PERFIL DOS USUÁRIOS DE TERAPIA NUTRICIONAL PARENTERAL EM HOSPITAIS NO CENÁRIO BRASILEIRO: UMA REVISÃO SISTEMÁTICA DE LITERATURA

2021 ◽  
Vol 2 (9) ◽  
pp. e29688
Author(s):  
Jerônimo Gregório da Silva Neto ◽  
Ana Lourdes dos Reis Silva ◽  
Bruna Rayelle Freitas Lira ◽  
Maria Eduarda Pereira Alves ◽  
Amanda Cristine Ferreira dos Santos
Keyword(s):  
Systematic Reviews ◽  
Meta Analysis ◽  
A Priori ◽  
Electronic Library ◽  
Nrs 2002

A Terapia Nutricional são procedimentos terapêuticos realizados nos pacientes incapazes de satisfazer adequadamente suas necessidades nutricionais e metabólicas por via oral. Esse conjunto de procedimentos visa à manutenção ou recuperação do paciente em estado nutricional por meio da Nutrição Parenteral (NP) ou Enteral (NE). Investigar o perfil dos pacientes submetidos à Terapia Nutricional Parenteral (TNP) em hospitais brasileiros.  Trata-se de uma revisão sistemática realizada seguindo as recomendações PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis). Realizou-se busca para seleção dos estudos em cinco bases de dados: Literatura Latino-Americana em Ciências da Saúde (LILACS), Scientific Electronic, Library Online (SciELO) e Medline, usando os descritores de busca: “Terapia Nutricional”, “Nutrição Parenteral” e “Brasil”, por meio dos operadores boleanos “and” e “or”. Os critérios de inclusão foram: artigos originais, relacionados ao tema de interesse desse estudo e publicados nos últimos cinco anos (2015-2020) nos idiomas português e inglês. Por meio da investigação nas bases de dados foram encontrados 57 artigos, desses foram selecionados 43 dos últimos 5 anos, dos quais 2 eram duplicados e 12 não atendiam aos critérios de inclusão estabelecidos à priori, resultando em 14 artigos. Verificou-se risco de desnutrição de acordo com NRS-2002 e alto risco de desnutrição de acordo com 'MUST' aumentaram os custos do paciente, respectivamente, em 21,1% e 28,8%. A terapia nutricional parenteral retrata uma parte importante dos custos no tratamento de indivíduos hospitalizados, principalmente nos casos de cânceres. De acordo com os dados analisados o custo com dieta parenteral foi maior no grupo de óbitos.  

Quality Assessment of Systematic Reviews on Platform-Switching vs Platform-Matched Implants: An Overview

2020 ◽  
Vol 46 (2) ◽  
pp. 153-162
Author(s):  
Joel Ferreira Santiago ◽  
Cleidiel Aparecido Araújo Lemos ◽  
Jéssica Marcela de Luna Gomes ◽  
Fellippo Ramos Verri ◽  
Sandra Lucia Dantas Moraes ◽  
...  
Keyword(s):  
Quantitative Analysis ◽  
Systematic Reviews ◽  
Meta Analysis ◽  
Mean Difference ◽  
Quality Analysis ◽  
Electronic Library ◽  
Implant Abutment ◽  
Bone Preservation ◽  
Platform Switching ◽  
Meta Analyses

The objective of this study was to perform a quality analysis of systematic reviews with meta-analyses that focused on the comparison of platform-switching (implant-abutment mismatching) and platform-matched (PM) implants. The assessment of multiple systematic reviews (AMSTAR) and Glenny (Checklist) Scales were used to qualify the studies. PubMed, Scientific Electronic Library Online (SciELO), Web of Science (formerly ISI Web of Knowledge), and Cochrane databases were searched, by topic, for systematic reviews on dental implants with switching platforms. A total of 8 systematic reviews, including 7 studies with meta-analyses, were selected. The AMSTAR scale indicated a high (n = 6) to moderate (n = 2) score for the included studies. The quantitative analysis indicated that platform-switching implants preserved more bone tissue when compared with platform-matched implants (6 meta-analyses; P < .001, smaller mean difference: −0.29 mm, 95% CI: −0.38, −0.19 and greater mean difference: −0.49 mm, 95% CI: −0.73, −0.26). Quantitative analysis based on 7 systematic reviews with meta-analysis indicated positive peri-implant bone preservation for implants restored with an implant-abutment mismatching (PSW). Further, there is evidence to improve the design of current systematic reviews. Future systematic reviews in this thematic area should consider searches in gray literature and different databases and include only randomized controlled clinical studies.

