Survival outcomes of patients with cervical cancer and accompanying hydronephrosis: A systematic review of the literature

Hydronephrosis is a sign of advanced stage disease in patients with cervical cancer. Its presence is believed to negatively affect the survival of patients. To date, however, consensus in this field is still lacking. The purpose of the present systematic review is to gather the available data and to provide directions for future research in the field. We systematically searched Medline, Scopus, Clinicaltrials.gov, EMBASE, Cochrane Central Register of Controlled Trials CENTRA and Google Scholar databases from inception till June 2018. Overall, 22 studies were included in the present systematic review that evaluated outcomes from 8521 patients with cervical cancer. The findings of our systematic review support that hydronephrosis negatively affects the overall survival of cervical cancer patients. Specifically, the reported 5-year OS hazards ratio for hydronephrosis ranged between 1.34 and 3.74. Outcomes concerning the disease-free survival of these patients were, however, less discrete. None of the included studies reported whether the decreased survival of patients with hydronephrosis was attributed to complications of obstructive uropathy such as uremia and sepsis. Thus, it remains, to date, unclear whether placement of ureteral stents or percutaneous nephrostomy may actually benefit these patients. More studies are needed to evaluate the actual impact of hydronephrosis on survival rates at the various stages of cervical cancer and to help establish consensus regarding the optimal mode of management of these patients.

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Azithromycin in patients with Covid-19; a systematic review and metanalysis

10.1101/2021.08.03.21261414 ◽

2021 ◽

Author(s):

Luis Ayerbe ◽

Ivo Forgnone ◽

Carlos Risco-Risco ◽

Maria Perez-Pinar ◽

Salma Ayis

Keyword(s):

Systematic Review ◽

Clinical Severity ◽

Future Research ◽

Controlled Trials ◽

Clinical Settings ◽

Cochrane Central Register ◽

Random Effects Models ◽

Central Register ◽

Significant Difference ◽

Observational Design

Background: Azithromycin (AZM) has been widely used in the management of Covid-19. However, the evidence on its actual effects remains disperse and difficult to apply in clinical settings. This systematic review and metanalysis summarizes the studies on the beneficial and adverse effect of AZM in patients with Covid-19. Methods: The PRISMA 2020 statement criteria were followed. Randomized controlled trials (RCTs) and observational studies comparing clinical outcomes of patients treated, and not treated, with AZM, indexed until the 5th of July 2021, were searched in PubMed, Embase, The Web of Science, Scopus, The Cochrane Central Register of Controlled Trials, and MedRXivs. We used Random-effects models to estimate pooled effect size from aggregate data. Results: The initial search produced 4950 results. Finally, 16 studies, five RCTs and 11 with an observational design, with a total of 22984 patients, were included. The metanalysis showed no difference in mortality for those treated, or not, with AZM, OR: 0.95 (0.79-1.13). There was also no significant difference for those treated, and not, with AZM in need for hospital admission or time to admission from ambulatory settings, clinical severity, need for intensive care, or adverse effects. Conclusions: These results presented in this review do not support the use of AZM in the management of Covid-19. They also show that any harm caused to the patient who received it is unlikely. Future research on treatment for patients with Covid-19 may need to focus on other drugs

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Weaning and Extubation Assisted with Conversational Hypnosis : A Systematic Review

10.21203/rs.3.rs-273882/v3 ◽

2021 ◽

Author(s):

Johan Wormser ◽

Christophe Romanet ◽

Aurel Bellaïche ◽

François Philippart

Keyword(s):

