scholarly journals Therapeutics of xeroderma pigmentosum: A PRISMA-compliant systematic review

2021 ◽  
Vol 0 ◽  
pp. 1-14
Author(s):  
Fernando Antônio Gomes de Andrade ◽  
Claudio Eduardo de Oliveira Cavalcanti ◽  
Felipe Contoli Isoldi ◽  
Lydia Masako Ferreira
Keyword(s):  
Systematic Review ◽  
Xeroderma Pigmentosum ◽  
Meta Analysis ◽  
Scientific Evidence ◽  
Treatment Options ◽  
Skin Lesions ◽  
Medical Subject Headings ◽  
Level Of Evidence ◽  
Therapeutic Modalities ◽  
Surgical Treatments

Xeroderma pigmentosum is a rare hereditary autosomal recessive genodermatosis. At present, there are many treatment options for xeroderma pigmentosum, covering medical/procedural, surgical and combined modalities. However, the quality of these interventions has not been assessed. Our study aimed to perform a systematic review of the literature regarding the treatment of xeroderma pigmentosum. Multiple medical databases were accessed with the Medical Subject Headings terms; “xeroderma pigmentosum,” “therapeutics” and “surgical procedures, operative” from January 2000 to April 2019, including articles published in Portuguese, Spanish and English (PROSPERO-CRD42018114858). Two hundred and ninety-eight studies were found in the databases researched, of which, after applying the inclusion criteria, only 33 studies remained. The 33 complete articles were read by three of the authors, having been found: 16 reported medical/procedural and 17 reported surgical treatments. Only one clinical study presented a good level of evidence (EL: 2): a randomized clinical trial using a T4 endonuclease V (T4N5) liposome lotion which reduced the development of skin lesions in patients with xeroderma pigmentosum. Amongst surgical modalities, all studies presented low evidence level (EL: 4). Three illustrative cases are also presented, to emphasize the multiple number of times that surgical modalities may be required in these patients. The therapeutic modalities, both clinical and surgical, for xeroderma pigmentosum presented a low level of scientific evidence which did not allow meta-analysis. More therapeutic studies, both clinical and surgical, with better scientific evidence are needed.

scholarly journals Indications and outcomes of enterovesical and colovesical fistulas: systematic review of the literature and meta-analysis of prevalence

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Stefano Granieri ◽  
Francesco Sessa ◽  
Alessandro Bonomi ◽  
Sissi Paleino ◽  
Federica Bruno ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Symptoms ◽  
Rare Complication ◽  
Meta Analysis ◽  
Treatment Options ◽  
Palliative Surgery ◽  
Review Of The Literature ◽  
Colovesical Fistula ◽  
Level Of Evidence ◽  
Meta Analyses

Abstract Background Entero-colovesical fistula is a rare complication of various benign and malignant diseases. The diagnosis is prominently based on clinical symptoms; imaging studies are necessary not only to confirm the presence of the fistula, but more importantly to demonstrate the extent and the nature of the fistula. There is still a lack of consensus regarding the if, when and how to repair the fistula. The aim of the study is to review the different surgical treatment options, focus on surgical indications, and explore cumulative recurrence, morbidity, and mortality rates of entero-vesical and colo-vesical fistula patients. Methods A systematic review of the literature was conducted according to PRISMA guidelines. Random effects meta-analyses of proportions were developed to assess primary and secondary endpoints. I2 statistic and Cochran’s Q test were computed to assess inter-studies’ heterogeneity. Results Twenty-two studies were included in the analysis with a total of 861 patients. Meta-analyses of proportions pointed out 5, 22.2, and 4.9% rates for recurrence, complications, and mortality respectively. A single-stage procedure was performed in 75.5% of the cases, whereas a multi-stage operation in 15.5% of patients. Palliative surgery was performed in 6.2% of the cases. In 2.3% of the cases, the surgical procedure was not specified. Simple and advanced repair of the bladder was performed in 84.3% and 15.6% of the cases respectively. Conclusions Although burdened by a non-negligible rate of complications, surgical repair of entero-colovesical fistula leads to excellent results in terms of primary healing. Our review offers opportunities for significant further research in this field. Level of Evidence Level III according to ELIS (SR/MA with up to two negative criteria).

scholarly journals Articular Cartilage Defects of the Glenohumeral Joint: A Systematic Review of Treatment Options and Outcomes

