scholarly journals Association between Anticholinergic Burden and Constipation: A Systematic Review

Healthcare ◽  
2021 ◽  
Vol 9 (5) ◽  
pp. 581
Author(s):  
Héctor Rodríguez-Ramallo ◽  
Nerea Báez-Gutiérrez ◽  
Elena Prado-Mel ◽  
Eva Rocío Alfaro-Lara ◽  
Bernardo Santos-Ramos ◽  
...  

The association between anticholinergic burden and constipation is not well defined and documented; for this reason, a systematic review was carried out in five databases (Medline, Embase, Cochrane Central Register of Controlled Trials, CINAHL, and Scopus), including studies assessing the correlation between anticholinergic burden, and constipation between January 2006 and December 2020. Data extraction was conducted independently by two researchers. Abstracts and titles were reviewed to determine eligibility for review with eligible articles read in full. From 2507 identified articles, 11 were selected for this review: six cross-sectional studies, four retrospective cohort studies, and a post hoc analysis of a randomized clinical trial. Overall, nine studies reported at least one statistical association between anticholinergic burden and constipation, finding 13 positive results out of 24 association measurements. A total of 211,921 patients were studied. The association between constipation and anticholinergic burden could be demonstrated in studies including 207,795 patients. Most studies were not designed to find differences in constipation prevalence and did not adjust the results by confounding factors. Our findings suggest that a correlation between anticholinergic burden and constipation exists. Higher quality-evidence studies are needed, including analysis that considers confounding factors, such as other non-pharmacological causes of constipation.

BMJ Open ◽  
2017 ◽  
Vol 7 (11) ◽  
pp. e014611 ◽  
Author(s):  
Caio Chaves Guimaraes ◽  
Rogério Heládio Lopes Motta ◽  
Cristiane de Cássia Bergamaschi ◽  
Jimmy de Oliveira Araújo ◽  
Natalia Karol de Andrade ◽  
...  

IntroductionThe use of vasoconstrictors combined with local anaesthetics (LAs) in dentistry for patients with cardiovascular disease (CVD) is still controversial in the scientific literature. It raises concerns regarding the possibility of transient episodes, triggering negative cardiovascular outcomes.Method/designTrials eligible for our systematic review will enrol patients with CVD who have undergone dental treatments carried out with the use of LAs by comparing two arms: LAs with vasoconstrictors and LAs without vasoconstrictors. The research will be conducted in the electronic databases, namely Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, Healthstar (via Ovid), Cumulative Index to Nursing and Allied Health Literature and Web of Science, from their inception to December 2017, without any restrictions in terms of language and status of publication. A team of reviewers will independently assess titles, abstracts and complete text to determine eligibility. For eligible studies, the same reviewers will perform data extraction and evaluate the risk of bias in the selected articles. The selected outcomes comprise death, mortality by a specific cause, stroke, acute myocardial infarction, hospitalisation, pain, bleeding, arrhythmias, ischaemic episodes, anxiety, adverse effects, changes in blood pressure, changes in heart rate, anxiety and results obtained via oximetry. Whenever possible, we will conduct a meta-analysis to establish the effects of LAs with and without vasoconstrictors in the patients with CVD, and the overall quality of evidence for each outcome will be determined using the Grading of Recommendations Assessment, Development and Evaluation classification system.Ethics and disseminationEthics committee approval was not necessary because this is a protocol of systematic review. This systematic review will be submitted for presentation at conferences and for publication in a peer-reviewed journal. Our review will assess the risks of cardiovascular events when using LAs with and without vasoconstrictors in patients with CVD, focusing on important clinical outcomes.PROSPERO registration numberCRD42016045421.


Rheumatology ◽  
2019 ◽  
Vol 59 (5) ◽  
pp. 1031-1040 ◽  
Author(s):  
Cristina Macía-Villa ◽  
Eugenio De Miguel

