scholarly journals Opioids and Breast Cancer Recurrence: A Systematic Review

Cancers ◽  
2021 ◽  
Vol 13 (21) ◽  
pp. 5499
Author(s):  
Merlino Lucia ◽  
Titi Luca ◽  
Del Prete Federica ◽  
Galli Cecilia ◽  
Mandosi Chiara ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Systematic Review ◽  
Pain Management ◽  
Postoperative Period ◽  
Clinical Studies ◽  
In Vivo Studies ◽  
Standards Of Care ◽  
Surgical Time ◽  
Pubmed Database ◽  
Opioid Administration

Breast cancer has the greatest epidemiological impact in women. Opioids represent the most prescribed analgesics, both in surgical time and in immediate postoperative period, as well as in chronic pain management as palliative care. We made a systematic review analyzing the literature’s evidence about the safety of opioids in breast cancer treatment, focusing our attention on the link between opioid administration and increased relapses. The research has been conducted using the PubMed database. Preclinical studies, retrospective and prospective clinical studies, review articles and original articles were analyzed. In the literature, there are several preclinical in vitro and in vivo studies, suggesting a possible linkage between opioids administration and progression of cancer disease. Nevertheless, these results are not confirmed by clinical studies. The most recent evidence reassures the safety of opioids during surgical time as analgesic associated with anesthetics drugs, during postoperative period for optimal cancer-related pain management and in chronic use. Currently, there is controversial evidence suggesting a possible impact of opioids on breast cancer progression, but to date, it remains an unresolved issue. Although there is no conclusive evidence, we hope to arouse interest in the scientific community to always ensure the best standards of care for these patients.

Viscum album (L) extracts in cancer treatment: a systematic review of in vitro and in vivo studies

2021 ◽  
Vol 14 (2) ◽  
pp. 52-52
Author(s):  
Aloisio Cunha de Carvalho ◽  
Leoni Villano Bonamin
Keyword(s):  
Systematic Review ◽  
Experimental Studies ◽  
Pharmaceutical Preparations ◽  
Viscum Album ◽  
In Vitro Models ◽  
In Vivo Studies ◽  
Pubmed Database ◽  
Anti Cancer

Background: Several reviews about phytotherapy and homeopathy have been published in the last years, including Viscum album (VA.L). VA is a parasite plant whose extract has anti-cancer proprieties and is used alone or in combination with conventional chemotherapy. Methods: We performed a systematic review about the in vivo and in vitro models described in the literature, including veterinary clinical trials. The literature was consulted from Pubmed database. Results: There are several kinds of pharmaceutical preparations about VA and their active principles used in experimental studies, lectin being frequently studied (alone or as an extract compound). More than 50% of available literature about VA is related to the lectin effects. On the other hand, the effects of viscotoxins are less studied. Among the in vivo experimental studies about VA and its compounds, the B16 murine melanoma is the most used model, followed by Ehrlich, Walker and Dalton tumors. The results point to the apoptotic effects, metastasis control and tumor regression. Some veterinary clinical studies about the use of VA in the treatment of sarcoid, fibrosarcoma and neuroblastoma are quoted in literature too, with interesting results. Considering the in vitro models, our review revealed that NALM6 leukemia cells, B16 melanoma and NC1-H460 lung carcinoma were the most studied tumor models, apoptosis signals being the most important findings. Only one study verified immunoglobulin and interleukin production. All consulted papers were related to phytotherapy preparations only. Conclusions: Although the literature about the anti-cancer activity of VA extract and its lectins is enough, there is a marked lack of information about viscotoxin activities and about the effects of homeopathic preparations of this plant on animal tumors and on in vitro cultivated tumor cells.

Orthopedic Injuries and Their Treatment in Children During Earthquakes: A Systematic Review

2015 ◽  
Vol 30 (5) ◽  
pp. 478-485 ◽  
Author(s):  
Ilaria Morelli ◽  
Maria Grazia Sabbadini ◽  
Michelangelo Bortolin
Keyword(s):  
Systematic Review ◽  
Hospital Admissions ◽  
Case Reports ◽  
Lower Limbs ◽  
Standards Of Care ◽  
Body Distribution ◽  
Fractures In Children ◽  
Pubmed Database ◽  
Orthopedic Injuries ◽  
Child Hospital