Cartilage ◽  
2019 ◽  
pp. 194760351987085 ◽  
Author(s):  
Anthony Fiegen ◽  
Devin P. Leland ◽  
Christopher D. Bernard ◽  
Aaron J. Krych ◽  
Jonathan D. Barlow ◽  
...  
Keyword(s):  
Systematic Review ◽  
Patient Reported Outcomes ◽  
Glenohumeral Joint ◽  
Meta Analysis ◽  
Treatment Options ◽  
Surgical Techniques ◽  
Cartilage Defects ◽  
Imaging Findings ◽  
Level Of Evidence ◽  
Patient Reported

Objective To report radiographic and magnetic resonance imaging findings, patient-reported outcomes, and complications and/or reoperations following nonarthroplasty surgical intervention for focal glenohumeral cartilage defects. Design A literature search was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Patients were included if they possessed a chondral defect of the humeral head, glenoid, or both, which had been treated with a joint preserving nonarthroplasty procedure. Risk of bias assessment was performed using the Methodological Index for Non-Randomized Studies scoring system. Study demographics, surgical technique, imaging findings, patient-reported outcomes, complications, failures, and reoperations were collected. Results Fourteen studies with 98 patients (100 shoulders) met the inclusion criteria. Patient ages ranged from 7 to 74 years. The nonarthroplasty surgical techniques utilized included microfracture (67 shoulders), osteochondral transplantation (28 shoulders), chondrocyte transplantation (4 shoulders), and internal fixation (1 shoulder). The rates of radiographic union and progression of osteoarthritis ranged between 90% to 100% and 57% to 100%, respectively. Visual analog scores ranged from 0 to 1.9 at final follow-up. Mean postoperative ASES (American Shoulder and Elbow Surgeons) shoulder scores ranged from 75.8-100. Mean postoperative CSS (Constant Shoulder Score) scores ranged from 83.3-94. Mean postoperative SSV (Subjective Shoulder Value) ranged from 70% to 99%. Failure and reoperation rates ranged between 0% to 35% and 0% to 30%, respectively, with the most common reoperation being conversion to prosthetic arthroplasty. Conclusions In this systematic review, nonarthroplasty surgical techniques demonstrated acceptable rates of radiographic healing, improved patient reported outcomes, minimal complications, and low rates of failure or reoperation. Joint preserving techniques are likely viable options to prolong function of the native shoulder and provide short- to midterm pain relief in young and highly active patients. Level of Evidence Level IV.

scholarly journals Mindfulness-based interventions for mental well-being among people with multiple sclerosis: a systematic review and meta-analysis of randomised controlled trials

2019 ◽  
Vol 90 (9) ◽  
pp. 1051-1058 ◽  
Author(s):  
Robert Simpson ◽  
Sharon Simpson ◽  
Nitish Ramparsad ◽  
Margaret Lawrence ◽  
Jo Booth ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Systematic Review ◽  
Randomised Controlled Trials ◽  
Meta Analysis ◽  
Treatment Options ◽  
Well Being ◽  
Controlled Trials ◽  
Medical Subject Headings ◽  
Randomised Controlled ◽  
Mental Well Being

ObjectiveImpairment of mental well-being (anxiety, depression, stress) is common among people with multiple sclerosis (PwMS). Treatment options are limited, particularly for anxiety. The aim of this study was to update our previous systematic review (2014) and evaluate via meta-analysis the efficacy of mindfulness-based interventions (MBIs) for improving mental well-being in PwMS.MethodsSystematic searches for eligible randomised controlled trials (RCTs) were carried out in seven major databases (November 2017, July 2018), using medical subject headings and key words. Studies were screened, data extracted, quality appraised and analysed by two independent reviewers, using predefined criteria. Study quality was assessed using the Cochrane Collaboration risk of bias tool. Mental well-being was the primary outcome. Random effects model meta-analysis was performed, with effect size reported as standardised mean difference (SMD).ResultsTwelve RCTs including 744 PwMS were eligible for inclusion in the systematic review, eight had data extractable for meta-analysis; n=635. Ethnicity, socioeconomic status, comorbidity and disability were inconsistently reported. MBIs varied from manualised to tailored versions, lasting 6–9 weeks, delivered individually and via groups, both in person and online. Overall SMD for mental well-being (eight studies) was 0.40 (0.28–0.53), p<0.01, I2=28%; against active comparators only (three studies) SMD was 0.17 (0.01–0.32), p<0.05, I2 =0%. Only three adverse events were reported.ConclusionsMBIs are effective at improving mental well-being in PwMS. More research is needed regarding optimal delivery method, cost-effectiveness and comparative-effectiveness.PROSPERO registration numberCRD42018093171.

scholarly journals Handling errors in conventional and smart pump infusions: A systematic review with meta-analysis

