scholarly journals The effect of early exercise on intracranial pressure in neurocritical patients: a systematic review

2020 ◽  
Vol 3 (2) ◽  
pp. 40-45
Author(s):  
Sayu Aryantari Putri Thanaya ◽  
Putu Eka Mardhika
Keyword(s):  
Systematic Review ◽  
Intracranial Pressure ◽  
Range Of Motion ◽  
Isometric Exercise ◽  
Review Literature ◽  
Increased Intracranial Pressure ◽  
Early Exercise ◽  
Literature Searches ◽  
Motion Exercise ◽  
Meta Analyses

Background: Neurocritical patients commonly present with increased intracranial pressure and are regularly treated with physiotherapy through exercise early after admission to the intensive care unit. However, the effect of exercise on intracranial pressure is minimally investigated, and there appears to be no systematic reviews or meta-analyses addressing this topic in the published literature. This study aimed to determine the effect of exercise on the intracranial pressure of neurocritical patients. Methods: Through a systematic review, literature searches on PubMed, PEDro, and CENTRAL were conducted in January 2020. The keywords used were: “physical therapy”, “physiotherapy”, “exercise”, “range of motion”, “intracranial pressure”, and “ICP”, combined using Boolean operators “OR” and “AND”. Only studies published in the English and Indonesian language were considered. Results: A total of five studies involving 193 patients (mean age 41-56 years old) were included in this review. Most included studies reported that intracranial pressure did not change significantly after passive range of motion exercise, and some studies found that intracranial pressure actually decreased significantly during and after passive range of motion and active exercise. An additional finding was that isometric exercise significantly increased mean intracranial pressure in patients with normal intracranial pressure. All studies reported that exercise could be used safely in patients. Conclusion: Exercise, in particular passive range of motion, does not increase the intracranial pressure of neurocritical patients and does not lead to any adverse effects, as long as isometric or Valsalva-like maneuvers are avoided.

scholarly journals Impact of Non-Confinement Accommodation on Farrowing Performance: A Systematic Review and Meta-Analysis of Farrowing Crates Versus Pens

Animals ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. 957 ◽  
Author(s):  
Dannielle Glencorse ◽  
Kate Plush ◽  
Susan Hazel ◽  
Darryl D’Souza ◽  
Michelle Hebart
Keyword(s):  
Systematic Review ◽  
Relative Risk ◽  
Web Of Science ◽  
Meta Analysis ◽  
Inclusion Criteria ◽  
Literature Searches ◽  
Piglet Mortality ◽  
Partial Confinement ◽  
Meta Analyses ◽  
Piglet Survival

There are conflicting reports regarding the effect of farrowing house accommodation on piglet performance. The aim of this investigation was to use a systematic review and meta-analyses to summarise the results of publications that focused on direct comparisons between full confinement conventional crates and various designs of loose-housed farrowing pens from loading until weaning. Literature searches in Scopus, BIOSIS Previews, Cab Abstracts, and Web of Science identified 6695 articles. Twenty-two publications were retained for the systematic review and individual meta-analyses after screening for inclusion criteria. The random effects meta-analyses were performed on crate versus pen for number of piglets born alive, number of stillborn piglets, pre-weaning mortality, and number of piglets weaned. Additionally, the modifiers of confinement length (no confinement from loading until weaning or partial confinement for shorter periods of time in the early stages post parturition), enrichment (no enrichment or enrichment provided), and pen size (small, medium, or large) were examined. There was a 14% increase in the relative risk of piglet mortality in farrowing pens when they were compared with crates (p = 0.0015). The number of stillborns per litter was not different between the pen and crate. However, when providing enrichment in the pens, there was an increase in stillborns within farrowing crates versus pens (p = 0.009). There was no overall effect on piglets that were born alive or number weaned. As there is no difference between piglets born alive and mortality is significantly higher in farrowing pens, a reduction in the number of piglets weaned was expected but not observed, which was possibly due to the lack of weaning details provided in the publications. This was the first systematic review and meta-analysis conducted on the performance of farrowing accommodation and identified that farrowing pens do compromise post-natal piglet survival. Future efforts should focus on improving sow comfort in the farrowing crate to maximize both piglet and sow welfare.

