The Carcinogenic Effects of Formaldehyde Occupational Exposure: A Systematic Review

Background: Formaldehyde, classified as a carcinogen in 2004, as of today is widely used in many work activities. From its classification, further studies were performed to evaluate its carcinogenicity. The aim of the systematic review is to update the evidence on occupational exposure to formaldehyde and cancer onset. Methods: The review, in accordance with the PRISMA statement, includes articles in English reporting original results of studies conducted on workers exposed to formaldehyde, considering all types of cancer, published from 1 January 2000 to 30 July 2021 and selected from the Pubmed and Scopus databases. The studies’ quality was assessed by the Newcastle–Ottawa Scale. Results: A total of 21 articles were included, conducted in different European, American, and Asian countries. The most investigated occupational areas are those characterized by a deliberate use of formaldehyde. Some studies evaluated all types of cancer, whereas others focused on specific sites such as thyroid and respiratory, lymphohematopoietic, or central nervous systems. The results showed weak associations with lung cancer, nasopharyngeal cancer, leukemia, and non-Hodgkin’s lymphoma. Conclusions: The results demonstrate the need for further original studies carried out on representative samples of workers exposed to measured levels of FA. These studies should be designed to reduce the bias due to co-exposure to other carcinogens.

Download Full-text

A Systematic Review of Zero-markup Policy for Essential Drugs Effect on Medical Treatment

10.21203/rs.3.rs-15650/v1 ◽

2020 ◽

Author(s):

Wen-Yi Liu ◽

Chia-Hsien Hsu ◽

Ting-Jun Liu ◽

Pei-En Chen ◽

Tao-Hsin Tung ◽

...

Keyword(s):

Systematic Review ◽

Medical Treatment ◽

Economic Effects ◽

Medical Expenditure ◽

Essential Drugs ◽

Prisma Statement ◽

Newcastle Ottawa Scale ◽

Increasing Trends ◽

Ottawa Scale

Abstract Objective. This systematic review is conducted to synthesize recent empirical evidence of Zero-markup Policy for Essential Drugs Effect on Medical Treatment in China. Methods. We searched the PubMed, Embase, Scopus, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) for all related studies published from inception to 30 April 2019 without restriction on language. In addition, grey literatures were captured through other sources, such as OpenGrey and Open Access Theses and Dissertations (OATD), to avoid selection bias. Methodological quality were evaluated using the PRISMA statement the Newcastle Ottawa Scale Collaboration tool. Results. Thirty-four full texts were initially searched, but only nine studies met our inclusion criteria. Most of studies indicated the significant reduction for both the total expense and drug expense per visit. Additionally, outpatient and inpatient services indicated increasing trends in annual patient-visits. Conclusions. In conclusion, the available limited, relative low-quality evidence does not support the long-term association between zero-markup policy for essential drugs and reduced medical expenditure. Further longitudinal studies that provide data for hospitals over a wider range of regions would make the economic effects more discursive.

Download Full-text

Safety of Systemic Medications Among Older Adults With Psoriasis and Atopic Dermatitis: A Systematic Review of Observational Studies

Journal of Cutaneous Medicine and Surgery ◽

10.1177/1203475421993770 ◽

2021 ◽

pp. 120347542199377

Author(s):

Evan Tang ◽

Talha Maqbool ◽

Megan Lam ◽

Gaelen P. Adam ◽

Mina Tadrous ◽

...

Keyword(s):

Systematic Review ◽

Older Adults ◽

Atopic Dermatitis ◽

Observational Studies ◽

Relative Effect ◽

Emergency Department Visits ◽

Major Cardiovascular Events ◽

Quantitative Synthesis ◽

Newcastle Ottawa Scale ◽

Ottawa Scale

Background Psoriasis and atopic dermatitis are common among older adults (≥65 years old), but clinical trials often exclude that population. Objective To synthesize evidence from observational studies on the safety of systemic therapies (conventional or biologic) for psoriasis and atopic dermatitis among older adults in a systematic review. Methods We searched MEDLINE and EMBASE (inception to October 31, 2019) and included observational studies reporting adverse events among older people treated with systemic therapy for psoriasis or atopic dermatitis. Outcomes were death, hospitalization, emergency department visits, infections, major cardiovascular events, renal toxicity, hepatotoxicity, and cytopenias. We assessed study quality using the Newcastle-Ottawa Scale. Results We included 22 studies on treatment for psoriasis and 2 for atopic dermatitis. Most studies were small and non-comparative and 20 of 24 were low quality. Studies comparing safety between medications or medication classes or between older and younger adults did not show apparent differences but had wide confidence intervals around relative effect estimates. Heterogeneity of study design and reporting precluded quantitative synthesis. Conclusions There is scant evidence on the safety of conventional systemic and biologic medications for older adults with psoriasis or atopic dermatitis; older adults and their clinicians should be aware of this evidence gap.