2020 ◽  
Vol 54 ◽  
Author(s):  
Ana Paula Amorim Moreira ◽  
Márglory Fraga de Carvalho ◽  
Roberto Carlos Lyra da Silva ◽  
Cristiano Bertolossi Marta ◽  
Eliana Rosa da Fonseca ◽  
...  
Keyword(s):  
Systematic Review ◽  
Error Rate ◽  
Meta Analysis ◽  
Scientific Evidence ◽  
Infusion Pump ◽  
Eligibility Criteria ◽  
Level Of Evidence ◽  
Intravenous Insulin ◽  
Smart Pump ◽  
Programming Errors

Abstract Objective: To identify the scientific evidence on the frequency of handling errors of conventional and smart pump infusions in intravenous insulin therapy in intensive care units. Method: A systematic review with meta-analysis conducted in the Virtual Health Library, MEDLINE via PubMed, Scopus and Web of Science databases. Articles were assessed regarding the level of evidence by applying the Oxford Center for Evidence-Based Medicine Evidence Scale. Results: Twelve (12) publications were selected which met the eligibility criteria. The programming error rate using the conventional infusion pump ranged from 10% to 40.1%, and the smart pump technology error rate ranged from 0.3 to 14%. The meta-analysis of two studies favored the smart pump in reducing the relative risk of programming errors by 51%. Conclusion: Based on selected articles, the smart pump reduces the risk of programming errors.

Treatment of Acute Achilles Tendon Ruptures: A Systematic Review and Meta-analysis of Complication Rates With Best- and Worst-Case Analyses for Rerupture Rates

2021 ◽  
pp. 036354652199828
Author(s):  
Dexter Seow ◽  
Youichi Yasui ◽  
James D.F. Calder ◽  
John G. Kennedy ◽  
Christopher J. Pearce
Keyword(s):  
Systematic Review ◽  
Surgical Treatment ◽  
Meta Analysis ◽  
Treatment Options ◽  
Nonsurgical Treatment ◽  
Case Scenario ◽  
Level Of Evidence ◽  
Worst Case

Background: An acute Achilles tendon rupture (AATR) is a common injury. The controversy that has surrounded the optimal treatment options for AATRs warrants an updated meta-analysis that is comprehensive, accounts for loss to follow-up, and utilizes the now greater number of available studies for data pooling. Purpose: To meta-analyze the rates of all complications after the treatment of AATRs with a “best-case scenario” and “worst-case scenario” analysis for rerupture rates that assumes that all patients lost to follow-up did not or did experience a rerupture, respectively. Study Design: Systematic review and meta-analysis; Level of evidence, 1. Methods: Two authors performed a systematic review of the PubMed and Embase databases according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines on February 17, 2020. The included studies were assessed in terms of the level of evidence, quality of evidence, and quality of the literature. A meta-analysis by fixed-effects models was performed if heterogeneity was low ( I2 < 25%) and by random-effects models if heterogeneity was moderate to high ( I2≥ 25%). Results: Surgical treatment was significantly favored over nonsurgical treatment for reruptures. Nonsurgical treatment was significantly favored over surgical treatment for complications other than reruptures, notably infections. Minimally invasive surgery was significantly favored over open repair for complications other than reruptures (no difference for reruptures), in particular for minor complications. Conclusion: This meta-analysis demonstrated that surgical treatment was superior to nonsurgical treatment in terms of reruptures. However, the number needed to treat analysis produced nonmeaningful values for all treatment options, except for surgical versus nonsurgical treatment and minimally invasive surgery versus open repair. No single treatment option was revealed to be profoundly favorable with respect to every complication. The results of this meta-analysis can guide clinicians and patients in their treatment decisions that should be made jointly and on a case-by-case basis.

scholarly journals Effects of Sport-Based Interventions on Children’s Executive Function: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 11 (6) ◽  
pp. 755
Author(s):  
Falonn Contreras-Osorio ◽  
Christian Campos-Jara ◽  
Cristian Martínez-Salazar ◽  
Luis Chirosa-Ríos ◽  
Darío Martínez-García
Keyword(s):  
Systematic Review ◽  
Working Memory ◽  
Executive Function ◽  
Inhibitory Control ◽  
Cognitive Flexibility ◽  
Meta Analysis ◽  
Scientific Evidence ◽  
Healthy Children ◽  
Meta Analyses ◽  
The Impact