Abstract Objective To perform a systematic review of the literature to evaluate the use of the enthesis ultrasound Madrid Sonographic Entesis Index (MASEI) from its publication. Methods A systematic search of MEDLINE, EMBASE, and Cochrane Central Register databases was performed. The search strategy was constructed to identify publications containing terms related to enthesis and ultrasound. The only applied filter was studies conducted in humans. One reviewer systematically screened the search. A second reviewer verified the selection. The data extraction was focused on study characteristics, including population and components of the OMERACT filter. Results Sixty-eight of the 1581 identified studies had used MASEI, including 41 (60%) abstracts and 27 (40%) articles. Of the 27 articles, MASEI was mainly used for spondyloarthritis and related diseases in 12 (44%) articles, followed by both psoriatic arthritis and rheumatoid arthritis in five (19%) articles; however, it was also used in diseases such as Behçet disease, FM, familiar Mediterranean fever, SS, crystal arthropathies and systemic sclerosis. The feasibility of MASEI was reported in three (11%) articles, and the reliability in 12 (44%) with good to excellent values. No article evaluated the responsiveness to treatment. The construct validity of MASEI was assessed using biomarkers in seven (26%) articles, clinical examination in 13 (48%) and imaging procedures (only X-rays) in two (7%). The discriminative validity was assessed in 16 (59%) articles, not only in SpAs. Conclusion MASEI is a feasible, reliable and valid ultrasound score for the study of enthesis in spondyloarthritis, psoriatic arthritis and other diseases.


2021 ◽  
pp. 088506662110529
Author(s):  
Daisuke Hasegawa ◽  
Ryota Sato ◽  
Narut Prasitlumkum ◽  
Kazuki Nishida

Objective The aim of this study was to conduct a systematic review and meta-analysis to investigate the impact of premorbid beta-blockers on mortality in patients with sepsis. Data Sources We searched EMBASE, the Cochrane Central Register of Controlled Trials, and MEDLINE for eligible studies. The protocol was registered at the PROSPERO (CRD42021256813). Study Selection Two authors independently evaluated the following inclusion criteria: (1) randomized controlled trials, cohort studies, cross-sectional studies; (2) patients with sepsis aged ≥18 years, and (3) premorbid beta-blocker use. Data Extraction Two authors extracted the patients’ characteristics and outcomes independently. All analyses were performed using the random-effects models. The primary outcome was short-term mortality, defined as mortality within 30 days, in-hospital or intensive care unit mortality. Data Synthesis Ten studies (n = 24 748 patients) were included. The pooled odds ratio (OR) of short-term mortality associated with the premorbid use of beta-blockers was 0.85 (95% confidence interval [CI], 0.69-1.04; P = .12; I2 = 50%). Five studies reported an adjusted OR of short-term mortality. The pooled adjusted OR of short-term mortality associated with the premorbid use of beta-blockers was 0.73 (95% CI, 0.65-0.83; P < .001; I2 = 0%). Conclusion Premorbid beta-blockers were associated with a lower short-term mortality in patients with sepsis.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Eman Abukmail ◽  
Mina Bakhit ◽  
Chris Del Mar ◽  
Tammy Hoffmann

Abstract Background Understanding prognostic information can help patients know what may happen to their health over time and make informed decisions. However, communicating prognostic information well can be challenging. Purpose To conduct a systematic review to identify and synthesize research that has evaluated visual presentations that communicate quantitative prognostic information to patients or the public. Data sources MEDLINE, EMBASE, CINAHL, PsycINFO, ERIC and the Cochrane Central Register of Controlled Trials (CENTRAL) (from inception to December 2020), and forward and backward citation search. Study selection Two authors independently screened search results and assessed eligibility. To be eligible, studies required a quantitative design and comparison of at least one visual presentation with another presentation of quantitative prognostic information. The primary outcome was comprehension of the presented information. Secondary outcomes were preferences for or satisfaction with the presentations viewed, and behavioral intentions. Data extraction Two authors independently assessed risk of bias and extracted data. Data synthesis Eleven studies (all randomized trials) were identified. We grouped studies according to the presentation type evaluated. Bar graph versus pictograph (3 studies): no difference in comprehension between the groups. Survival vs mortality curves (2 studies): no difference in one study; higher comprehension in survival curve group in another study. Tabular format versus pictograph (4 studies): 2 studies reported similar comprehension between groups; 2 found higher comprehension in pictograph groups. Tabular versus free text (3 studies): 2 studies found no difference between groups; 1 found higher comprehension in a tabular group. Limitations Heterogeneity in the visual presentations and outcome measures, precluding meta-analysis. Conclusions No visual presentation appears to be consistently superior to communicate quantitative prognostic information.


2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Aldona Pietrzak ◽  
Ewelina Grywalska ◽  
Mateusz Socha ◽  
Jacek Roliński ◽  
Kinga Franciszkiewicz-Pietrzak ◽  
...  