Download Full-text

The promise of Telemedicine in Pakistan: A Systematic Review (Preprint)

10.2196/preprints.27961 ◽

2021 ◽

Author(s):

Syed Sarosh Mahdi ◽

Franceso Amenta ◽

Raheel Allana ◽

Gopi Battineni 3rd ◽

Tamsal Khalid ◽

...

Keyword(s):

Systematic Review ◽

Rural Areas ◽

Urban Region ◽

Middle Income ◽

Web Based ◽

Study Characteristics ◽

Implementation Costs ◽

Newcastle Ottawa Scale ◽

Good Support ◽

Ottawa Scale

BACKGROUND Telemedicine is a medical practice of assisting remote patients and it has great potential in developing countries like Pakistan. Telemedicine solves the logistical barriers, deliver good support to weak health systems and unite worldwide networks of healthcare personals. Because of high implementation costs, yet it is not possible to adopt telehealth systems for low and middle-income nations. OBJECTIVE In this systematic review, we aim to present an update revision of region-based telemedical services in Pakistan. METHODS Libraries such as PubMed (Medline), CINAHL (Cumulative Index to Nursing and Allied Health Literature), Scopus (EMBASE) and Google Scholar were used for document search. Newcastle Ottawa Scale (NOS) is adopted to conduct study quality. Majority of the studies (n-8) included in the review were of high quality as assessed through the Newcastle Ottawa scale. Selected study characteristics further analyzed based on different parameters such as publication year, sample size, study design, methods, motivation and outcomes. RESULTS Search produced 955 articles and 11 items were ultimately selected to conduct the review. These studies further characterized as region-based telemedicine implementation. Out of 11, eight studies were conducted in the urban region and three studies were conducted in the rural areas of Pakistan. Majority of studies produced evidence on telehealth interventions by smartphone services like SMS, apps and web-based telemedicine. CONCLUSIONS Telehealth interventions like mHealth, eHealth, telemedicine, and telepharmacy are starting to evaluate for the last two decades but certainly needs to become an integral part of Pakistan's current health infrastructure.

Download Full-text

Sleep in youth with autism spectrum disorders: systematic review and meta-analysis of subjective and objective studies

Evidence-Based Mental Health ◽

10.1136/ebmental-2018-300037 ◽

2018 ◽

Vol 21 (4) ◽

pp. 146-154 ◽

Cited By ~ 23

Author(s):

Amparo Díaz-Román ◽

Junhua Zhang ◽

Richard Delorme ◽

Anita Beggiato ◽

Samuele Cortese

Keyword(s):

Systematic Review ◽

Autism Spectrum Disorders ◽

Evidence Synthesis ◽

Meta Analysis ◽

Autism Spectrum ◽

Newcastle Ottawa Scale ◽

Spectrum Disorders ◽

Sleep Alterations ◽

The Impact ◽

Ottawa Scale

BackgroundSleep problems are common and impairing in individuals with autism spectrum disorders (ASD). Evidence synthesis including both subjective (ie, measured with questionnaires) and objective (ie, quantified with neurophysiological tools) sleep alterations in youth with ASD is currently lacking.ObjectiveWe conducted a systematic review and meta-analysis of subjective and objective studies sleep studies in youth with ASD.MethodsWe searched the following electronic databases with no language, date or type of document restriction up to 23 May 2018: PubMed, PsycInfo, Embase+Embase Classic, Ovid Medline and Web of Knowledge. Random-effects models were used. Heterogeneity was assessed with Cochran’s Q and I2 statistics. Publication (small studies) bias was assessed with final plots and the Egger’s test. Study quality was evaluated with the Newcastle Ottawa Scale. Analyses were conducted using Review Manager and Comprehensive Meta-Analysis.FindingsFrom a pool of 3359 non-duplicate potentially relevant references, 47 datasets were included in the meta-analyses. Subjective and objective sleep outcome measures were extracted from 37 and 15 studies, respectively. Only five studies were based on comorbidity free, medication-naïve participants. Compared with typically developing controls, youth with ASD significantly differed in 10/14 subjective parameters and in 7/14 objective sleep parameters. The average quality score in the Newcastle-Ottawa Scale was 5.9/9.Discussion and clinical implicationsA number of subjective and, to a less extent, objective sleep alterations might characterise youth with ASD, but future studies should assess the impact of pharmacological treatment and psychiatric comorbidities.