One of the most studied aspects of children’s cognitive development is that of the development of the executive function, and research has shown that physical activity has been demonstrated as a key factor in its enhancement. This meta-analysis aims to assess the impact of specific sports interventions on the executive function of children and teenagers. A systematic review was carried out on 1 November 2020 to search for published scientific evidence that analysed different sports programs that possibly affected executive function in students. Longitudinal studies, which assessed the effects of sports interventions on subjects between 6 and 18 years old, were identified through a systematic search of the four principal electronic databases: Web of Science, PubMed, Scopus, and EBSCO. A total of eight studies, with 424 subjects overall, met the inclusion criteria and were classified based on one or more of the following categories: working memory, inhibitory control, and cognitive flexibility. The random-effects model for meta-analyses was performed with RevMan version 5.3 to facilitate the analysis of the studies. Large effect sizes were found in all categories: working memory (ES −1.25; 95% CI −1.70; −0.79; p < 0.0001); inhibitory control (ES −1.30; 95% CI −1.98; −0.63; p < 0.00001); and cognitive flexibility (ES −1.52; 95% CI −2.20; −0.83; p < 0.00001). Our analysis concluded that healthy children and teenagers should be encouraged to practice sports in order to improve their executive function at every stage of their development.

Vitamin D in Basketball Players: Current Evidence and Future Directions

2021 ◽  
pp. 194173812110193
Author(s):  
Emilija Stojanović ◽  
Dragan Radovanović ◽  
Tamara Hew-Butler ◽  
Dušan Hamar ◽  
Vladimir Jakovljević
Keyword(s):  
Systematic Review ◽  
Vitamin D ◽  
Body Composition ◽  
Physical Performance ◽  
Bone Health ◽  
Meta Analysis ◽  
Vitamin D Supplementation ◽  
Current Evidence ◽  
Basketball Players ◽  
Level Of Evidence

Context: Despite growing interest in quantifying and correcting vitamin D inadequacy in basketball players, a critical synthesis of these data is yet to be performed to overcome the low generalizability of findings from individual studies. Objective: To provide a comprehensive analysis of data in basketball pertaining to (1) the prevalence of vitamin D inadequacy; (2) the effects of vitamin D supplementation on 25-hydroxyvitamin D [25(OH)D] concentration (and its association with body composition), bone health, and performance; and (3) crucial aspects that warrant further investigation. Data Sources: PubMed, MEDLINE, ERIC, Google Scholar, SCIndex, and ScienceDirect databases were searched. Study Selection: After screening, 15 studies were included in the systematic review and meta-analysis. Study Design: Systematic review and meta-analysis. Level of Evidence: Level 3. Data Extraction: The prevalence of vitamin D inadequacy, serum 25(OH)D, body composition, stress fractures, and physical performance were extracted. Results: The pooled prevalence of vitamin D inadequacy for 527 basketball players in 14 studies was 77% ( P < 0.001; 95% CI, 0.70-0.84). Supplementation with 4000 IU/d and 4000 IU/wk (absolute mean difference [AMD]: 25.39 nmol/L; P < 0.001; 95% CI, 13.44-37.33), as well as 10,000 IU/d (AMD: 100.01; P < 0.001; 95% CI, 70.39-129.63) vitamin D restored 25(OH)D to normal concentrations. Body composition data revealed inverse correlations between changes in serum 25(OH)D (from pre- to postsupplementation) and body fat ( r = −0.80; very large). Data concerning positive impacts of vitamin D supplementation on bone health and physical performance remain sparse. Conclusion: The high proportion of vitamin D inadequacy underscores the need to screen for serum 25(OH)D in basketball players. Although supplementation restored vitamin D sufficiency, the beneficial effects on bone health and physical performance remain sparse. Adiposity can modulate 25(OH)D response to supplementation.

scholarly journals 1578. Treatments for complicated urinary tract infections (cUTI) caused by multidrug resistant (MDR) Gram-negative (GN) pathogens- a systematic review and network meta-analysis (NMA)

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S787-S787
Author(s):  
Tim Reason ◽  
Karan Gill ◽  
Christopher Longshaw ◽  
Rachael McCool ◽  
Katy Wilson ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Economics ◽  
Meta Analysis ◽  
Treatment Options ◽  
Final Analysis ◽  
Similar Efficacy ◽  
Global Public Health ◽  
Efficacy And Safety ◽  
Support Unit ◽  
Tract Infections