Systematic Review ◽

Oxygen Saturation ◽

Web Of Science ◽

Case Series ◽

Anxiety Reduction ◽

Cochrane Central Register ◽

Central Register ◽

Registration Number ◽

The One ◽

Present Systematic Review

Abstract Background : Patients admitted in intensive care units often receive mechanical ventilation. Prior to extubation, weaning process could be a major cause of dyspnea and anxiety in awake intubated patients. Hypnosis is commonly used to manage anxiety and pain. Our hypothesis is that hypnosis would decrease stress during the weaning and extubation process. Methods: This systematic review follows PRISMA Guidelines and was registered in PROSPERO (CRD42020171445). Web of Science, MEDLINE and Cochrane Central Register of Controlled Trials databases were searched until 11 March 2020. We included all interventional trials assessing hypnotherapy for intubated patients whom were undergoing weaning or extubation. Two of the authors independently screened studies, extracted data and assessed risk of bias from identified trials. Results: One study fulfilled our selection. This case series included 2 patients. Eleven sessions were completed. Dyspnea was not assessed/reported. Hypnotherapy decreased anxiety during the weaning process from a median of 1 point (Interquartile Range: 1.0-2.5). Increase in oxygen saturation is also reported. There was no evidence of neither an anxiety reduction or an oxygen saturation improvement. This is due to the scarcity of publication and the methodological design of the one selected study. Conclusions: We cannot conclude whether or not hypnosis could be recommended in the weaning process of intubated patients. Further studies are needed to assess hypnosis effects. Registration: The present systematic review was registered in the International prospective register of systematic reviews (PROSPERO) under registration number CRD42020171445.

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Evaluation of the Effect of Limosilactobacillus fermentum CECT5716 on Gastrointestinal Infections in Infants: A Systematic Review and Meta-Analysis

Microorganisms ◽

10.3390/microorganisms9071412 ◽

2021 ◽

Vol 9 (7) ◽

pp. 1412

Author(s):

Belén Pastor-Villaescusa ◽

Ruth Blanco-Rojo ◽

Mónica Olivares

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Well Being ◽

Preventive Therapy ◽

Controlled Trials ◽

Cochrane Central Register ◽

Gastrointestinal Infections ◽

Early Stages ◽

Central Register ◽

Present Systematic Review

Reducing the incidence of gastrointestinal infections (GIs) that occur at early stages to mitigate hospitalizations and treatments with adverse effects is a promising strategy for providing well-being to infants and their families. This systematic review and meta-analysis explores whether the early administration of Limosilactobacillus fermentum CECT5716 might be effective as a preventive therapy for GIs. We reviewed the literature to identify randomized controlled trials (RCTs) investigating the effectiveness of milk formulas supplemented with L. fermentum CECT5716 administered to infants at early stages to reduce the incidence of GIs. The MEDLINE (via PubMed), Web of Science (WoS), and Cochrane Central Register of Controlled Trials (via CENTRAL) databases were searched up to 15 June 2021. GI data from the included studies were synthesized in a random-effects model. Three RCTs were finally selected including 435 infants. There was a significant reduction in the incidence rate of GIs for those receiving L. fermentum CECT5716 compared with those receiving placebo (IRR: 0.52, 95% CI: 0.36–0.74, p = 0.0004). Heterogeneity between studies was moderate (I2 = 54.5%). Based on the present systematic review and meta-analysis, the administration of L. fermentum CECT5716 at doses from 1 × 109 to 8.4 × 108 cfu/day in milk formulas may prevent GIs in infants up to 12 months old. Longer-term studies including a higher number of infants are needed to determine whether the use of this probiotic during the early stages of life is an efficient way to reduce the incidence of GIs.

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Impact of Tumor–Stroma Ratio on the Prognosis of Colorectal Cancer: A Systematic Review

Frontiers in Oncology ◽

10.3389/fonc.2021.738080 ◽

2021 ◽

Vol 11 ◽

Author(s):

Jinlai Gao ◽

Zhangguo Shen ◽

Zaixing Deng ◽

Lina Mei

Keyword(s):

