scholarly journals Smoking and Outcomes After Knee and Hip Arthroplasty: A Systematic Review

2011 ◽  
Vol 38 (9) ◽  
pp. 1824-1834 ◽  
Author(s):  
JASVINDER A. SINGH

Objective.Studies have suggested higher rates of perioperative and postoperative complications in smokers compared to nonsmokers. The objective of this systematic review was to assess the association of smoking and postoperative outcomes following total hip arthroplasty (THA) or total knee arthroplasty (TKA).Methods.A search of 6 databases (The Cochrane Library, Scopus, Proquest Dissertation abstracts, CINAHL, Ovid Medline, and Embase) was performed by a Cochrane librarian. All titles and abstracts were screened by 2 independent reviewers with expertise in performing systematic reviews. Studies were included if they were fully published reports that included smoking and any perioperative or postoperative clinical outcome in patients with TKA or THA.Results.A total of 21 studies were included for the review, of which 6 provided multivariable-adjusted analyses, 14 univariate analyses, and one statistical modeling. For most outcomes, results from 1–2 studies could be pooled. Current smokers were significantly more likely to have any postoperative complication (risk ratio 1.24, 95% CI 1.01 to 1.54) and death (risk ratio 1.63, 95% CI 1.06 to 2.51) compared to nonsmokers. Former smokers were significantly more likely to have any post-operative complication (risk ratio 1.32, 95% CI 1.05 to 1.66) and death (risk ratio 1.69, 95% CI 1.08 to 2.64) compared to nonsmokers.Conclusion.This systematic review found that smoking is associated with significantly higher risk of postoperative complication and mortality following TKA or THA. Studies examining longterm consequences of smoking on implant survival and complications are needed. Smoking cessation may improve outcomes after THA or TKA.

2018 ◽  
Vol 22 (2) ◽  
pp. 122-136 ◽  
Author(s):  
Ashraf Fayad ◽  
Sasha Shillcutt ◽  
Massimiliano Meineri ◽  
Terrence D. Ruddy ◽  
Mohammed Toseef Ansari

Intraoperative use of transesophageal echocardiography (TEE) has become commonplace in high-risk noncardiac surgeries but the balance of benefits and harms remains unclear. This systematic review investigated the comparative effectiveness and harms of intraoperative TEE in noncardiac surgery. We searched Ovid MEDLINE, PubMed, EMBASE, and the Cochrane Library from 1946 to March 2017. Two reviewers independently screened the literature for eligibility. Studies were assessed for the risk of selection bias, confounding, measurement bias, and reporting bias. Three comparative and 13 noncomparative studies were included. Intraoperative TEE was employed in a total of 1912 of 3837 patients. Studies had important design limitations. Data were not amenable to quantitative synthesis due to clinical and methodological diversity. Reported incidence of TEE complications ranged from 0% to 1.7% in patients undergoing various procedures (5 studies, 540 patients). No serious adverse events were observed for mixed surgeries (2 studies, 197 patients). Changes in surgical or medical management attributable to the use of TEE were noted in 17% to 81% of patients (7 studies, 558 patients). The only randomized trial of intraoperative TEE was grossly underpowered to detect meaningful differences in 30-day postoperative outcomes. There is lack of high-quality evidence of effectiveness and harms of intraoperative TEE in the management of non-cardiac surgeries. Evidence, however, indicates timely evaluation of cardiac function and structure, and hemodynamics. Future studies should be comparative evaluating confounder-adjusted impact on both intraoperative and 30-day postoperative clinical outcomes.


2018 ◽  
Author(s):  
Daniel Axelrod ◽  
Kim Madden ◽  
Laura Banfield ◽  
Mitchell Winemaker ◽  
Justin deBeer ◽  
...  

