◽

Antiepileptic Drugs ◽

Neurodevelopmental Outcome ◽

Case Series ◽

Primary Data ◽

Cochrane Library ◽

Neonatal Seizures ◽

Case Control Studies ◽

Long Term Outcomes

IntroductionSeizures are one of the most common neurological disorders of neonates, which is also an emergency in the neonatal intensive care unit. For neonates, the recommended first-line antiepileptic drugs (AEDs) include phenobarbitone, which may be effective in only 50% of seizures. Some new AEDs, such as levetiracetam, have been shown to be effective in adults and older children. However, their efficacy for neonatal seizures remains uncertain. The aim of this investigation is to conduct a systematic review to evaluate the efficacy of all AEDs in neonates. Additionally, the long-term outcomes following neonatal seizures, in relation to the development of cerebral palsy and epilepsy, will be studied.MethodWe will perform a systematic review including randomised controlled studies (RCTs), cohort studies, case-controlled studies and case series studies which evaluated the efficacy of AEDs and short-term and long-term outcomes in neonatal seizures. PubMed, Embase, Web of Science, Cochrane Library and Clinical trial.gov will be searched. There will be no language restriction. Risk bias in RCTs will be evaluated by the Cochrane risk-of-bias tool, while cohort and case-control studies will be evaluated by the Newcastle-Ottawa Scale. A network meta-analysis will be performed by the Bayesian model using WinBUGS V.1.4.3 and R software if there is a high degree of homogeneity among studies. Otherwise, we will perform a narrative review without pooling. Subgroup analyses will be performed in different AEDs and dosage groups.OutcomeThe primary outcomes will be seizure cessation confirmed by electroencephalogram and long-term neurodevelopmental outcome. Secondary outcomes will be neonatal mortality during hospitalisation and suspected drug toxicity.Ethics and disseminationFormal ethical approval is not required as no primary data are collected. This systematic review will be disseminated through a peer-reviewed publication.

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Evaluation of earlier versus later dietary management in long-chain 3-hydroxyacyl-CoA dehydrogenase or mitochondrial trifunctional protein deficiency: a systematic review

Orphanet Journal of Rare Diseases ◽

10.1186/s13023-019-1226-y ◽

2019 ◽

Vol 14 (1) ◽

Cited By ~ 4

Author(s):

Hannah Fraser ◽

Julia Geppert ◽

Rebecca Johnson ◽

Samantha Johnson ◽

Martin Connock ◽

...

Keyword(s):

Systematic Review ◽

Cochrane Library ◽

Dietary Management ◽

Long Term Outcomes ◽

Significant Difference ◽

Hydroxyacyl Coa Dehydrogenase ◽

Mitochondrial Trifunctional Protein ◽

Long Chain

Abstract Background Mitochondrial trifunctional protein (MTP) and long-chain 3-hydroxyacyl-CoA dehydrogenase (LCHAD) deficiencies are rare fatty acid β-oxidation disorders. Without dietary management the conditions are life-threatening. We conducted a systematic review to investigate whether pre-symptomatic dietary management following newborn screening provides better outcomes than treatment following symptomatic detection. Methods We searched Web of Science, Medline, Pre-Medline, Embase and the Cochrane Library up to 23rd April 2018. Two reviewers independently screened titles, abstracts and full texts for eligibility and quality appraised the studies. Data extraction was performed by one reviewer and checked by another. Results We included 13 articles out of 7483 unique records. The 13 articles reported on 11 patient groups, including 174 people with LCHAD deficiency, 18 people with MTP deficiency and 12 people with undifferentiated LCHAD/MTP deficiency. Study quality was moderate to weak in all studies. Included studies suggested fewer heart and liver problems in screen-detected patients, but inconsistent results for mortality. Follow up analyses compared long-term outcomes of (1) pre-symptomatically versus symptomatically treated patients, (2) screened versus unscreened patients, and (3) asymptomatic screen-detected, symptomatic screen-detected, and clinically diagnosed patients in each study. For follow up analyses 1 and 2, we found few statistically significant differences in the long-term outcomes. For follow up analysis 3 we found a significant difference for only one comparison, in the incidence of cardiomyopathy between the three groups. Conclusions There is some evidence that dietary management following screen-detection might be associated with a lower incidence of some LCHAD and MTP deficiency-related complications. However, the evidence base is limited by small study sizes, quality issues and risk of confounding. An internationally collaborative research effort is needed to fully examine the risks and the benefits to pre-emptive dietary management with particular attention paid to disease severity and treatment group.