scholarly journals Effectiveness of Global Postural Reeducation in Ankylosing Spondylitis: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 9 (9) ◽  
pp. 2696
Author(s):  
Gloria Gonzalez-Medina ◽  
Veronica Perez-Cabezas ◽  
Antonio-Jesus Marin-Paz ◽  
Alejandro Galán-Mercant ◽  
Carmen Ruiz-Molinero ◽  
...  
Keyword(s):  
Systematic Review ◽  
Ankylosing Spondylitis ◽  
Systematic Reviews ◽  
Activity Index ◽  
Meta Analysis ◽  
Disease Activity Index ◽  
Spinal Mobility ◽  
Electronic Library ◽  
Specific Population

The aim of this study was to determine the role of global postural reeducation for people with ankylosing spondylitis. We compared the effects of treatments on pain, dysfunction (using the Bath Ankylosing Spondylitis Disease Activity Index and Bath Ankylosing Spondylitis Functional Index), range of motion, and chest expansion in a specific population aged over 18 years old with ankylosing spondylitis. We performed a systematic review and meta-analysis following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statements. The search was conducted using the PubMed, Physiotherapy Database (PEDro), Scientific Electronic Library Online (SciELO), and Web of Science (WoS) databases. Clinical trials and systematic reviews/meta-analysis were reviewed. Results: 154 studies were found. Finally, four were included. Conclusions: global postural reeducation is beneficial for ankylosing spondylitis, but no more so than other conventional treatments, except for spinal mobility, where Global Postural Reeducation demonstrated an advantage.

scholarly journals Volar locking plate versus external fixation in distal radius fractures: A meta-analysis

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Giuseppe Maccagnano ◽  
Giovanni Noia ◽  
Giovanni Vicenti ◽  
Marco Baglioni ◽  
Maria Rosa Masciale ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Distal Radius ◽  
Systematic Reviews ◽  
External Fixator ◽  
Meta Analysis ◽  
A Priori ◽  
Wrist Fracture ◽  
Distal Radius Fractures ◽  
Radius Fractures

The purpose of this meta-analysis is to evaluate the efficacy of plate or external fixator treatments in distal radius fractures, based not only on clinical and radiographic parameters but on Health Related Quality of Life (HRQOL) parameters. The Preferred Reporting Items for Systematic Reviews and Metanalyses (PRISMA) guidelines were followed when conducting this systematic review. The Revised Assessment of Multiple Systematic Reviews (RAMSTAR) checklist was additionally consulted in order to ensure a high-quality methodological process, encompassing such elements as an ‘a priori’ design, independent reviews and comprehensive search. The literature search was carried out on PubMed, MEDLINE and Scopus. The search terms used were “Radius fracture AND osteosynthesis”, “Wrist fracture AND external fixator” and “Wrist fracture AND plate”. Two reviewers independently screened titles, abstracts and full texts. To determine inter-reviewer agreement, a k score was calculated after each screening state. Of the 5753 studies collected through the initial databases search, two studies were included in the final meta-analysis (125 treated with external fixator vs 132 with volar plate). There was a substantial inter-reviewer agreement as to the title (0.73; 95% confidence interval, 0.67-0.79) abstract (0.65; 95% CI, 0.46-0.83) and fulltext screening stages (0.89; 95%CI, 0.67-1). The meta-analysis reported a mean difference equal to 0.00 (95%CI= -0.05 – 0.05), in accordance with I2= 0% and p test for the heterogeneity value=0.089. This meta analysis confirms and quantifies that the two techniques are superimposable as regards the quality of life reported by patients at least one year of follow-up.