Colorectal Cancer ◽

Systematic Review ◽

Disease Free Survival ◽

Cost Effective ◽

Tumor Stroma ◽

Stage Ii ◽

Cochrane Central Register ◽

Treatment Optimization ◽

Central Register ◽

Meta Analyses

BackgroundIt is critical to develop a reliable and cost-effective prognostic tool for colorectal cancer (CRC) stratification and treatment optimization. Tumor–stroma ratio (TSR) may be a promising indicator of poor prognosis in CRC patients. As a result, we conducted a systematic review on the predictive value of TSR in CRC.MethodsThis study was carried out according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guideline. An electronic search was completed using commonly used databases PubMed, CENTRAL, Cochrane Central Register of Controlled Trials, and Google scholar till the last search up to May 30, 2021. STATA version 13 was used to analyze the data.ResultsA total of 13 studies [(12 for disease-free survival (DFS) and nine studies for overall survival (OS)] involving 4,857 patients met the inclusion criteria for the systematic review in the present study. In individuals with stage II CRC, stage III CRC, or mixed stage CRC, we observed a significantly higher pooled hazard ratio (HR) in those with a low TSR/greater stromal content (HR, 1.54; 95% CI: 1.20 to 1.88), (HR, 1.90; 95% CI: 1.35 to 2.45), and (HR, 1.70; 95% CI: 1.45 to 1.95), respectively, for predicting DFS. We found that a low TSR ratio had a statistically significant predictive relevance for stage II (HR, 1.43; 95% CI: 1.09 to 1.77) and mixed stages of CRC (HR, 1.65; 95% CI: 1.31 to 2.0) for outcome OS.ConclusionIn patients with CRC, low TSR was found to be a prognostic factor for a worse prognosis (DFS and OS).

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Weaning and Extubation Assisted with Conversational Hypnosis: A systematic review

10.21203/rs.3.rs-273882/v2 ◽

2021 ◽

Author(s):

Johan Wormser ◽

Christophe Romanet ◽

Aurel Bellaïche ◽

François Philippart

Keyword(s):

Systematic Review ◽

Oxygen Saturation ◽

Web Of Science ◽

Case Series ◽

Anxiety Reduction ◽

Cochrane Central Register ◽

Central Register ◽

Registration Number ◽

The One ◽

Present Systematic Review

Abstract Background: Patients admitted in intensive care units often receive mechanical ventilation. Prior to extubation, weaning process could be a major cause of dyspnea and anxiety in awake intubated patients. Hypnosis is commonly used to manage anxiety and pain. Our hypothesis is that hypnosis would decrease stress during the weaning and extubation process.Methods: This systematic review follows PRISMA Guidelines and was registered in PROSPERO (CRD42020171445). Web of Science, MEDLINE and Cochrane Central Register of Controlled Trials databases were searched until 11 March 2020. We included all interventional trials assessing hypnotherapy for intubated patients whom were undergoing weaning or extubation. Two of the authors independently screened studies, extracted data and assessed risk of bias from identified trials.Results: One study fulfilled our selection. This case series included 2 patients. Eleven sessions were completed. Dyspnea was not assessed/reported. Hypnotherapy decreased anxiety during the weaning process from a median of 1 point (Interquartile Range: 1.0-2.5). Increase in oxygen saturation is also reported. There was no evidence of neither an anxiety reduction or an oxygen saturation improvement. This is due to the scarcity of publication and the methodological design of the one selected study.Conclusions: We cannot conclude whether or not hypnosis could be recommended in the weaning process of intubated patients. Further studies are needed to assess hypnosis effects.Registration: The present systematic review was registered in the International prospective register of systematic reviews (PROSPERO) under registration number CRD42020171445.

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Functional cortical changes associated with shoulder instability – a systematic review

Shoulder & Elbow ◽

10.1177/17585732211019016 ◽

2021 ◽

pp. 175857322110190

Author(s):

Morissa F Livett ◽

Deborah Williams ◽

Hayley Potter ◽

Melinda Cairns

Keyword(s):

Systematic Review ◽

Joint Instability ◽

Glenohumeral Joint ◽

Controlled Trials ◽

Cochrane Central Register ◽

Cortical Function ◽

High Quality Research ◽

Central Register ◽

Rehabilitative Measures ◽

Randomised Controlled

Background Glenohumeral joint instability is associated with structural deficits and/or alterations in sensory and motor processing; however, a proportion of patients with glenohumeral joint instability fail to respond to surgical and rehabilitative measures. This systematic review aimed to establish if functional cortical changes occur in patients with glenohumeral joint instability. Methods AMED, CINAHL, Cochrane Central Register of Controlled Trials, Embase, Medline, PEDro, Pubmed, PsychINFO and Scopus were searched from inception to 17 March 2021. Randomised controlled trials and non-randomised trials were included and quality was appraised using the Downs and Black tool. Results One thousand two hundred seventy-nine records were identified of which five were included in the review. All studies showed altered cortical function when comparing instability patients with healthy controls and included areas associated with higher cortical functions. Discussion The findings of this systematic review offer some insight as to why interventions addressing peripheral pathoanatomical factors in patients with glenohumeral joint instability may fail in some cases due to functional cortical changes. However, data are of moderate to high risk of bias. Further high-quality research is required to ascertain the degree of functional cortical changes associated with the type and duration of glenohumeral joint instability.