AbstractOrthopedic injuries commonly affect children during earthquakes, but reports about them are rare. This setting may lead to different standards of care, but guidelines are still missing in this field. A systematic review was performed to: (1) assess type and body distribution of pediatric earthquake-related injuries, treatment performed, length of stay, and complications; and (2) identify starting points to define standards of care.PubMed database was researched for papers (1999-2014 period) in agreement with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement. Inclusion criteria were: English, French, Spanish, or Italian language and data reported about orthopedic lesions in children (≤18 years old). Reviews, letters, commentaries, editorials, and single case reports were excluded. Two independent reviewers selected articles after abstract and full-text reading.Traumatic injuries caused child hospital admissions ranging from 46.9% to 100.0%; 16% to 53% suffered fractures. Lower limbs mostly were involved. Soft-tissue injuries affected 55% of patients. Debridement and external fixation (EF) were the most frequent surgical treatments. Amputation rates varied from 5% to 11%.This study revealed that field hospitals should be prepared to: (1) treat mainly lower extremities fractures in children; and (2) use especially EF techniques. The presence of orthopedic surgeons familiar with pediatric traumatology should be considered.MorelliI, SabbadiniMG, BortolinM. Orthopedic injuries and their treatment in children during earthquakes: a systematic review. Prehosp Disaster Med. 2015;30(5):478–485.

Stevens–Johnson syndrome and toxic epidermal necrolysis: a systematic review and meta-analysis

2021 ◽  
Vol 30 (12) ◽  
pp. 1012-1019
Author(s):  
Khosrow S Houschyar ◽  
Christian Tapking ◽  
Mimi R Borrelli ◽  
Behrus Puladi ◽  
Mark Ooms ◽  
...  
Keyword(s):  
Systematic Review ◽  
Toxic Epidermal Necrolysis ◽  
Clinical Studies ◽  
English Language ◽  
Meta Analysis ◽  
Treatment Protocol ◽  
Stevens Johnson Syndrome ◽  
Inclusion Criteria ◽  
Johnson Syndrome ◽  
Pubmed Database

Objective: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare and severe skin and mucosal reactions that are associated with high mortality. Despite the severity, an evidence-based treatment protocol for SJS/TEN is still lacking. Method: In this systematic review and meta-analysis, the PubMed database was searched using the following terms: [Stevens–Johnson syndrome] OR [toxic epidermal necrolysis] AND [therapy] OR [treatment] over a 20-year period (1999–2019) in the German and English language. All clinical studies reporting on the treatment of SJS/TEN were included, and epidemiological and diagnostic aspects of treatment were analysed. A meta-analysis was conducted on all comparative clinical studies that met the inclusion criteria. Results: A total of 88 studies met the inclusion criteria, reporting outcomes in 2647 patients. Treatment was either supportive or used systemic corticosteroid, intravenous immunoglobulin, plasmapheresis, cyclosporine, thalidomide or cyclophosphamide therapy. The meta-analysis included 16 (18%) studies, reporting outcomes in 976 (37%) patients. Systemic glucocorticoids showed a survival benefit for SJS/TEN patients in all analyses compared with other forms of treatment. Cyclosporine treatment also showed promising results, despite being used in a small cohort of patients. No beneficial effects on mortality could be demonstrated for intravenous immunoglobulins. Conclusion: Glucocorticoids and cyclosporine may be tentatively recommended as the most promising immunomodulatory therapies for SJS/TEN, but these results should be investigated in future prospective controlled trials.

Can gray values be converted to Hounsfield units? A systematic review

2021 ◽  
pp. 20210140
Author(s):  
Marjorie Eguren ◽  
Anderson Holguin ◽  
Karla Diaz ◽  
Jose Vidalon ◽  
Carlos Linan ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Systematic Review ◽  
Clinical Studies ◽  
Assessment Tool ◽  
Grey Literature ◽  
In Vivo Studies ◽  
Hounsfield Units ◽  
General Terms ◽  
Diagnostic Capacity ◽  
Gray Values