scholarly journals Prevention and Management of Hormonal Crisis during Theragnosis with LU-DOTA-TATE in Neuroendocrine Tumors. A Systematic Review and Approach Proposal

2020 ◽  
Vol 9 (7) ◽  
pp. 2203 ◽  
Author(s):  
Maria Isabel del Olmo-García ◽  
Maria Angustias Muros ◽  
Martín López-de-la-Torre ◽  
Marc Agudelo ◽  
Pilar Bello ◽  
...  
Keyword(s):  
Systematic Review ◽  
Neuroendocrine Tumors ◽  
Somatostatin Receptors ◽  
Somatostatin Analogs ◽  
Progression Free Survival ◽  
Metabolic Complications ◽  
Literature Searches ◽  
Prisma Statement ◽  
Well Differentiated ◽  
Meta Analyses

Neuroendocrine tumors (NETs) frequently overexpress somatostatin receptors (SSTR) on their cell surface. The first-line pharmacological treatment for inoperable metastatic functioning well-differentiated NETs are somatostatin analogs. On second line, Lu-DOTA-TATE (177Lu-DOTA0 Tyr 3 octreotate) has shown stabilization of the disease and an increase in progression free survival, as well as effectiveness in controlling symptoms and increasing quality of life. The management of functional NETs before and during LU-DOTA-TATE treatment is specially challenging, as several complications such as severe carcinoid and catecholamine crisis have been described. The aim of this review is to establish practical guidance for the management and prevention of the most common hormonal crises during radionuclide treatment with Lu-DOTA-TATE: carcinoid syndrome (CS) and catecholamine hypersecretion, as well as to provide a brief commentary on other infrequent metabolic complications. To establish a practical approach, a systematic review was performed. This systematic review was developed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and conducted using MEDLINE (accessed from PubMed), Google Scholar and ClinicalTrials.gov. Literature searches found 449 citations, and finally nine were considered for this systematic review.

TNF-Alpha Inhibitors and Rhinosinusitis—A Systematic Review and Meta-Analysis

2020 ◽  
Vol 34 (3) ◽  
pp. 436-442
Author(s):  
Zalan Piski ◽  
Imre Gerlinger ◽  
Nelli Nepp ◽  
Kornelia Farkas ◽  
Rainer Weber
Keyword(s):  
Systematic Review ◽  
Maxillary Sinusitis ◽  
Meta Analysis ◽  
Prescription Medication ◽  
Review Literature ◽  
Healthy Population ◽  
Necrosis Factor Alpha ◽  
Antagonist Therapy ◽  
Scientific Databases ◽  
Literature Searches

Background Tumor necrosis factor alpha (TNFα) plays key role in immunologic process. Patients receiving anti-TNFα therapy may likely be more predisposed to infections including sinus disorders. Objectives Our aims were to review literature and evaluate data regarding TNFα antagonist therapy and its association with reference to various sinus disorders in the form of a systematic review and meta-analysis. Methods Different keyword combinations were used in the screening of the literature including leading scientific databases (PubMed, Embase, and Web of Science). Papers reporting sinus disorders as supposed adverse events of the treatment were included into the meta-analysis. Results A thorough review of literature searches extracted 1154 records and 8 articles were found through other sources. Seventeen papers fulfilled our criteria for inclusion into the meta-analysis. Among 16 174 observed patients, 3018 suffered from a sinus infection. An event rate (ER) of 0.058 was calculated for all the cases. Analysis with regard to the confirmed diseases showed an 0.038 ER. Calculations were performed in accordance to the diagnostic categories used for sinus disorder. Six groups were found including the following: “Bacterial Sinusitis” (ER: 0.046), “Chronic Rhinosinusitis” (ER: 0.027), “Sinusitis Requiring Prescription Medication” (ER: 0.295), “Recurrent Sinusitis” (ER: 0.070), “Sinusitis” (ER: 0.076), “Acute Rhinosinusitis” (ER: 0.002) and, lastly, “Maxillary Sinusitis” (ER: 0.028). Conclusions Our results exhibited a similar prevalence to the healthy population; therefore, infective sinus disorders cannot directly be considered as complications of TNFα antagonist therapy.