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Systematic Review and Meta-Analysis of Liver Resection for Colorectal Metastases in Elderly Patients

Digestive Surgery ◽

10.1159/000487274 ◽

2018 ◽

Vol 36 (2) ◽

pp. 111-123 ◽

Cited By ~ 8

Author(s):

Tim van Tuil ◽

Ali A. Dhaif ◽

Wouter W. te Riele ◽

Bert van Ramshorst ◽

Hjalmar C. van Santvoort

Keyword(s):

Systematic Review ◽

Liver Resection ◽

Elderly Patients ◽

Postoperative Morbidity ◽

Meta Analysis ◽

Colorectal Metastases ◽

Cochrane Library ◽

Long Term Outcomes ◽

Short And Long Term

Background: This systematic review and meta-analysis evaluated the short- and long-term outcomes of liver resection for colorectal liver metastases (CRLM) in elderly patients. Methods: A PubMed, EMBASE, and Cochrane Library search was performed from January 1995 to April 2017, for studies comparing both short- and long-term outcomes in younger and elderly patients undergoing liver resection for CRLM. Results: Eleven studies comparing patients aged <70 years with patients aged >70 years and 4 studies comparing patients aged <75 years with patients aged >75 years were included. Postoperative morbidity was similar in patients aged >70 years (27 vs. 30%; p = 0.35) but higher in patients aged >75 years (21 vs. 32%; p = 0.001). Postoperative mortality was higher in both patients aged >70 years (2 vs. 4%; p = 0.01) and in patients aged >75 years (1 vs. 6%; p = 0.02). Mean 5-year overall survival was lower in patients aged >70 years (40 vs. 32%; p < 0.001) but equal in patients aged >75 years (42 vs. 32%; p = 0.06). Conclusion: Although postoperative morbidity and mortality were increased with higher age, liver resection for CRLM seems justified in selected elderly patients.

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Robotic Versus Laparoscopic Gastrectomy for Gastric Cancer: A Systematic Review and Meta-Analysis

10.21203/rs.3.rs-84003/v1 ◽

2020 ◽

Author(s):

Jianglei Ma ◽

Xiaoyao Li ◽

Shifu Zhao ◽

Ruifu Zhang ◽

Dejun Yang

Keyword(s):

Gastric Cancer ◽

Systematic Review ◽

Robotic Surgery ◽

Laparoscopic Gastrectomy ◽

Resection Margin ◽

Meta Analysis ◽

Cochrane Library ◽

Long Term Outcomes ◽

Significant Difference

Abstract Background To date, robotic surgery has been widely used worldwide. We conducted a systematic review and meta-analysis to evaluate short- and long-term outcomes of robotic gastrectomy (RG) in gastric cancer patients to determine whether RG can replace laparoscopic gastrectomy (LG).Methods Pubmed, Cochrane Library, WanFang, China National Knowledge Infrastructure (CNKI) and VIP databases were comprehensively searched for studies published before May 2020 that compared RG with LG. Next, two independent reviewers conducted literature screening and data extraction. The quality of the literature was assessed using the Newcastle-Ottawa Scale (NOS),and the data analyzed using the Review Manager 5.3 software. Random effects or fixed effects models were applied according to heterogeneity.Results A total of 19 studies including 7275 patients were included in the meta-analyses, of which 4598 patients were in the LG group and 2677 in the RG group. Compared with LG,RG was associated with longer operative time (WMD=−32.96 min; 95% CI:-42.08~-23.84, P<0.00001),less blood loss (WMD=28.66 ml; 95% CI: 18.59~38.73, P<0.00001),and shorter time to first flatus (WMD=0.16days; 95%CI:0.06~0.27, P=0.003).There was no significant difference between RG and LG in terms of the hospital stay (WMD=0.23days, 95 % CI:-0.53~0.98, P=0.56),overall postoperative complication (OR=1.07, 95 % CI:0.91~1.25, P=0.43),mortality (OR=0.67, 95% CI=0.24~1.90, P=0.45),the number of harvested lymph nodes (WMD=-0.96, 95% CI:-2.12~0.20, P=0.10),proximal resection margin (WMD=-0.10 cm,95% CI:-0.29~0.09, P=0.30),and distal resection margin (WMD=0.15cm,95% CI:-0.21~0.52, P=0.41).No significant differences were found between the two treatments in overall survival(OS) (HR=0.95, 95% CI:0.76~1.18; P=0.64), recurrence-free survival(RFS) (HR=0.91, 95% CI:0.69~1.21;P=0.53), and recurrence rate (OR=0.90, 95% CI:0.67~1.21; P=0.50). Conclusions The results of this study suggested that RG is as acceptable as LG in terms of short-term and long-term outcomes. RG can be performed as effectively and safely as LG. Moreover, more randomized controlled trials comparing the two techniques with rigorous study designs are still essential to evaluate the value of the robotic surgery for gastric cancer.