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Prognostic and Clinicopathological Significance of MiR-155 in Breast Cancer: A Systematic Review

International Journal of Molecular Sciences ◽

10.3390/ijms21165834 ◽

2020 ◽

Vol 21 (16) ◽

pp. 5834

Author(s):

Anna Maria Grimaldi ◽

Silvia Nuzzo ◽

Gerolama Condorelli ◽

Marco Salvatore ◽

Mariarosaria Incoronato

Keyword(s):

Breast Cancer ◽

Systematic Review ◽

Prognostic Biomarker ◽

Survival Rates ◽

Prognostic Significance ◽

Unmet Need ◽

Non Invasive ◽

Clinicopathological Significance ◽

Present Systematic Review

There is an unmet need for novel non-invasive prognostic molecular tumour markers for breast cancer (BC). Accumulating evidence shows that miR-155 plays a pivotal role in tumorigenesis. Generally, miR-155 is considered an oncogenic miRNA promoting tumour growth, angiogenesis and aggressiveness of BC. Therefore, many researchers have focused on its use as a prognostic biomarker and therapeutic target. However, its prognostic value for BC patients remains controversial. To address this issue, the present systematic review aims to summarize the available evidence and give a picture of a prognostic significance of miR-155 in BC pathology. All eligible studies were searched on PubMed and EMBASE databases through various search strategies. Starting from 289 potential eligible records, data were examined from 28 studies, comparing tissue and circulating miR-155 expression levels with clinicopathological features and survival rates in BC patients. We discuss the pitfalls and challenges that need to be assessed to understand the power of miR-155 to respond to real clinical needs, highlighting the consistency, robustness or lack of results obtained to sate in translating this molecule to clinical practice. Our paper suggests that the prognostic role of miR-155 in the management of BC needs to be further verified.

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Abstract NS6: To Rest or Mobilize... When to Start Early Mobilization in Acute Stroke: a Systematic Review

Stroke ◽

10.1161/str.47.suppl_1.ns6 ◽

2016 ◽

Vol 47 (suppl_1) ◽

Author(s):

Michelle Whaley ◽

Wendy Dusenbury ◽

Andrei V Alexandrov ◽

Georgios Tsivgoulis ◽

Anne W Alexandrov

Keyword(s):

Systematic Review ◽

Ischemic Stroke ◽

Acute Stroke ◽

Early Mobilization ◽

Future Research ◽

Cochrane Central Register ◽

Large Artery ◽

Stroke Subtype ◽

Vascular Insufficiency ◽

The Impact

Background: Recent nursing initiatives encourage early mobilization of neurocritical care patients, but whether this intervention can be safely generalized to acute stroke is debatable. We performed a systematic review of findings from recent studies to provide direction for patient management and future research. Methods: An exhaustive literature search was performed in Medline, SCOPUS and the Cochrane Central Register of Controlled Trials to identify published clinical trial research using a very early mobility intervention (within 24 hours) in acute ischemic stroke patients. The primary efficacy outcome supporting the search was neurologic disability reduction or improved functional outcomes, and the primary safety outcome was neurologic deterioration. Studies were critically reviewed for inclusion by 3 separate investigators, findings were synthesized, and an overall recommendation for very early mobilization use in acute stroke was assigned according to GRADE criteria. Results: We initially identified 12 papers focused on early mobilization in acute stroke; of these, 6 observational studies were excluded, 1 study was excluded due to an ambiguous population, and 3 studies were excluded due to first initial mobilization out of bed occurring greater than 24 hours after admission. Two prospective randomized outcome blinded evaluation (PROBE) studies were retained, consisting of a total 2160 patients; ischemic stroke subtype was not disclosed in either study, limiting an understanding of the impact of very early mobilization on small versus large artery occlusion. Slower mobilization occurring beyond the first 24 hours was associated with higher rates of favorable outcome (mRS 0-2) at 90 days, whereas very early mobilization within the first 24 hours was associated with a number needed to harm of 25. Conclusions: In acute stroke, evidence supports a rested approach to care within the first 24 hours of hospitalization (GRADE: Strong recommendation, high quality of evidence). Similar to acute myocardial infarction, vascular insufficiency experienced in stroke likely warrants a more guarded approach to mobility. Additional studies exploring timing beyond 24 hours and dose of mobility interventions are warranted in discreet populations.