Background: Total hip arthroplasty (THA) is one of the most common surgical procedures. Although THA surgeries are typically very successful, between 3% and 17% of all patients experience trochanteric pain after surgery. Unfortunately, there remains little high quality and reproducible evidence surrounding this disorder, especially following total hip replacement. The objectives of this review are to describe, among pre-operative or post-operative primary THA patients the prevalence, treatments, prognosis, risk factors, and diagnostic methods available for trochanteric pain. Methods: This is a protocol for a descriptive systematic review of trochanteric pain among THA patients. We will include studies of all study designs, with the exception of non-systematic reviews and expert opinion, with no date limits. We will search Medline, Embase, CINAHL, and the Cochrane Library using the Ovid search interface. We will also search the reference lists of included studies for possible missed studies. We will use the systematic review management software Rayyan to assist with study screening. Two reviewers will independently review studies for inclusion and extract data into a study-specific database. Discussion: This study will add to the literature by comprehensively and systematically evaluating the available literature on trochanteric pain after THA. Previous studies have been conducted on the topic but they were not comprehensive or did not review the literature systematically. Additionally, our study will critically evaluate the methodological quality of the included studies, adding an evidence-based component to the review. This review will help orthopaedic surgeons better care for patients with trochanteric pain after THA, and will identify knowledge gaps for future research. Registration: This protocol will be registered on PROSPERO


2018 ◽  
Author(s):  
Daniel Axelrod ◽  
Kim Madden ◽  
Laura Banfield ◽  
Mitchell Winemaker ◽  
Justin deBeer ◽  
...  

Background: Total hip arthroplasty (THA) is one of the most common surgical procedures. Although THA surgeries are typically very successful, between 3% and 17% of all patients experience trochanteric pain after surgery. Unfortunately, there remains little high quality and reproducible evidence surrounding this disorder, especially following total hip replacement. The objectives of this review are to describe, among pre-operative or post-operative primary THA patients the prevalence, treatments, prognosis, risk factors, and diagnostic methods available for trochanteric pain. Methods: This is a protocol for a descriptive systematic review of trochanteric pain among THA patients. We will include studies of all study designs, with the exception of non-systematic reviews and expert opinion, with no date limits. We will search Medline, Embase, CINAHL, and the Cochrane Library using the Ovid search interface. We will also search the reference lists of included studies for possible missed studies. We will use the systematic review management software Rayyan to assist with study screening. Two reviewers will independently review studies for inclusion and extract data into a study-specific database. Discussion: This study will add to the literature by comprehensively and systematically evaluating the available literature on trochanteric pain after THA. Previous studies have been conducted on the topic but they were not comprehensive or did not review the literature systematically. Additionally, our study will critically evaluate the methodological quality of the included studies, adding an evidence-based component to the review. This review will help orthopaedic surgeons better care for patients with trochanteric pain after THA, and will identify knowledge gaps for future research. Registration: This protocol will be registered on PROSPERO


Author(s):  
Soo Yeon Yang ◽  
Seon Heui Lee ◽  
Seung-Joo Chon

(1) Background: The aim of this work was to systematically review existing studies on whether hysteroscopy improves the reproductive outcomes of women with infertility even in the absence of intrauterine pathologies when compared to women who did not receive a hysteroscopy. (2) Methods: We established the Participant-Intervention-Comparison-Outcome strategy and used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement to conduct a systematic review of 11 studies which were retrieved from 3 electronic databases: Ovid-Medline, Ovid-Embase, and the Cochrane Library. Two independent investigators extracted the data from the included studies and used the Cochrane risk-of-bias tool to assess their quality. (3) Results: The primary outcome measures were the clinical pregnancy rates (CPRs) and live birth rates (LBRs) in the in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) cycles. Hysteroscopy in infertile women without intrauterine pathologies showed higher CPRs and LBRs than those in the same population who did not receive hysteroscopy in cases of recurrent implantation failure and IVF (odds ratio: 1.79 and 1.46, 95% confidence interval: 1.46-2.30 and 1.08-1.97 for CPR and LBR, respectively); however, the degree of significance was not as high for LBR. (4) Conclusions: Hysteroscopy before IVF/ICSI in infertile women without intrauterine pathologies may potentially be effective in improving the CPRs and LBRs in patients with RIF. Robust and high-quality randomized trials are warranted to confirm this finding.


2020 ◽  
pp. 112070002097819
Author(s):  
Henryk Haffer ◽  
Michael Müller ◽  
Rudolf Ascherl ◽  
Carsten Perka ◽  
Tobias Winkler