Abstract Background Antimicrobial resistance is a major and growing threat to global public health. Cefiderocol (CFDC) is a new siderophore-cephalosporin with a wide activity spectrum covering all aerobic GN pathogens including all WHO critical priority pathogens, that was recently approved by FDA for the treatment of GN cUTI in susceptible organisms. We aim to understand the relative efficacy and safety of current treatment options for cUTI caused by MDR GN pathogens. Methods We conducted a systematic review to identify all relevant trials that investigated the efficacy and safety of antimicrobial regimens, for the treatment of GN pathogens in cUTI. Outcomes of interest included clinical cure and microbiological eradication (ME) at time of cure (TOC) and sustained follow up (SFU), and safety. Evidence networks were constructed using data for outcomes of interest and analyses were conducted in a frequentist framework using NMA methods outlined by the NICE decision support unit using the netmeta package in R. Results A total of 5 studies, 6 interventions and 2,349 randomised patients were included in the final analysis. Interventions included CFDC, imipenem-cilastatin (IPM-CIL), ceftazidime-avibactam (CAZ/AVI), doripenem (DOR), levofloxacin and ceftolozane-tazobactam (CEF/TAZ). Trials included predominantly Enterobacterales, and Pseudomonas aeruginosa and very few Acinetobacter baumannii. The patient population presented some clinical differences across trials, which were not adjusted for the NMA. Overall, there were numerical differences (especially in endpoints at SFU favouring CFDC), but all treatments showed similar efficacy and safety, with exception of higher ME rate at TOC for CFDC vs IPM, Table 1, also observed at SFU, consistent with the data from the individual clinical trial. Table 1- Results for microbiological eradication Table 1- Results for microbiological eradication Conclusion This NMA, showed superiority of CFDC vs IPM-CIL in ME at TOC and SFU and similar efficacy and safety vs all other comparators, with numeric differences favouring CFDC for outcomes at SFU. These traditional methodologies for NMA, are only valid within a similar pathogens pool and population across the trials, and may not reflect the full value of breadth of coverage that new therapeutic options bring for the treatment of MDR GN pathogens. Disclosures Tim Reason, PhD, Shionogi (Consultant) Karan Gill, MSc, Shionogi BV (Employee) Christopher Longshaw, PhD, Shionogi B.V. (Employee) Rachael McCool, PhD, York Health Economics Consortium (Employee, YHEC was commissioned by Shionogi to conduct the systematic review) Katy Wilson, PhD, York Health Economics Consortium (Employee, Shionogi commissioned YHEC to conduct the systematic review) Sara Lopes, PharmD, Shionogi BV (Employee)

Treatment Options for Hirsutism: A Systematic Review and Network Meta-Analysis

2018 ◽  
Vol 103 (4) ◽  
pp. 1258-1264 ◽  
Author(s):  
Patricia Barrionuevo ◽  
Mohammed Nabhan ◽  
Osama Altayar ◽  
Zhen Wang ◽  
Patricia J Erwin ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Treatment Options

scholarly journals Effectiveness of web-based feedback interventions for people with overweight and obesity: systematic review and network meta-analysis of randomized controlled trials

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Carmen Varela ◽  
Camila Oda-Montecinos ◽  
Ana Andrés ◽  
Carmina Saldaña
Keyword(s):  
Systematic Review ◽  
Confidence Interval ◽  
Weight Control ◽  
Meta Analysis ◽  
Treatment Options ◽  
Overweight And Obesity ◽  
Mean Difference ◽  
Effective Treatment Option ◽  
Web Based ◽  
Self Help

Abstract Background Web-based delivered interventions have become an innovative option to treat health problems, like obesity. The aim of this systematic review and network meta-analysis was to analyze the effectiveness of web-based behavioral treatments for adults with overweight and obesity. Web-based interventions and comparison interventions (traditional weight control programs) were classified according to the following feedback characteristics: frequency, personalization, and provider (human versus machine). Method From the initial 1789 studies, 15 were included in this review. A network meta-analysis was conducted to analyze the efficacy of web-based programs with traditional interventions, considering direct and indirect comparisons. The main outcome was the weight loss mean difference (kg) between baseline and post-treatment. Heterogeneity and consistency assumptions were validated to conduct the network meta-analysis. Results Network meta-analysis showed comparisons between different treatment options. The main results were that Intensive Contact Web-based programs were more effective than wait-list (Mean Difference − 1.86 kg; 95% Confidence Interval: − 3.61, − 0.12). Moreover, Intensive Contact Web-based programs were more effective than the other web-based options and self-help traditional interventions. However, the only significant comparison was Intensive Contact Web-based programs versus Guided Self-Help Web-based programs (Mean Difference − 4.31 kg; 95% Confidence Interval: − 5,22, − 3,41). Intensive Contact Web-based programs were the most effective treatment option according the obtained results, achieving the first place in the ranking provided by the network meta-analysis with 98.5% of probabilities. Conclusions Intensive Contact Web-based interventions have obtained the first position in the ranking, proving the relevance of frequent, personalized, and professional feedback and their association with a better prognosis for people with overweight and obesity. These results provide relevant information to design more effective treatments for people with overweight and obesity, in a new format especially appropriate for the current situation.

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