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Children and adolescents with ADHD followed up to adulthood: a systematic review of long-term outcomes

Acta Neuropsychiatrica ◽

10.1017/neu.2021.23 ◽

2021 ◽

pp. 1-42

Author(s):

Rosaria Di Lorenzo ◽

Jessica Balducci ◽

Chiara Poppi ◽

Elisa Arcolin ◽

Anna Cutino ◽

...

Keyword(s):

Quality Of Life ◽

Systematic Review ◽

Quantitative Analysis ◽

Prospective Studies ◽

Depressive Disorders ◽

Neurodevelopmental Disorder ◽

Alcohol Use Disorders ◽

Long Term Outcomes

Abstract Objective: To highlight the clinical and social outcomes among adults who suffered from ADHD in their childhood/adolescence. Method: PubMed, PsycINFO, Scopus databases were searched for prospective studies published during the last 5 years addressing patients with ADHD in childhood/adolescence followed up to adulthood. We also included studies published before 2015 reported in other reviews with similar outcomes. Results: 1485 studies were identified but only 39 were included for qualitative and 27 for quantitative analysis. Overall, we found that ADHD persisted into adulthood with a mean rate of 43% and was mainly associated with both substance/alcohol use disorders and antisocial behavior and, less frequently, with anxiety and depressive disorders. The prevalence of persistent ADHD in adulthood reported by studies published after 2011 (55%) was higher than that reported by studies published previously from 1985 to 2011 (34%), suggesting a greater focus on ADHD. Conclusion: Our results highlight that ADHD can be considered not only a neurodevelopmental disorder but a persistent and complex condition, with detrimental consequences for quality of life in adulthood.

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Oncologic and long-term outcomes of enhanced recovery after surgery in cancer surgeries — a systematic review

World Journal of Surgical Oncology ◽

10.1186/s12957-021-02306-2 ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Qianyun Pang ◽

Liping Duan ◽

Yan Jiang ◽

Hongliang Liu

Keyword(s):

Systematic Review ◽

Overall Survival ◽

Enhanced Recovery ◽

Enhanced Recovery After Surgery ◽

Current Evidence ◽

Cochrane Library ◽

Long Term Outcomes ◽

High Adherence ◽

Eras Protocol

Abstract Background Clinical evidence has proved that enhanced recovery after surgery (ERAS) can improve short-term clinical outcomes after various types of surgeries, but the long-term benefits have not yet been examined, especially with respect to cancer surgeries. Therefore, a systematic review of the current evidence was conducted. Methods The Pubmed, Cochrane Library, Embase, and Web of Science databases were searched using the following key words as search terms: “ERAS” or “enhanced recovery” or “fast track”, “oncologic outcome”, “recurrence”, “metastasis”, “long-term outcomes”, “survival”, and “cancer surgery”. The articles were screened using the inclusion and exclusion criteria, and the data from the included studies were extracted and analyzed. Results A total of twenty-six articles were included in this review. Eighteen articles compared ERAS and conventional care, of which, 12 studies reported long-term overall survival (OS), and only 4 found the improvement by ERAS. Four studies reported disease-free survival (DFS), and only 1 found the improvement by ERAS. Five studies reported the outcomes of return to intended oncologic treatment after surgery (RIOT), and 4 found improvements in the ERAS group. Seven studies compared high adherence to ERAS with low adherence, of which, 6 reported the long-term OS, and 3 showed improvements by high adherence. One study reported high adherence could reduce the interval from surgery to RIOT. Four studies reported the effect of altering one single item within the ERAS protocol, but the results of 2 studies were controversial regarding the long-term OS between laparoscopic and open surgery, and 1 study showed improvements in OS with restrictive fluid therapy. Conclusions The use of ERAS in cancer surgeries can improve the on-time initiation and completion of adjuvant chemotherapy after surgery, and the high adherence to ERAS can lead to better outcomes than low adherence. Based on the current evidence, it is difficult to determine whether the ERAS protocol is associated with long-term overall survival or cancer-specific survival.

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Corticosteroids for Treating Sepsis in Adult Patients: A Systematic Review and Meta-Analysis

Frontiers in Immunology ◽

10.3389/fimmu.2021.709155 ◽

2021 ◽

Vol 12 ◽

Author(s):

Huoyan Liang ◽

Heng Song ◽

Ruiqing Zhai ◽

Gaofei Song ◽

Hongyi Li ◽

...