Although fungal colonization is implicated in the pathogenesis of psoriasis, its prevalence remains unclear. The aim of this systematic review and meta-analysis was to provide an overview on the prevalence of Candida species in patients with psoriasis. We searched databases (MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and http://clinicaltrials.gov) to identify studies involving subjects of any age with an established diagnosis of psoriasis and healthy controls, who were tested for carriage of Candida spp. on the skin or mucosal membranes (or saliva and stool), or presented with clinical candidiasis with microbiologically confirmed etiology. We identified nine cross-sectional studies including a total of 1038 subjects with psoriasis (psoriatics) and 669 controls. We found Candida species detection rates for psoriatics were significantly higher than those in the controls, especially in the oral mucosa milieux. These results suggest psoriasis may be one of the systemic diseases that predispose to oral Candida spp. carriage and infection.


2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Lucas Bandeira Marchesan ◽  
Ramon Bossardi Ramos ◽  
Monica Oliveira ◽  
Poli Mara Spritzer

Abstract Introduction. PCOS is a frequent endocrine disease and its clinical expression may be influenced by ethnicity and sociocultural backgrounds. Despite its high prevalence, few studies are available regarding clinical characteristics of Brazilian women with PCOS. The aim of this study was to summarize the available evidence regarding metabolic risks in PCOS population in Brazil trough a systematic review and meta-analysis. Materials and Methods. We systematically searched EMBASE, MEDLINE, Cochrane Central Register of Controlled Trials for studies published until July 31, 2019. Results. Eleven cross-sectional and case-control studies were selected for the present meta-analysis, including 898 women diagnosed with PCOS and 2176 controls. All used the Rotterdam criteria for the diagnosis of PCOS. Compared to controls, BMI was higher in PCOS [standardized mean difference (SMD) 0.67 (95% CI 0.29, 1.05) I²=91%], as well as waist circumference [SMD 0.88 (0.40, 1.37) I²=93%]. Systolic and diastolic blood pressure were higher in PCOS, SMD 0.66 (0.30, 1.01) I²=83%, SMD 0.55 (0.24, 0.87) I²=81%, respectively. Glucose and HOMA-IR were higher in PCOS, SMD 0.22 (0.02, 0.41) I²= 57%, SMD 0.78 (0.52, 1.04) I² =26% respectively. Regarding lipid profile, PCOS had higher values for triglyceride [SMD= 0.39 (0.14, 0.64, I² =63%)], total cholesterol [SMD 0.36 (0.15, 0.57, I²=57%)] and LDL [SMD 0.44 (0.11, 0.78, I²=82%)] and lower values for HDL [SMD -0.56 (-0.78, -0.34) I²=68%]. Conclusions. Even though the studies considered were observational, including mostly small samples, the evidence from this meta-analysis indicates women with PCOS from different regions of Brazil present worse cardiometabolic profile than women without PCOS. This systematic review and meta-analysis is registered in PROSPERO (CRD42016038537).


2020 ◽  
Author(s):  
Geovanna Cárdenas ◽  
Francisco Novillo ◽  
Shuheng Lai ◽  
Héctor Fuenzalida ◽  
Francisca Verdugo ◽  
...  

ABSTRACTObjectiveThe objective of this systematic review is to assess the impact of oxymetazoline in patients with moderate to severe rosacea.Data SourcesWe will conduct a comprehensive search in PubMed/Medline, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), Lilacs, the International Clinical Trials Registry Platform (ICTRP), ClinicalTrials.gov, US National Institutes of Health (NIH) and grey literature, to identify all relevant randomized controlled trials regardless of language or publication status (published, unpublished, in press and in progress).Eligibility criteria for selecting studies and methodsWe will include randomized trials evaluating the effect of oxymetazoline in patients with moderate to severe rosacea. Two reviewers will independently screen each study for eligibility, data extraction, and assess the risk of bias. We will pool the results using meta-analysis and will apply the GRADE [1] system to assess the certainty of the evidence for each outcome.Ethics and DisseminationNo ethics approval is considered necessary. The results of this review will be widely disseminated via peer-reviewed publications, social networks and traditional media.Protocol and RegistrationThis protocol was adapted to the specificities of the question assessed in this review and registered to PROSPERO with the ID CRD42020150262.


2021 ◽  
Vol 2021 ◽  
pp. 1-11
Author(s):  
Cynthia Engels ◽  
Robin Bairet ◽  
Florence Canoui-Poitrine ◽  
Marie Laurent