scholarly journals Optic nerve sheath diameter sonography for the diagnosis of increased intracranial pressure: a systematic review and meta-analysis protocol

BMJ Open ◽  
2017 ◽  
Vol 7 (8) ◽  
pp. e016194 ◽  
Author(s):  
Alex Koziarz ◽  
Niv Sne ◽  
Fraser Kegel ◽  
Waleed Alhazzani ◽  
Siddharth Nath ◽  
...  
Keyword(s):  
Systematic Review ◽  
Optic Nerve ◽  
Intracranial Pressure ◽  
Diagnostic Accuracy ◽  
Meta Analysis ◽  
Optic Nerve Sheath Diameter ◽  
Increased Intracranial Pressure ◽  
Nerve Sheath ◽  
Registration Number ◽  
Increased Icp

IntroductionIncreased intracranial pressure (ICP) is a significant neurological issue that may lead to permanent neurological sequelae. When evaluating patients with traumatic brain injury, it is crucial to identify those with high ICP in order to expedite ICP lowering measures and maintain adequate cerebral perfusion. Several measures are used to recognise patients with increased ICP including CT scan, MRI, ICP monitor, and lumbar puncture (LP). However, these tests can be invasive, associated with radiation exposure, contraindicated, or not readily available. Ultrasonography measurement of the optic nerve sheath diameter (ONSD) is proposed as a non-invasive and quick measure to identify high ICP. The aim of this systematic review and meta-analysis will be to examine the accuracy of ONSD sonography for increased ICP diagnosis.Methods and analysesWe will include published and unpublished randomised controlled trials, observational studies, and abstracts, with no publication type or language restrictions. Search strategies will be designed to peruse the MEDLINE, Embase, Web of Science, WHO Clinical Trials, ClinicalTrials.gov, CINAHL, and the Cochrane Library databases. We will also implement strategies to search grey literature. Two reviewers will independently complete data abstraction and conduct quality assessment. Included studies will be assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool. We will construct the hierarchical summary receiver operating characteristic curve for included studies and pool sensitivity and specificity using the bivariate model. We also plan to conduct prespecified subgroup analyses to explore heterogeneity. The overall quality of evidence will be rated using Grading of Recommendations, Assessment, Development and Evaluations (GRADE).Ethics and disseminationResearch ethics board approval is not required for this study as it draws from published data and raises no concerns related to patient privacy. This review will provide a comprehensive assessment of the evidence on ONSD sonography diagnostic accuracy and is directed to a wide audience. Results from the review will be disseminated extensively through conferences and submitted to a peer-reviewed journal for publication.PROSPERO registration numberCRD42017055485.Clinical trial numberTrial registration number isNCT00783809.

scholarly journals Rehabilitation following meniscal repair: a systematic review

2018 ◽  
Vol 4 (1) ◽  
pp. e000212 ◽  
Author(s):  
Robert C Spang III ◽  
Michael C Nasr ◽  
Amin Mohamadi ◽  
Joseph P DeAngelis ◽  
Ara Nazarian ◽  
...  
Keyword(s):  
Systematic Review ◽  
Range Of Motion ◽  
Clinical Studies ◽  
Weight Bearing ◽  
Meniscal Repair ◽  
Rehabilitation Protocol ◽  
Early Motion ◽  
Accelerated Rehabilitation ◽  
Rehabilitation Protocols ◽  
Meta Analyses

ObjectiveTo review existing biomechanical and clinical evidence regarding postoperative weight-bearing and range of motion restrictions for patients following meniscal repair surgery.Methods and data sourcesFollowing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline, we searched MEDLINE using following search strategy: ((((“Weight-Bearing/physiology”[Mesh]) OR “Range of Motion, Articular”[Mesh]) OR “Rehabilitation”[Mesh])) AND (“Menisci, Tibial”[Mesh]). Additional articles were derived from previous reviews. Eligible studies were published in English and reported a rehabilitation protocol following meniscal repair on human. We summarised rehabilitation protocols and patients’ outcome among original studies.ResultsSeventeen clinical studies were included in this systematic review. There was wide variation in rehabilitation protocols among clinical studies. Biomechanical evidence from small cadaveric studies suggests that higher degrees of knee flexion and weight-bearing may be safe following meniscal repair and may not compromise the repair. An accelerated protocol with immediate weight-bearing at tolerance and early motion to non-weight-bearing with immobilising up to 6 weeks postoperatively is reported. Accelerated rehabilitation protocols are not associated with higher failure rates following meniscal repair.ConclusionsThere is a lack of consensus regarding the optimal postoperative protocol following meniscal repair. Small clinical studies support rehabilitation protocols that allow early motion. Additional studies are needed to better clarify the interplay between tear type, repair method and optimal rehabilitation protocol.