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Length Of Hospital Stay ◽

Evaluation Methodology ◽

Cochrane Library ◽

Assessment Development ◽

Short Time ◽

Long Term Mortality

ObjectiveCorticosteroids are a common option used in sepsis treatment. However, the efficacy and potential risk of corticosteroids in septic patients have not been well assessed. This review was performed to assess the efficacy and safety of corticosteroids in patients with sepsis.MethodsPubMed, Embase, and Cochrane library databases were searched from inception to March 2021. Randomized controlled trials (RCTs) that evaluated the effect of corticosteroids on patients with sepsis were included. The quality of outcomes in the included articles was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation methodology. The data were pooled by using risk ratio (RR) and mean difference (MD). The random-effects model was used to evaluate the pooled MD or RR and 95% confidence intervals (CIs).ResultsFifty RCTs that included 12,304 patients with sepsis were identified. Corticosteroids were not associated with the mortality in 28-day (RR, 0.94; 95% CI, 0.87–1.02; evidence rank, moderate) and long-term mortality (>60 days) (RR, 0.96; 95% CI, 0.88–1.05) in patients with sepsis (evidence rank, low). However, corticosteroids may exert a significant effect on the mortality in the intensive care unit (ICU) (RR, 0.9; 95% CI, 0.83–0.97), in-hospital (RR, 0.9; 95% CI, 0.82–0.99; evidence rank, moderate) in patients with sepsis or septic shock (evidence rank, low). Furthermore, corticosteroids probably achieved a tiny reduction in the length of hospital stay and ICU. Corticosteroids were associated with a higher risk of hypernatremia and hyperglycemia; furthermore, they appear to have no significant effect on superinfection and gastroduodenal bleeding.ConclusionsCorticosteroids had no significant effect on the 28-day and long-term mortality; however, they decreased the ICU and hospital mortality. The findings suggest that the clinical corticosteroids may be an effective therapy for patients with sepsis during the short time.Systematic Review Registrationhttps://inplasy.com/wp-content/uploads/2021/05/INPLASY-Protocol-1074-4.pdf

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Long-term outcomes and quality of life of patients with Hirschsprung disease: a systematic review and meta-analysis

BMC Gastroenterology ◽

10.1186/s12876-020-01208-z ◽

2020 ◽

Vol 20 (1) ◽

Cited By ~ 1

Author(s):

Ying Dai ◽

Yongfang Deng ◽

Yan Lin ◽

Runxian Ouyang ◽

Le Li

Keyword(s):

Quality Of Life ◽

Systematic Review ◽

Meta Analysis ◽

Hirschsprung Disease ◽

Long Term Outcomes

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Omalizumab and long-term quality of life outcomes in patients with moderate-to-severe allergic asthma: a systematic review

Therapeutic Advances in Respiratory Disease ◽

10.1177/1753466619841350 ◽

2019 ◽

Vol 13 ◽

pp. 175346661984135 ◽

Cited By ~ 4

Author(s):

Giorgio Lorenzo Colombo ◽

Sergio Di Matteo ◽

Chiara Martinotti ◽

Martina Oselin ◽

Maria Chiara Valentino ◽

...

Keyword(s):

Quality Of Life ◽

Systematic Review ◽

Allergic Asthma ◽

Subjective Experience ◽

Cochrane Library ◽

Study Results ◽

Patient Reported ◽

Severe Allergic Asthma

Background: Asthma is a highly prevalent chronic inflammatory airways disease, with a considerable impact on quality of life (QoL). To express the effects of asthma on patients’ subjective experience, patient-reported outcomes (PROs) represent an important instrument. The asthma QoL questionnaire (AQLQ) is one of the main PROs among these. Materials and methods: To identify long-term asthma-related QoL outcomes associated with omalizumab therapy in patients with moderate-to-severe asthma, we developed a systematic review according to the PRISMA guidelines. Published real-world effectiveness studies of adults or adolescents (12 years or older) with moderate-to-severe allergic asthma treated with omalizumab for at least 48 weeks were reviewed. Sources used were Medline ( PubMed), the Cochrane Library and Google Scholar up to February 2018. In addition, a cross-referencing search was conducted to complete the revision. Results: A total of 255 potential papers were identified in the first search through the database. After full-text viewing, eight articles were finally included in the review. We summarized the results according to the study design, patient baseline characteristics and effectiveness outcomes assessed by AQLQ score results: variation from baseline to the end of study. Results confirmed the long-term benefits of omalizumab as an add-on therapy in patients with uncontrolled moderate-to-severe allergic asthma. Since there is a lot of evidence on omalizumab effectiveness, we aimed to focus on how a therapy can change patient’s QoL in a long time period. Data showed long-term effects of omalizumab treatment on subjective (PROs) and objective (lung function, corticosteroid use, hospitalizations, asthma exacerbation) effectiveness measures. Conclusion: Studies included in our review were observational trials that, due to their design, present a potential risk of selection bias in the patients included. Beyond this limit, the evaluation of QoL using the AQLQ showed a clear increase over time, following both 48 weeks and 9 years of observation, where QoL improvements still were significant over baseline values.

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