Statistical heterogeneity in systematic reviews of clinical trials: a critical appraisal of guidelines and practice

2002 ◽  
Vol 7 (1) ◽  
pp. 51-61 ◽  
Author(s):  
Julian Higgins ◽  
Simon Thompson ◽  
Jonathan Deeks ◽  
Douglas Altman
Keyword(s):  
Clinical Trials ◽  
Systematic Reviews ◽  
Current Practice ◽  
Meta Analysis ◽  
A Priori ◽  
Potential Effect ◽  
Cochrane Reviews ◽  
Study Results ◽  
Statistical Heterogeneity ◽  
Meta Regression

Objective: Heterogeneity between study results can be a problem in any systematic review or meta-analysis of clinical trials. Identifying its presence, investigating its cause and correctly accounting for it in analyses all involve difficult decisions for the researcher. Our objectives were: to collate recommendations on the subject of dealing with heterogeneity in systematic reviews of clinical trials; to investigate current practice in addressing heterogeneity in Cochrane reviews; and to compare current practice with recommendations. Methods: We review guidelines for those undertaking systematic reviews and examine how heterogeneity is addressed in practice in a sample of systematic reviews, and their protocols, from the Cochrane Database of Systematic Reviews. Results: Advice to reviewers is on the whole consistent and sensible. However, examination of a sample of Cochrane protocols and reviews demonstrates that the advice is difficult to follow given the small numbers of studies identified in many systematic reviews, the difficulty of pre-specifying important effect modifiers for subgroup analysis or meta-regression and the unresolved debate concerning fixed versus random effects metaanalyses. There was disagreement between protocols and reviews, often either regarding choice of important potential effect modifiers or due to the review identifying too few studies to perform planned analyses. Conclusion: Guidelines that address practical issues are required to reduce the risk of spurious findings from investigations of heterogeneity. This may involve discouraging statistical investigations such as subgroup analyses and meta-regression, rather than simply adopting a cautious approach to their interpretation, unless a large number of studies is available. The notion of a priori specification of potential effect modifiers for a retrospective review of studies is ill-defined, and the appropriateness of using a statistical test for heterogeneity to decide between analysis strategies is suspect.

scholarly journals Low Methodological Quality of Systematic Reviews on Acupuncture: A Cross- Sectional Study

2021 ◽  
Author(s):  
Leonard TF Ho ◽  
Fiona YT Ke ◽  
Charlene HL Wong ◽  
Irene XY Wu ◽  
Andy KL Cheung ◽  
...  
Keyword(s):  
Systematic Reviews ◽  
Methodological Quality ◽  
Meta Analysis ◽  
A Priori ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Quality Ratings ◽  
Cochrane Reviews

Abstract Background: While well-conducted systematic reviews (SRs) can provide best evidence on the potential effectiveness of acupuncture, limitations on methodological rigour of SRs may impact trustworthiness of their conclusions. This cross-sectional study aimed to evaluate the methodological quality of a representative sample of SRs on acupuncture effectiveness.Methods: CDSR, MEDLINE, and EMBASE were searched for SRs on acupuncture. AMSTAR2 was applied for assessing methodological quality. Associations between bibliographical characteristics and methodological quality ratings were examined. Results: A total of 106 SRs were appraised. Only one (0.9%) SR was of high overall methodological quality, zero (0%) was of moderate-quality, six (5.7%) and 99 (93.4%) were of low-quality and critically low-quality respectively. Among appraised SRs, only ten (9.4%) provided an a priori protocol, four (3.8%) conducted a comprehensive literature search, five (4.7%) provided a list of excluded study, and six (5.7%) performed meta-analysis appropriately. Cochrane reviews, update reviews, reviews with corresponding authors from the America, and reviews that searched non-English databases had relatively higher overall quality. Conclusions: Methodological quality of SRs on acupuncture is unsatisfactory. Future reviewers should improve critical areas of publishing protocols, performing comprehensive search, providing a list of excluded studies with justifications for exclusion, and conducting meta-analysis appropriately.