Download Full-text

Reduction of ileocolic intussusception under sedation or anaesthesia: a systematic review of complications

Archives of Disease in Childhood ◽

10.1136/archdischild-2021-322706 ◽

2021 ◽

pp. archdischild-2021-322706

Author(s):

Moran Gal ◽

Shirly Gamsu ◽

Ron Jacob ◽

Daniel M Cohen ◽

Itai Shavit

Keyword(s):

Systematic Review ◽

Intestinal Perforation ◽

English Language ◽

Data Extraction ◽

Current Data ◽

Pulmonary Aspiration ◽

Ileocolic Intussusception ◽

Newcastle Ottawa Scale ◽

Permanent Neurological Deficit ◽

Ottawa Scale

BackgroundDespite the increased use of sedation in children undergoing stressful procedures, reduction of ileocolic intussusception (RII) is usually performed on awake children without any form of sedation.ObjectiveTo evaluate the incidence of severe complications of RII under sedation or anaesthesia.DesignA systematic review including English language original articles of any date.PatientsChildren undergoing RII (pneumatic or hydrostatic) under sedation or anaesthesia.Data sourcesOvid Embase, Scopus, PubMed, the Cochrane Database of Systematic Reviews and the internet search engine Google Scholar.Data extractionThree authors independently reviewed each article for eligibility. The Newcastle-Ottawa Scale was used to assess the quality of included studies.Main outcome measuresThe primary outcome was the incidence of intestinal perforation during RII. The secondary outcomes were the incidence of sentinel adverse events defined as death, cardiopulmonary resuscitation, permanent neurological deficit and pulmonary aspiration syndrome.ResultsThe search yielded 368 articles. Nine studies with 1391 cases were included in the analysis. Of the nine studies, six had a score of ≤6 stars in the Newcastle-Ottawa Scale assessment, indicating low-to-moderate quality. Propofol-based sedation was used in 849 (59.2%) cases; 5 (0.6%) had intestinal perforation. Intestinal perforation was not reported in patients who were sedated with other sedatives. One patient had pulmonary aspiration syndrome.ConclusionsAlthough caution remains warranted, current data suggest that the incidence of severe complications due to RII under sedation or anaesthesia is low. Due to the lack of prospective data, it is difficult to ascertain the exact incidence of severe complications.

Download Full-text

Does the Animal Model Influence in Vertical Alveolar Distraction? A Systematic Review of the Literature

Animals ◽

10.3390/ani10122347 ◽

2020 ◽

Vol 10 (12) ◽

pp. 2347

Author(s):

Mario García-González ◽

Fernando Muñoz ◽

Antonio González-Cantalapiedra ◽

Mónica López-Peña ◽

Nikola Saulacic

Keyword(s):

Systematic Review ◽

Animal Model ◽

Quality Score ◽

Inclusion Criteria ◽

Animal Trials ◽

Mongrel Dog ◽

Medium Quality ◽

Newcastle Ottawa Scale ◽

High Quality Score ◽

Ottawa Scale

This study is aimed at synthesizing all available evidence on vertical alveolar osteogenesis distraction (VAOD) in animal trials to determine whether the animal model used and its handling influence or not, and find which is the most appropriate animal model for this specific technique. This systematic review has been carried out following the PRISMA statements. Bibliographic sources have been consulted manually by two reviewers. Risk of bias was assessed using a version of the Newcastle-Ottawa-Scale (NOS). The selection criteria established by expert researchers were applied in order to decide which studies should be included in the review. Twenty-six studies met the inclusion criteria and were included in the review. Twenty-four of them had a high quality (score between 7 and 9), two medium quality (score between 4 and 6), and none low quality (score between 1 and 3). The highest possible score was 9 (using the NOS). Six studies complied with all NOS criteria. The animal model has been seen to influence the results, leading to failure in some cases. The most used animal model on VAOD, with fewer complications, was the Mongrel dog. The use of the pig and minipig is not recommended, due to the difficulties in handling and complications encountered.