Objectives: The purpose of this systematic review was to answer the focus question: “Could the gray values (GVs) from CBCT (cone beam computed tomography) be converted to Hounsfield units (HUs) in multidetector computed tomography (MDCT)?” Methods: The included studies try to answer the research question according to the PICO strategy. Studies were gathered by searching several electronic databases and partial grey literature up to January 2021 without language or time restrictions. The methodological assessment of the studies was performed using The Oral Health Assessment Tool (OHAT) for in vitro studies and the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) for in vivo studies. The Grading of Recommendations Assessment, Development and Evaluation (GRADE system) instrument was applied to assess the level of evidence across the studies. Results: 2710 articles were obtained in Phase 1, and 623 citations remained after removing duplicates. Only three studies were included in this review using a two-phase selection process and after applying the eligibility criteria. All studies were methodologically acceptable, although in general terms with low risks of bias. There are some included studies with quite low and limited evidence estimations and recommendation forces; evidencing the need for clinical studies with diagnostic capacity to support its use. Conclusions: This systematic review demonstrated that the GVs from CBCT cannot be converted to HUs due to the lack of clinical studies with diagnostic capacity to support its use. However, it is evidenced that three conversion steps (equipment calibration, prediction equation models, and a standard formula (converting GVs to HUs)) are needed to obtain pseudo Hounsfield values instead of only obtaining them from a regression or directly from the software.

Reproducibility of Mass Spectrometry Based Protein Profiles for Diagnosis of Breast Cancer across Clinical Studies: A Systematic Review

2008 ◽  
Vol 7 (4) ◽  
pp. 1395-1402 ◽  
Author(s):  
Anne K. Callesen ◽  
Werner Vach ◽  
Per E. Jørgensen ◽  
Søren Cold ◽  
Ole Mogensen ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Mass Spectrometry ◽  
Systematic Review ◽  
Clinical Studies ◽  
Protein Profiles

scholarly journals Exposure to pesticides and digestive system cancers: systematic review and meta-analysis

2021 ◽  
Vol 10 (11) ◽  
pp. e06101119163
Author(s):  
Iago Sávyo Duarte Santiago ◽  
Estelita Lima Cândido ◽  
Lucas Farias Lopes ◽  
João Pedro Leite de Medeiros Almeida ◽  
Cláudio Gleidiston Lima da Silva
Keyword(s):  
Breast Cancer ◽  
Colorectal Cancer ◽  
Systematic Review ◽  
Binary Data ◽  
Digestive System ◽  
Meta Analysis ◽  
Continuous Data ◽  
Positive Evidence ◽  
Pubmed Database

Pesticides are substances often described as carcinogenic initiators for some neoplasms, such as lympho-hematopoietic and breast cancer. As for cancer of the digestive system, this relationship is still poorly explored and requires more evidence. A systematic review with meta-analysis was conducted on the association between pesticides and cancer of the digestive system in the PUBMED database. Of the 567 papers found, 32 were approved for qualitative analysis and seven for meta-analysis. Hexachlorobenzene and DDT were significantly associated with colorectal cancer (MD: 15.92; CI: 6.45; 25.40) in the analysis of continuous data and showed a borderline association in the analysis of binary data (OR: 1.17; CI: 0.93; 1.47). The cyclodienes family showed similar results in both analyzes. Polychlorinated biphenyls with low dosages were also associated with colorectal cancer (MD: 38.95; CI: 12.78; 65.11). Organophosphates (OR: 0.54; 95% CI: 0.29; 0.98), carbamates (OR: 0.96; CI: 0.77; 1.21) and triazines (OR: 0.91; 95% CI: 0.74; 1.13) showed inconclusive results. This review presents positive evidence for the association of pesticides with colorectal cancer. However, more evidence is required to determine the role of pesticides in the development of other cancers of the digestive system.

scholarly journals H-Wave® Device Stimulation: A Critical Review

2021 ◽  
Vol 11 (11) ◽  
pp. 1134
Author(s):  
Tyler K. Williamson ◽  
Hugo C. Rodriguez ◽  
Andrew Gonzaba ◽  
Neil Poddar ◽  
Stephen M. Norwood ◽  
...  
Keyword(s):  
Pain Management ◽  
Clinical Studies ◽  
Low Cost ◽  
Standards Of Care ◽  
Medication Usage ◽  
Level Of Evidence ◽  
Biphasic Waveform ◽  
Reasonable Evidence ◽  
Excellent Safety Profile ◽  
Study Designs