scholarly journals AMSTAR 2 Appraisal of Systematic Reviews and Meta-analyses in the Field of Heart Failure from High-impact Journals

2021 ◽  
Author(s):  
LIN LI ◽  
IRIAGBONSE ROTIMI ASEMOTA ◽  
BOLUN LIU ◽  
JAVIER GOMEZ-VALENZIA ◽  
LIFENG LIN ◽  
...  
Keyword(s):  
Heart Failure ◽  
Systematic Reviews ◽  
Meta Analysis ◽  
A Priori ◽  
Compliance Rate ◽  
High Impact ◽  
Measurement Tool ◽  
High Quality ◽  
Critical Appraisal Tool ◽  
Meta Analyses

Abstract Background: The MeaSurement Tool to Assess systematic Reviews (AMSTAR) 2 is a critical appraisal tool for systematic reviews (SRs) and meta-analyses (MAs) of interventions. We aimed to perform the first AMSTAR 2-based quality assessment of heart failure-related studies. Methods: Eleven high-impact journals were searched from 2009 to 2019. The included studies were assessed on the basis of 16 domains. Seven domains were deemed critical for high-quality studies. On the basis of the performance in these 16 domains with different weights, overall ratings were generated and the quality was determined to be “high,” “moderate,” “low,” or “critically low.” Results: Eighty-one heart failure-related SRs with MAs were included. Overall, 79 studies were of “critically low quality” and two were of “low quality.” These findings were attributed to insufficiency in the following critical domains: a priori protocols (compliance rate, 5%), complete list of exclusions with justification (5%), risk of bias assessment (69%), meta-analysis methodology (78%), and investigation of publication bias (60%).Conclusions: The low ratings for these potential high-quality heart failure-related SRs and MAs challenge the discrimination capacity of AMSTAR 2. In addition to identifying certain areas of insufficiency, these findings indicate the need to justify or modify AMSTAR 2’s rating rules.

Replication of the Superstition and Performance Study by

2014 ◽  
Vol 45 (3) ◽  
pp. 239-245 ◽  
Author(s):  
Robert J. Calin-Jageman ◽  
Tracy L. Caldwell
Keyword(s):  
Task Difficulty ◽  
Statistical Power ◽  
Meta Analysis ◽  
A Priori ◽  
Significant Heterogeneity ◽  
Performance Study ◽  
Improve Performance ◽  
Research Designs ◽  
Series Of Experiments ◽  
And Performance

A recent series of experiments suggests that fostering superstitions can substantially improve performance on a variety of motor and cognitive tasks ( Damisch, Stoberock, & Mussweiler, 2010 ). We conducted two high-powered and precise replications of one of these experiments, examining if telling participants they had a lucky golf ball could improve their performance on a 10-shot golf task relative to controls. We found that the effect of superstition on performance is elusive: Participants told they had a lucky ball performed almost identically to controls. Our failure to replicate the target study was not due to lack of impact, lack of statistical power, differences in task difficulty, nor differences in participant belief in luck. A meta-analysis indicates significant heterogeneity in the effect of superstition on performance. This could be due to an unknown moderator, but no effect was observed among the studies with the strongest research designs (e.g., high power, a priori sampling plan).

Current Therapy of Diabetic Macular Edema Bevacizumab, Triamcinolone Acetonide, and Laser Photocoagulation

2019 ◽  
Vol 45 (1) ◽  
pp. 13
Author(s):  
Gladys Kusumowidagdo ◽  
Randy Sarayar ◽  
Kartika Rahayu ◽  
Gitalisa Andayani
Keyword(s):  
Macular Edema ◽  
Triamcinolone Acetonide ◽  
Diabetic Macular Edema ◽  
Systematic Reviews ◽  
Laser Photocoagulation ◽  
Meta Analysis ◽  
Intravitreal Bevacizumab ◽  
Current Therapy ◽  
Intravitreal Triamcinolone ◽  
Mesh Terms