scholarly journals Meta-analyses of the effect of flossing on ankle range of motion and power jump performance

2020 ◽  
Vol 12 (2) ◽  
pp. 19-26
Author(s):  
ANNA PISZ ◽  
KATARINA KRALOVA ◽  
DUSAN BLAZEK ◽  
ARTUR GOLAS ◽  
PETR STASTNY
Keyword(s):  
Systematic Review ◽  
Range Of Motion ◽  
Key Words ◽  
Positive Impact ◽  
Vascular Occlusion ◽  
Mean Difference ◽  
Jump Performance ◽  
The Mean ◽  
Gait Abnormalities ◽  
Meta Analyses

Decreased ankle range of motion (ROM) leads to many disorders, ranging in severity from gait abnormalities to knee and pelvis injuries. Therefore, maintaining full ankle ROM is very important, especially for athletes, for whom ankle ROM may affect their results during competitions. Medical flossing is a technique used by physiotherapists to improve ROM. The aim of this review was to investigate the effect of medical flossing on ankle ROM according to the results in previous studies. ‪The search was conducted with the following key words individually and/or in combinations: range of motion, flossband, mobility bands, vascular occlusion, flossing bands, compression, voodoo floss, and tack floss. F‪rom the identified 5600 articles, only 4 studies were included in this systematic review. The results showed that the mean difference in ROM after treatment was 1.20 cm (Hedge’s g = 0.31, p < 0.01, I2= 89%). ‪There is evidence showing that the application of flossing can be beneficial to increase the ROM. Moreover, some of the studies confirmed a positive impact of flossing on jump performance; nonetheless, data to confirm this effect in this review are insufficient.

The effectiveness of exercise therapy for temporomandibular dysfunction: a systematic review and meta-analysis

2016 ◽  
Vol 31 (8) ◽  
pp. 1039-1048 ◽  
Author(s):  
Shantil M Dickerson ◽  
Jarod M Weaver ◽  
Ashley N Boyson ◽  
Jared A Thacker ◽  
Andrew A Junak ◽  
...  
Keyword(s):  
Systematic Review ◽  
Range Of Motion ◽  
Temporomandibular Joint ◽  
Exercise Therapy ◽  
Meta Analysis ◽  
Functional Improvement ◽  
Level Of Evidence ◽  
Temporomandibular Joint Dysfunction ◽  
Mean Differences ◽  
Meta Analyses

Objective: To investigate the effectiveness of exercise therapy on pain, function, and mobility outcomes in patients with temporomandibular joint dysfunction. Study design: Systematic review with meta-analysis. Methods: A systematic review and meta-analysis undertaken following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies that met the inclusion criteria: (1) randomized controlled trials; (2) a population with the diagnosis of temporomandibular joint dysfunction; and (3) interventions that included exercise therapy were considered for review. When studies demonstrated homogeneity on outcome measures, the mean differences or standardized mean differences with 95% confidence interval were calculated and pooled in a meta-analysis for pooled synthesis. Results: Six articles with a total of 419 participants were included in the review and only four studies were included in the meta-analysis. Mobility and mixed exercise therapy approaches appear to be the most common exercise approaches utilized for management of temporomandibular joint dysfunction. Exercise therapy and the associated dosage provide moderate short-term and varying long-term benefits in reduction of pain and improvement of range of motion of the in patients with temporomandibular joint dysfunction. Conclusion: Included studies suggest a mobility or a mixed approach to exercise therapies have impact on reducing pain, significant impact for increasing range of motion, but lack a significant impact for functional improvement. Level of evidence: Therapy, level 1a-.

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