Download Full-text

Depression, anthropometric parameters, and body image in adults: a systematic review

Revista da Associação Médica Brasileira ◽

10.1590/1806-9282.65.5.731 ◽

2019 ◽

Vol 65 (5) ◽

pp. 731-738 ◽

Cited By ~ 5

Author(s):

Daniela Silva ◽

Lara Ferriani ◽

Maria Carmen Viana

Keyword(s):

Systematic Review ◽

Body Image ◽

Anthropometric Parameters ◽

Cross Sectional ◽

Employed Women ◽

Language Restriction ◽

Newcastle Ottawa Scale ◽

The Relationship ◽

Ottawa Scale

SUMMARY OBJECTIVE: To evaluate the association between depression, anthropometric parameters and body image in adults through a systematic review of the literature. METHOD: Medline, Lilacs and PsycInfo databases were searched by two independent reviewers up to August 2018, without language restriction, including cross-sectional, case-control, and cohort studies in adults (18-65 years), of both genders. The quality of the studies was assessed using the Newcastle-Ottawa Scale instrument. The PRISMA standards were adopted for the conduct of this review, whose protocol is registered in PROSPERO, number CRD42018105248. RESULTS: The search resulted in 1,770 articles; however, a total of 5 articles were included in this review, whose designs were transversal. Quality scores ranged from 8 to 9 points. The association between depression, anthropometric parameters, and body image was found in all included studies, regardless of the different statistical methods employed. Women perceived their body larger than it really was by idealizing a lean body, whereas in men the perception of being underweight or dissatisfaction was observed by idealizing a larger body, both conditions were associated with the presence of depression or depressive symptoms and body mass index in the same time. CONCLUSION: Depression, anthropometric parameters and body image were associated. It is necessary to conduct other studies, especially longitudinal studies to elucidate the relationship among depression, weight, body image, and other associated factors.

Download Full-text

Metabolic Syndrome and Its Components in Patients with COVID-19: Severe Acute Respiratory Syndrome (SARS) and Mortality. A Systematic Review and Meta-Analysis

Journal of Cardiovascular Development and Disease ◽

10.3390/jcdd8120162 ◽

2021 ◽

Vol 8 (12) ◽

pp. 162

Author(s):

Sergio Rico-Martín ◽

Julián F. Calderón-García ◽

Belinda Basilio-Fernández ◽

María Zoraida Clavijo-Chamorro ◽

Juan F. Sánchez Muñoz-Torrero

Keyword(s):

Systematic Review ◽

Metabolic Syndrome ◽

Severe Acute Respiratory Syndrome ◽

Meta Analysis ◽

Risk Of Bias ◽

Newcastle Ottawa Scale ◽

Abstract Screening ◽

The Relationship ◽

Metabolic Comorbidities ◽

Ottawa Scale

Recent meta-analysis studies have reported that metabolic comorbidities such as diabetes, obesity, dyslipidaemia and hypertension are associated with higher risk of severe acute respiratory syndrome (SARS) and mortality in patients with COVID-19. This meta-analysis aims to investigate the relationship between metabolic syndrome (MetS) and its components with SARS and mortality in COVID-19 patients. Methods: A systematic search was conducted in the several databases up until 1 September 2021. Primary observational longitudinal studies published in peer review journals were selected. Two independent reviewers performed title and abstract screening, extracted data and assessed the risk of bias using the Newcastle–Ottawa Scale. Results: The random effects meta-analysis showed that MetS was significantly associated with SARS with a pooled OR (95% CI) of 3.21 (2.88–3.58) and mortality with a pooled OR (95% CI) of 2.32 (1.16–4.63). According to SARS, the pooled OR for MetS was 2.19 (1.71–2.67), p < 0.001; significantly higher than the hypertension component. With regard to mortality, although the pooled OR for MetS was greater than for its individual components, no significant differences were observed. Conclusions: this meta-analysis of cohort studies, showed that MetS is better associated to SARS and mortality in COVID-19 patients than its individual components.