Pain treatments have historically centered on drugs, but an “opioid crisis” has necessitated new standards of care, with a paradigm shift towards multi-modal pain management emphasizing early movement, non-narcotics, and various adjunctive therapies. Electrotherapies remain understudied and most lack high-quality clinical trials, despite a desperate need for effective adjunctive options. A systematic search of human clinical studies on H-Wave® device stimulation (HWDS) was conducted as well as a comprehensive review of articles articulating possible HWDS mechanisms of action. Studies unrelated to H-Wave were excluded. Data synthesis summarizes outcomes and study designs, categorized as pre-clinical or clinical. Pre-clinical studies demonstrated that HWDS utilizes a biphasic waveform to induce non-fatiguing muscle contractions which positively affect nerve function, blood and lymph flow. Multiple clinical studies have reported significant benefits for diabetic and non-specific neuropathic pain, where function also improved, and pain medication usage substantially dropped. In conclusion, low- to moderate-quality HWDS studies have reported reduced pain, restored functionality, and lower medication use in a variety of disorders, although higher-quality research is needed to verify condition-specific applicability. HWDS has enough reasonable evidence to be considered as an adjunctive component of non-opioid multi-modal pain management, given its excellent safety profile and relative low cost. Level of Evidence: III.

scholarly journals The Impact of Genetic Variation on Sensitivity to Opioid Analgesics in Patients with Postoperative Pain: A Systematic Review and Meta-Analysis

2015 ◽  
Vol 2;18 (2;3) ◽  
pp. 131-152
Author(s):  
Prof. Lin Lu
Keyword(s):  
Systematic Review ◽  
Pain Management ◽  
Postoperative Pain ◽  
Genetic Polymorphisms ◽  
Postoperative Period ◽  
Meta Analysis ◽  
Receptor Gene ◽  
Opioid Analgesics ◽  
Allele Variant ◽  
The Impact

Background: Individual response to opioid analgesics varies among patients. Objective: This study sought to clarify the impact of distinct genetic variations on pain, opioid consumption, and opioid side effects in patients with postoperative pain. Study Design: A systematic review and meta-analysis of associations between genetic singlenucleotide polymorphisms (SNPs) and opioids used for acute postoperative pain. Setting: This meta-analysis examined all studies involving an association between genetic polymorphisms and the analgesic efficacy or clinical outcome of opioid analgesics for postoperative pain. Methods: A literature search was performed up to January 31, 2014, using the PubMed, EMBase, ISI Web of Science, and Cochrane Library databases. Results: Fifty-nine studies were included in this systematic review, and 23 studies (a total of 5,902 patients) were included in the final meta-analysis. The results showed that human μ-opioid receptor gene (OPRM1) 118G allele variant carriers consumed more opioids for analgesia (SMD = -0.17, 95% CI = [-0.25, -0.10], P < 0.00001), but reported higher pain scores (MD = -0.11, 95% CI = [-0.17, -0.04], P = 0.002) and less nausea and vomiting (odds ratio = 1.30, 95% CI = [1.08, 1.55], P = 0.005) than the homozygous 118AA patients during the first 24 hour but not the 48 hour postoperative period. Moreover, CYP3A4*1G carriers consumed less opioids than homozygous CYP3A4*1/*1 patients during the first 24 hours postoperative period (MD = 45.12, 95% CI = [36.17, 54.06], P < 0.00001). No significant differences were found in CYP3A5*3, ABCB1 C3435T, and G2477T/A genetic polymorphisms. Limitations: Some potential non-genetic factors can modify the effects of gene SNP on pain and opioid consumption during the postoperative period, such as age, gender, mood, anxiety, and drug-drug interactions. But further analyses could not be performed in the present meta-analysis due to limited information. Conclusion: The results indicate that among the genetic SNPs we studied which include those affecting analgesic drug metabolism, transport of analgesic agents across the blood-brain barrier, and their activity at target receptors and ion channels and in the modulation of neurotransmitter pathways, the A118G allele variant of OPRM1 has the most potent influence on pain management of postoperative patients. Opioid receptor gene information may provide valuable information for clinicians to properly manage the analgesic use of opioids individually for better pain management. Key words: Postoperative pain, meta-analysis, single-nucleotide polymorphism, opioid

scholarly journals Pain management after laminectomy: a systematic review and procedure-specific post-operative pain management (prospect) recommendations