Background: Heterotopic ossification (HO) is defined as the formation of lamellar bone in extraskeletal soft tissues. HO can be a severe complication after hip arthroplasty but can possibly be prevented by postoperative treatment with non-steroidal anti-inflammatory drugs (NSAIDs) or radiotherapy. Diclofenac is 1 of the most used drugs in HO prophylaxis because it is effective and long established. However, there is still no uniform therapy regimen in terms of duration, dose and side effect profile regarding the application of diclofenac in HO prevention. We have, therefore, conducted the first systematic review investigating diclofenac for HO prophylaxis after hip arthroplasty. The aim of this study is to assess the efficacy, dose and duration of diclofenac therapy in preventing HO after total hip arthroplasty (THA). Methods: According to the PRISMA Guidelines we performed a systematic literature search in EMBASE via Ovid, in MEDLINE via PubMed and in the Cochrane Library addressing all studies in English and German regarding the prophylaxis of HO with diclofenac after THA. We identified 731 potential studies and included 6 randomised controlled trials with 957 patients. Results: The studies were heterogeneous with regard to duration of therapy, dose, comparative group and follow-up period. The therapy duration ranged from 9 to 42 days, the applied diclofenac doses ranged from 75 mg to 150 mg daily. Patients treated with diclofenac showed a significant reduction in the total incidence of HO regarding to the Brooker Classification compared to placebo and no clinically relevant ossifications occured (Brooker III and IV). Conclusions: Diclofenac is efficacious in the prevention of HO and can be used routinely after THA. The existing data indicates that a minimum dose of 75 mg diclofenac per day started on the first postoperative day for a minimum of 9 days is needed to prevent HO with an acceptable incidence of side effects, such as gastrointestinal symptoms.


Healthcare ◽  
2021 ◽  
Vol 9 (3) ◽  
pp. 293
Author(s):  
Hee Kyung Choi ◽  
Seon Heui Lee

Elderly people are sensitive to loneliness, which may contribute to mental and physical health, serious illness, and increased mortality. This study investigates the development trend of information communication technology (ICT) interventions designed for the elderly to reduce loneliness and synthesize its effect. We searched relevant articles on 23 May 2020 using three databases: Ovid-Medline, Ovid-EMBASE, and the Cochrane library. Data extraction and quality assessment were independently performed by two authors. The development is changing from animal robots to online social platforms and from simple emotional support to a multifaceted system that promotes social participation, cognition, physical activity, and nutrition. Our systematic review reported that ICT interventions are being developed to alleviate loneliness and increase social participation. Our study revealed an increase in the use of ICT interventions among the elderly and a positive change in their attitude toward ICT interventions. ICT interventions in the field of nursing should continue to be developed in the future to meet social, health, and safety needs. In the context of coronavirus disease 2019 (COVID-19), ICT interventions are needed to respond effectively to the needs of the elderly. This study is expected to provide basic knowledge for the development of ICT interventions for the elderly.


2020 ◽  
Vol 108 (2) ◽  
Author(s):  
Michelle R. Demetres ◽  
Diana Delgado ◽  
Drew N. Wright

Objective: Institutional repositories are platforms for presenting and publicizing scholarly output that might not be suitable to publish in a peer-reviewed journal or that must meet open access requirements. However, there are many challenges associated with their launch and up-keep. The objective of this systematic review was to define the impacts of institutional repositories (IRs) on an academic institution, thus justifying their implementation and/or maintenance.Methods: A comprehensive literature search was performed in the following databases: Ovid MEDLINE, Ovid EMBASE, the Cochrane Library (Wiley), ERIC (ProQuest), Web of Science (Core Collection), Scopus (Elsevier), and Library, Information Science & Technology Abstracts (EBSCO). A total of 6,593 citations were screened against predefined inclusion and exclusion criteria.Results: Thirteen included studies were divided into 3 areas of impact: citation count, exposure or presence, and administrative impact. Those focusing on citation count (n=5) and exposure or presence (n=7) demonstrated positive impacts of IRs on institutions and researchers. One study focusing on administrative benefit demonstrated the utility of IRs in automated population of ORCID profiles.Conclusion: Based on the available literature, IRs appear to have a positive impact on citation count, exposure or presence, and administrative burden. To draw stronger conclusions, more and higher-quality studies are needed.


BJS Open ◽  
2021 ◽  
Vol 5 (Supplement_1) ◽  
Author(s):  
Sarah Biggs ◽  
Keng Siang Lee ◽  
Max Shah ◽  
Tom Brankin-Frisby ◽  
Tjun Wei Leow ◽  
...  