Background: Diabetic macular edema (DME) is the main cause of visual impairment in diabetic retinopathy (DR). Current gold standard therapy of DME is macular laser photocoagulation (MPC). Growing evidences have shown benefits of intravitreal anti-VEGF agents (i.e bevacizumab) and intravitreal corticosteroids (i.e triamcinolone acetonide). Aim: To compare the visual acuity (VA) improvement of patients with DME, treated with intravitreal bevacizumab (IVB), a combination of IVB and intravitreal triamcinolone (IVB/IVT), and MPC. Method: A comprehensive PubMed® and Cochrane® databases search was conducted on May 4th, 2017 using appropriate keywords (diabetic macular edema, bevacizumab, triamcinolone, and laser photocoagulation using their MeSH terms). Studies were filtered using inclusion criterions (clinical trials, RCT, meta-analysis, systematic review, English, humans, and publication within 10 years) Results: Three studies (2 systematic reviews and 1 RCT) were found suitable. From these results, all studies showed favoring effects of IVB when compared to IVB/IVT combination and MPC in short term period (up to 6 months). However, there was no significant improvement of VA beyond this period in all groups. Conclusion: IVB appears to be superior to IVB/IVT and MPC in improving VA during 6 months follow- up period. Future systematic reviews and meta-analysis are required on the effect of IVB and MPC combination in cases of DME.

Cinammon (Cinnamomum Spp.) and Type 2 Diabetes Mellitus

2019 ◽  
Vol 18 (3) ◽  
pp. 247-255
Author(s):  
Sierra-Puente D. ◽  
Abadi-Alfie S. ◽  
Arakanchi-Altaled K. ◽  
Bogard-Brondo M. ◽  
García-Lascurain M. ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Systematic Reviews ◽  
Meta Analysis ◽  
Fasting Blood Glucose ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Key Aspects

Spices such as cinnamon (Cinnamomum Spp.) have been of interest due to their phytochemical composition that exert hypoglycemic effects with potential for management of type 2 diabetes mellitus (T2DM). We summarize data from 27 manuscripts that include, one book chapter, 3 review articles, 10 randomized controlled trials, 4 systematic reviews with meta-analysis, and 9 preclinical studies. The most frequently used cinnamon variety was Cinnamomum cassia rather than the Cinnamomum zeylanicum, whereas outcomes were defined as fasting blood glucose, glycated hemoglobin, and oral glucose tolerance test. A great variability in methodology such as different doses (from 120 mg to 6 g), duration of intervention, data retrieved and use of different concomitant medication, were found to be key aspects of most of trials and systematic reviews with meta-analysis available to date. Low quality studies have been made in most cases with a lot of heterogeneity clouding significance of results. More research needs to be done in order to yield accurate evidence for evidence-based recommendations. Its use is not currently a reliable nor advisable option for the treatment of T2DM.

Web-based Tools for Drug Repurposing: Successful Examples of Collaborative Research

2020 ◽  
Vol 28 (1) ◽  
pp. 181-195
Author(s):  
Quentin Vanhaelen
Keyword(s):  
User Interfaces ◽  
Collaborative Research ◽  
Meta Analysis ◽  
A Priori ◽  
Drug Repurposing ◽  
Data Access ◽  
Estimation Methods ◽  
Large Set ◽  
Computational Tools ◽  
Web Based

: Computational approaches have been proven to be complementary tools of interest in identifying potential candidates for drug repurposing. However, although the methods developed so far offer interesting opportunities and could contribute to solving issues faced by the pharmaceutical sector, they also come with their constraints. Indeed, specific challenges ranging from data access, standardization and integration to the implementation of reliable and coherent validation methods must be addressed to allow systematic use at a larger scale. In this mini-review, we cover computational tools recently developed for addressing some of these challenges. This includes specific databases providing accessibility to a large set of curated data with standardized annotations, web-based tools integrating flexible user interfaces to perform fast computational repurposing experiments and standardized datasets specifically annotated and balanced for validating new computational drug repurposing methods. Interestingly, these new databases combined with the increasing number of information about the outcomes of drug repurposing studies can be used to perform a meta-analysis to identify key properties associated with successful drug repurposing cases. This information could further be used to design estimation methods to compute a priori assessment of the repurposing possibilities.

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