2020 ◽  
Author(s):  
Laurens Peene ◽  
◽  
Pauline Le Cacheux ◽  
Axel R. Sauter ◽  
Girish P. Joshi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Pain Management ◽  
Specific Inhibitor ◽  
Outpatient Basis ◽  
Surgical Wound ◽  
Rescue Analgesia ◽  
Post Operative Pain ◽  
Opioid Administration ◽  
Cox 2 ◽  
Wound Instillation

Abstract Purpose With lumbar laminectomy increasingly being performed on an outpatient basis, optimal pain management is critical to avoid post-operative delay in discharge and readmission. The aim of this review was to evaluate the available literature and develop recommendations for optimal pain management after one- or two-level lumbar laminectomy. Methods A systematic review utilizing the PROcedure-SPECific Post-operative Pain ManagemenT (PROSPECT) methodology was undertaken. Randomised controlled trials (RCTs) published in the English language from 1 January 2008 until 31 March 2020—assessing post-operative pain using analgesic, anaesthetic and surgical interventions—were identified from MEDLINE, EMBASE and Cochrane Databases. Results Out of 65 eligible studies identified, 39 RCTs met the inclusion criteria. The analgesic regimen for lumbar laminectomy should include paracetamol and a non-steroidal anti-inflammatory drug (NSAID) or cyclooxygenase (COX)—2 selective inhibitor administered preoperatively or intraoperatively and continued post-operatively, with post-operative opioids for rescue analgesia. In addition, surgical wound instillation or infiltration with local anaesthetics prior to wound closure is recommended. Some interventions—gabapentinoids and intrathecal opioid administration—although effective, carry significant risks and consequently were omitted from the recommendations. Other interventions were also not recommended because there was insufficient, inconsistent or lack of evidence. Conclusion Perioperative pain management for lumbar laminectomy should include paracetamol and NSAID- or COX-2-specific inhibitor, continued into the post-operative period, as well as intraoperative surgical wound instillation or infiltration. Opioids should be used as rescue medication post-operatively. Future studies are necessary to evaluate the efficacy of our recommendations.

scholarly journals FGF2 and EGF for the Regeneration of Tympanic Membrane: A Systematic Review

2021 ◽  
Vol 2021 ◽  
pp. 1-15
Author(s):  
Zhengcai Lou ◽  
Zihan Lou ◽  
Yumeng Jiang ◽  
Zhengnong Chen
Keyword(s):  
Systematic Review ◽  
Growth Factor ◽  
Tympanic Membrane ◽  
Clinical Studies ◽  
Experimental Studies ◽  
Saline Group ◽  
Closure Rate ◽  
Biological Scaffolds ◽  
Pubmed Database ◽  
Middle Ear Cholesteatoma

Objective. A systematic review was conducted to compare the effectiveness and safety of fibroblast growth factor-2 (FGF2) and epidermal growth factor (EGF) for regeneration of the tympanic membrane (TM). Methods. The PubMed database was searched for relevant studies. Experimental and clinical studies reporting acute and chronic TM perforations in relation to two healing outcomes (success rate and closure time) and complications were selected. Results. A total of 47 studies were included. Five experimental studies showed closure rates of 55%–100% with FGF2 compared with 10%–62.5% in controls for acute perforations. Five experimental studies showed closure rates of 30.3%–100% with EGF and 3.6%–41% in controls for chronic perforations. Two experimental studies showed closure rates of 31.6% or 85.7% with FGF2 and 15.8% or 100% with EGF. Nine clinical studies of acute large perforations showed closure rates of 91.4%–100% with FGF2 or EGF. Two clinical studies showed similar closure rates between groups treated with FGF2 and EGF. Seven clinical studies showed closure rates of 88.9%–100% within 3 months and 58%–66% within 12 months using FGF2 in repair of chronic perforations, but only one study showed a significantly higher closure rate in the saline group compared with the FGF2 group (71.4% vs. 57.5%, respectively, P = 0.547 ). In addition, three experimental studies showed no ototoxicity associated with FGF2 or EGF. No middle ear cholesteatoma or epithelial pearls were reported, except in one experimental study and one clinical study, respectively. Conclusions. FGF2 and EGF showed good effects and reliable safety for the regeneration of TM. In addition, EGF was better for the regeneration of acute perforations, while FGF2 combined with biological scaffolds was superior to EGF for chronic perforations, but was associated with high rates of reperforation over time. Further studies are required to determine whether EGF or FGF2 is better for TM regeneration.

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