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Use of opioids in patients with cancer with hepatic impairment—a systematic review

BMJ Supportive & Palliative Care ◽

10.1136/bmjspcare-2021-003065 ◽

2021 ◽

pp. bmjspcare-2021-003065

Author(s):

Lewis Thomas Hughes ◽

David Raftery ◽

Paul Coulter ◽

Barry Laird ◽

Marie Fallon

Keyword(s):

Systematic Review ◽

Cancer Pain ◽

Hepatic Impairment ◽

Evaluation System ◽

Meta Analysis ◽

Hepatic Function ◽

Cochrane Central Register ◽

Assessment Development ◽

Patients With Cancer ◽

Central Register

PurposeOpioids are recommended for moderate-to-severe cancer pain; however, in patients with cancer, impaired hepatic function can affect opioid metabolism. The aim of this systematic review was to evaluate the evidence for the use of opioids in patients with cancer with hepatic impairment.MethodsA systematic review was conducted and the following databases searched: AMED (−2021), MEDLINE (−2021), EMBASECLASSIC + EMBASE (−2021) and Cochrane Central Register of Controlled Trials (−2021). Eligible studies met the following criteria: patients with cancer-related pain, taking an opioid (as defined by the WHO Guidelines for the pharmacological and radiotherapeutic management of cancer pain in adults and adolescents); >18 years of age; patients with hepatic impairment defined using recognised or study-defined definitions; clinical outcome hepatic impairment related; and primary studies. All eligible studies were appraised using the Grading of Recommendations Assessment, Development and Evaluation system.ResultsThree studies (n=95) were eligible but heterogeneity meant meta-analysis was not possible. Each individual study focused on only one each of oxycodone±hydrocotarnine, oxycodone/naloxone and morphine. No recommendations could be formulated on the preferred opioid in patients with hepatic impairment.ConclusionsMorphine is the preferred opioid in hepatic impairment owing to clinical experience and pharmacokinetics. This review, however, found little clinical evidence to support this. Dose adjustments of morphine and the oxycodone formulations reviewed remain necessary in the absence of quality evidence. Overall, the quality of existing evidence on opioid treatments in cancer pain and hepatic impairment is low and there remains a need for high-quality clinical studies examining this.

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Dynamic compared to rigid fixation in lumbar spine: a systematic review

Revista da Associação Médica Brasileira ◽

10.1590/1806-9282.60.02.013 ◽

2014 ◽

Vol 60 (2) ◽

pp. 151-155 ◽

Cited By ~ 1

Author(s):

Ricardo Vieira Botelho ◽

Rafael Bastianello Junior ◽

Luciana DiniGianini de Albuquerque ◽

Wanderley Marques Bernardo

Keyword(s):

Systematic Review ◽

Lumbar Spine ◽

Randomized Trials ◽

Published Data ◽

Rigid Fixation ◽

Cochrane Central Register ◽

Pedicle Fixation ◽

Central Register ◽

Spine Fixation

Objective: The objective of this review is to reveal the quality of published data and the effect size of DPFs compared to rigid fixation in lumbar spine. Summary of background data: since 2002, several dynamic pedicle fixation (DPF) systems have been developed with the aim to stabilize the spine without the undesirable effects of rigid lumbar spine fixation. Nearly ten years later, there are several studies on these dynamic systems. Methods: A systematic review was done in MEDLINE/PubMED, Embase, Cochrane Central Register of Randomized Trials and Google Scholar to assess the quality of published literature and the available studied outcomes in randomized controlled trials of DPF. Results: Only three papers described randomized trials studying DPF. One of them focused on protection of adjacent level disease provided by DPF. Conclusion: It was not possible to reveal any evidence for benefits using DPF compared to rigid fixation in surgery for lumbar spine.

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