Abstract Introduction Liver resections are most commonly performed for either primary or secondary cancers. Consensus guidelines recommend that minor liver resections should be attempted laparoscopically, however this technique has limitations. These include difficulties with surgical access, ergonomics and visualization. Consequently, there has been increasing interest in innovative solutions such as robotic surgery. The IDEAL Collaboration has provided guidance for the reporting of surgical innovations, but it is not known how robotic liver resections have been reported. The aim of this study is to summarize technique descriptions and governance procedures, and understand which clinical outcomes have been reported. Methods A systematic review is being conducted in accordance with the PRISMA guideline. A search of Embase, Ovid Medline, the Cochrane Library and Web of Science was performed, using search concepts of “robotic” and “liver resection”. Articles will be screened to select primary research reporting outcomes of robotic liver resections. Data will be extracted on the reporting of study characteristics, governance and ethical arrangements, mitigations of harm, techniques and modifications, and outcomes. A descriptive summary of the data will be produced. The results will be critiqued in relation to guidance from the IDEAL Collaboration. Results The search returned 3063 articles, with 2385 remaining after de-duplication. An interim descriptive analysis of the data will be presented, summarizing how robotic liver resections have been reported. A critique of the available results in the context of IDEAL guidance will be provided. Conclusion This systematic review will describe how robotic liver resections have been reported as surgical innovations.


BJS Open ◽  
2021 ◽  
Vol 5 (Supplement_1) ◽  
Author(s):  
H Robertson ◽  
M Huttman ◽  
L Dixon ◽  
R Macefield ◽  
S Hossaini ◽  
...  

Abstract Introduction Roux-en-Y gastric bypass (RYGB) is one of the most commonly performed bariatric procedures, and robotic methods are increasingly used. Perceived benefits of robotic surgery include improved visualisation and ergonomics, fewer complications, and shorter hospital stay. Rigorous processes that facilitate the safe transition of surgical innovations such as robotic RYGB into clinical practice are currently lacking. This may place patients at risk, and lead to research waste. The IDEAL Collaboration has produced guidance on the reporting of surgical innovations, but it is not known how robotic RYGB has been reported. This project aims to summarise technique description, governance arrangements and outcome reporting in robotic RYGB. Methods A systematic review is being conducted, using PRISMA guidance. A search of Embase, Ovid Medline, the Cochrane Library and Web of Science was performed to identify primary studies reporting outcomes of robotic RYGB. Data will be extracted on study characteristics, governance and ethical arrangements, descriptions of technique, and outcomes. The data will be evaluated in relation to IDEAL principles. Results The literature search yielded 1012 studies; 754 remained after de-duplication. Following screening by abstract, 229 full texts were screened. 67 studies will undergo extraction of data. A descriptive summary of the data will be presented, with a critique of the findings. Conclusion This study will summarise and appraise how robotic RYGB has been reported. This will contribute towards the development of a standardised and methodical process for the introduction of surgical innovation into clinical practice.


2020 ◽  
Vol 63 (5) ◽  
pp. 1618-1635
Author(s):  
Céline Richard ◽  
Mary Lauren Neel ◽  
Arnaud Jeanvoine ◽  
Sharon Mc Connell ◽  
Alison Gehred ◽  
...  

Purpose We sought to critically analyze and evaluate published evidence regarding feasibility and clinical potential for predicting neurodevelopmental outcomes of the frequency-following responses (FFRs) to speech recordings in neonates (birth to 28 days). Method A systematic search of MeSH terms in the Cumulative Index to Nursing and Allied HealthLiterature, Embase, Google Scholar, Ovid Medline (R) and E-Pub Ahead of Print, In-Process & Other Non-Indexed Citations and Daily, Web of Science, SCOPUS, COCHRANE Library, and ClinicalTrials.gov was performed. Manual review of all items identified in the search was performed by two independent reviewers. Articles were evaluated based on the level of methodological quality and evidence according to the RTI item bank. Results Seven articles met inclusion criteria. None of the included studies reported neurodevelopmental outcomes past 3 months of age. Quality of the evidence ranged from moderate to high. Protocol variations were frequent. Conclusions Based on this systematic review, the FFR to speech can capture both temporal and spectral acoustic features in neonates. It can accurately be recorded in a fast and easy manner at the infant's bedside. However, at this time, further studies are needed to identify and validate which FFR features could be incorporated as an addition to standard evaluation of infant sound processing evaluation in subcortico-cortical networks. This review identifies the need for further research focused on identifying specific features of the neonatal FFRs, those with predictive value for early childhood outcomes to help guide targeted early speech and hearing interventions.


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