Download Full-text

Efficacy and safety of tocilizumab in the management of COVID-19: A systematic review and meta-analysis of observational studies

10.1101/2021.01.27.21250599 ◽

2021 ◽

Author(s):

Gollapalle L Viswanatha ◽

CH K V L S N Anjana Male ◽

Hanumanthappa Shylaja

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Standard Of Care ◽

Efficacy And Safety ◽

Risk Of Mortality ◽

Significant Difference ◽

Newcastle Ottawa Scale ◽

Soc Control ◽

Ottawa Scale

AbstractBackgroundThis systematic review and meta-analysis was aimed to evaluate the efficacy and safety of tocilizumab (TCZ) in treating severe coronavirus disease 2019 (COVID-19).MethodsThe electronic search was performed using PubMed, Scopus, CENTRAL, and Google scholar to identify the retrospective observational reports. The studies published from 01 January 2020 to 30th September 2020. Participants were hospitalized COVID-19 patients. Interventions included tocilizumab versus placebo/standard of care. The comparison will be between TCZ versus standard of care (SOC)/placebo. Inconsistency between the studies was evaluated with I2 and quality of the evidences were evaluated by Newcastle-Ottawa scale.ResultsBased on the inclusion criteria there were 24 retrospective studies involving 5686 subjects were included. The outcomes of the meta-analysis have revealed that the TCZ has reduced the mortality (M-H,RE-OR −0.11(−0.18 to −0.04) 95% CI, p =0.001, I2 =88%) and increased the incidences of super-infections (M-H, RE-OR 1.49(1.13 to 1.96) 95% CI, p=0.004, I2=47%). However, there is no significant difference in ICU admissions rate (M-H, RE-OR −0.06(−0.23 to 0.12), I2=93%), need of MV (M-H, RE-OR of 0.00(−0.06 to 0.07), I = 74%), LOS (IV −2.86(−0.91 to 3.38), I2=100%), LOS-ICU (IV: −3.93(−12.35 to 4.48), I2=100%), and incidences of pulmonary thrombosis (M-H, RE-OR 1.01 (0.45 to 2.26), I2=0%) compared to SOC/control.ConclusionBased on cumulative low to moderate certainty evidence shows that TCZ could reduce the risk of mortality in hospitalized patients. However, there is no statistically significant difference observed between the TCZ and SOC/control groups in other parameters.

Download Full-text

Efficiency and Quality of Data Collection Among Public Mental Health Surveys Conducted During the COVID-19 Pandemic: Systematic Review

Journal of Medical Internet Research ◽

10.2196/25118 ◽

2021 ◽

Vol 23 (2) ◽

pp. e25118

Author(s):

Yu-Hsuan Lin ◽

Chung-Yen Chen ◽

Shiow-Ing Wu

Keyword(s):

Mental Health ◽

Systematic Review ◽

Data Collection ◽

Health Surveys ◽

Public Mental Health ◽

World Health ◽

Quality Of Data ◽

Newcastle Ottawa Scale ◽

Ottawa Scale

Background The World Health Organization has recognized the importance of assessing population-level mental health during the COVID-19 pandemic. During a global crisis such as the COVID-19 pandemic, a timely surveillance method is urgently needed to track the impact on public mental health. Objective This brief systematic review focused on the efficiency and quality of data collection of studies conducted during the COVID-19 pandemic. Methods We searched the PubMed database using the following search strings: ((COVID-19) OR (SARS-CoV-2)) AND ((Mental health) OR (psychological) OR (psychiatry)). We screened the titles, abstracts, and texts of the published papers to exclude irrelevant studies. We used the Newcastle-Ottawa Scale to evaluate the quality of each research paper. Results Our search yielded 37 relevant mental health surveys of the general public that were conducted during the COVID-19 pandemic, as of July 10, 2020. All these public mental health surveys were cross-sectional in design, and the journals efficiently made these articles available online in an average of 18.7 (range 1-64) days from the date they were received. The average duration of recruitment periods was 9.2 (range 2-35) days, and the average sample size was 5137 (range 100-56,679). However, 73% (27/37) of the selected studies had Newcastle-Ottawa Scale scores of <3 points, which suggests that these studies are of very low quality for inclusion in a meta-analysis. Conclusions The studies examined in this systematic review used an efficient data collection method, but there was a high risk of bias, in general, among the existing public mental health surveys. Therefore, following recommendations to avoid selection bias, or employing novel methodologies considering both a longitudinal design and high temporal resolution, would help provide a strong basis for the formation of national mental health policies.

Download Full-text