Introduction. Self-care, leisure, and productivity are important occupational domains for older adults’ quality of life, which might be affected by cancer and its treatment. A great number of publications about older adults focus on function or self-care, so we aimed to analyse how cancer and its treatments affect leisure and productivity. Secondary objectives were to identify whether particular clinical and/or sociodemographic factors were associated with occupational disruptions and to assess the impact of rehabilitation approaches on leisure and productivity in this population. Methods. A systematic review of the 2009-2019 literature performed on Medline, Embase, and the Cochrane Central Register of Controlled Trials. Results. 1471 publications were retrieved: 48 full texts were assessed; seven of these (four cross-sectional studies, two cohort studies, and a case report) were reviewed, including data on 16668 people (12649 healthy controls, 3918 cancer survivors, and 101 ill patients). Older adults with comorbidities and a low level of activity before cancer diagnosis may be more at risk of occupational disruptions. However, studies focused more on physical activity than leisure and productivity. Two studies mentioned occupational therapy. Discussion. As cancer can become a chronic disease, it appears important to also offer occupation-centred assessments and follow-up. Conclusion. An occupation-centred approach could be developed; its effectiveness must be assessed.


2021 ◽  
Author(s):  
Hitesh Chander Mittal ◽  
Ram Bajpai ◽  
Rajesh Kumar Singh ◽  
Utkal Mohanty

Abstract Background Dental fluorosis has lifelong health impacts which can range from risk of dental caries to loss of teeth as well as aesthetic issues having psychological effects. The dental fluorosis burden in terms of its overall prevalence in India is lacking. Knowledge about the prevalence of dental fluorosis is important for healthcare planning and resource allocation. Therefore, this study aimed to estimate the pooled prevalence of dental fluorosis in India and its associated factors.Methods A systematic search of electronic databases viz. MEDLINE (via PubMed), IndMed, Web of Science, and the Cochrane Central Register of Controlled Trials (CENTRAL), and WHOLIS (WHO library database) will be undertaken from inception to 15th February 2021. Two investigators will independently screen the search results followed by full-text screening for inclusion in the review as per predefined criteria. The data will be extracted for included studies using a pre-designed data extraction form and results will be presented in tabulated form. The meta-analysis will be performed for a homogeneous group of studies if found any. Sensitivity analysis will be performed to address the heterogeneity across studies.Discussion This review will describe and summarize the available epidemiological evidence in India in terms of overall prevalence, geographical distribution, and associated factors of dental fluorosis. Further, the finding of this systematic review will be the result of the methodological assessment of the published literature. Understanding the epidemiology of dental fluorosis terms would help in identifying focus areas for intervention as well as better planning and utilization of scarce resources. Systematic review registration: PROSPERO, CRD42021235670


BDJ Open ◽  
2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Ilona G Johnson ◽  
Rhiannon J Jones ◽  
Jennifer E. Gallagher ◽  
William G. Wade ◽  
Waraf Al-Yaseen ◽  
...  

Abstract Introduction The emergence of the SARS-CoV-2 virus and subsequent COVID-19 pandemic has had a significant effect on the delivery of routine dentistry; and in particular, periodontal care across the world. This systematic review examines the literature relating to splatter, droplet settle and aerosol for periodontal procedures and forms part of a wider body of research to understand the risk of contamination in relation to periodontal care procedures relevant to COVID-19. Methods A search of the literature was carried out using key terms and MeSH words relating to the review questions. Sources included Medline (OVID), Embase (OVID), Cochrane Central Register of Controlled Trials, Scopus, Web of Science and LILACS, ClinicalTrials.Gov. Studies meeting inclusion criteria were screened in duplicate and data extraction was carried out using a template. All studies were assessed for methodological quality and sensitivity. Narrative synthesis was undertaken. Results Fifty studies were included in the review with procedures including ultrasonic scaling (n = 44), air polishing (n = 4), prophylaxis (n = 2) and hand scaling (n = 3). Outcomes included bacterial (colony-forming units e.g. on settle plates) or blood contamination (e.g. visible splatter) and non bacterial, non blood (e.g. chemiluminescence or coloured dyes) contamination. All studies found contamination at all sites although the contamination associated with hand scaling was very low. Contamination was identified in all of the studies even where suction was used at baseline. Higher power settings created greater contamination. Distribution of contamination varied in relation to operator position and was found on the operator, patient and assistant with higher levels around the head of the operator and the mouth and chest of the patient. Settle was identified 30 min after treatments had finished but returned to background levels when measured at or after an hour. The evidence was generally low to medium quality and likely to underestimate contamination. Conclusion Ultrasonic scaling, air polishing and prophylaxis procedures produce contamination (splatter, droplets and aerosol) in the presence of suction, with a small amount of evidence showing droplets taking between 30 min and 1 h to settle. Consideration should be given to infection control, areas of cleaning particularly around the patient and appropriate personal protective equipment, with particular attention to respiratory, facial and body protection for these procedures. In addition, the use of lower power settings should be considered to reduce the amount and spread of contamination.


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