High-dose rifamycins in the treatment of TB: a systematic review and meta-analysis

BackgroundThere is growing interest in using high-dose rifamycin (HDR) regimens in TB treatment, but the safety and efficacy of HDR regimens remain uncertain. We performed a systematic review and meta-analysis comparing HDR to standard-dose rifamycin (SDR) regimens.MethodsWe searched MEDLINE, Embase, CENTRAL, Cochrane Database of Systematic Reviews and clinicaltrials.gov for prospective studies comparing daily therapy with HDRs to SDRs. Rifamycins included rifampicin, rifapentine and rifabutin. Our primary outcome was the rate of severe adverse events (SAEs), with secondary outcomes of death, all adverse events, SAE by organ and efficacy outcomes of 2-month culture conversion and relapse. This study was prospectively registered in the International Prospective Register of Systematic Reviews (CRD42020142519).ResultsWe identified 9057 articles and included 13 studies with 6168 participants contributing 7930 person-years (PY) of follow-up (HDR: 3535 participants, 4387 PY; SDR: 2633 participants, 3543 PY). We found no significant difference in the pooled incidence rate ratio (IRR) of SAE between HDR and SDR (IRR 1.00, 95% CI 0.82 to 1.23, I2=41%). There was no significant difference when analysis was limited to SAE possibly, probably or likely medication-related (IRR 1.07, 95% CI 0.82 to 1.41, I2=0%); studies with low risk of bias (IRR 0.98, 95% CI 0.79 to 1.20, I2=44%); or studies using rifampicin (IRR 1.00, 95% CI 0. 0.75–1.32, I2=38%). No significant differences were noted in pooled outcomes of death, 2-month culture conversion and relapse.ConclusionsHDRs were not associated with a significant difference in SAEs, 2-month culture conversion or death. Further studies are required to identify specific groups who may benefit from HDR.

Surgical Results of Chronic Distal Biceps Ruptures: A Systematic Review

Background: Distal biceps tendon tears can cause weakness and fatigue with activities requiring elbow flexion and supination. Surgical management of chronic tears (>21 days) is not well described in the literature. Purpose: To determine the clinical outcomes of chronic distal biceps repairs and reconstructions. Study Design: Systematic review; Level of evidence, 4. Methods: We performed a search of Medline (PubMed and Ovid), EMBASE, CINAHL physical therapy, Cochrane Database of Systematic Reviews and Central Register of Controlled Trials, and PubMed Central from inception until September 29, 2020, to identify articles on chronic distal biceps ruptures. The inclusion criteria were studies with at least 1 outcome measure and 10 patients with chronic distal biceps ruptures treated surgically. The quality of the included studies was assessed with the methodological index for nonrandomized studies (MINORS) score. Functional outcomes and complications were reviewed. Results: A total of 12 studies were included after systematic database screenings. The MINORS scores ranged from 5 to 19. There were a total of 1704 distal biceps ruptures, of which 1270 were acute and 434 were chronic. Average follow-up time was 12 months to 5.1 years. Single-incision (n = 3), 2-incision (n = 2), or both (n = 6) surgical techniques were used in these studies. Four studies described the use of autografts, and 4 articles used allografts in the chronic repair. Range of motion, function, and strength outcomes were similar when compared with the contralateral arm. Pain was reduced to minimal levels. Main postoperative complications were of paresthesia (specifically to the lateral antebrachial cutaneous nerve), which were temporary in 69.1% of cases. Conclusion: The results of this review indicate that surgical management of chronic distal biceps ruptures demonstrates improvement in outcomes including pain reduction and functional ability. Although there may be a slightly higher immediate complication rate, the functional outcomes remain comparable with those seen in the patient population with acute distal biceps.

Nursing students' learning from involvement in research projects: an integrative literature review

ABSTRACT Objective: To identify the learning outcomes and skills obtained of undergraduate nursing students involved in research projects. Methods: This was an integrative literature review, based on a research protocol in the CINAHL Complete databases; Cochrane Central Register of Controlled Trials; Cochrane Database of Systematic Reviews; Cochrane Methodology Register; MedicLatina; MEDLINE, Scopus and JBI, including primary and secondary studies, published between 2015 and 2020. Results: A total of five heterogeneous articles were included, which were categorized using Kirkpatrick's (adapted) model. Seventeen learning outcomes acquired through participation in research projects were identified, from the learning of new knowledge and skills to the development of new attitudes and behaviors. Final considerations: The involvement of nursing students in research projects is important to their professional development. Future investment in research on this topic can help cement the potential of this type of student involvement.

Coriandrum sativum L.: A Review on Ethnopharmacology, Phytochemistry, and Cardiovascular Benefits

Coriandrum sativum (C. sativum), belonging to the Apiaceae (Umbelliferae) family, is widely recognized for its uses in culinary and traditional medicine. C. sativum contains various phytochemicals such as polyphenols, vitamins, and many phytosterols, which account for its properties including anticancer, anti-inflammatory, antidiabetic, and analgesic effects. The cardiovascular benefits of C. sativum have not been summarized before, hence this review aims to further evaluate and discuss its effectiveness in cardiovascular diseases, according to the recent literature. An electronic search for literature was carried out using the following databases: PubMed, Scopus, Google Scholar, preprint platforms, and the Cochrane Database of Systematic Reviews. Articles were gathered from the inception of the database until August 2021. Moreover, the traditional uses and phytochemistry of coriander were surveyed in the original resources and summarized. As a result, most of the studies that cover cardiovascular benefits and fulfilled the eligibility criteria were in vivo, while only a few were in vitro and clinical studies. In conclusion, C. sativum can be deemed a functional food due to its wide range of cardiovascular benefits such as antihypertensive, anti-atherogenic, antiarrhythmic, hypolipidemic as well as cardioprotective effects.

Protocolo de scoping review: auriculoterapia em crianças e adolescentes no âmbito da Atenção à Saúde

O objetivo deste estudo é mapear e analisar a produção científica acerca da auriculoterapia para crianças e adolescentes no âmbito da atenção à saúde. Para tanto, foi utilizada a estratégia PCC: (P) Participantes – Crianças e Adolescentes entre 6 e 12 anos (OMS); (C) conceito: auriculoterapia; e (C) Contexto: atenção integral à saúde, como recomendam estudiosos (Aromataris & Munn, 2020) . Que originou a seguinte questão: Quais as evidências na literatura científica sobre auriculoterapia para crianças e adolescentes no âmbito da atenção integral à saúde? Esta revisão de escopo considerará estudos originais, realizados exclusivamente com seres humanos, crianças com idade entre 6 e 12 anos incompletos, publicados na íntegra em periódicos nacionais e internacionais, gratuitos ou não, com abordagem qualitativa e/ou quantitativa, nos idiomas português, inglês e espanhol. Os estudos deverão abordar o uso da auriculoterapia na atenção à saúde. Assim, serão considerados os estudos com as variações de recursos da auriculoterapia (sementes de vaccaria, esferas magnéticas e cristais). As fontes indexadas que serão utilizadas para a revisão de escopo são: Medical Literature Anallysis and Retrieval System online (MEDLINE); Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS); Scientific Electronic Library online (SCIELO); as bases de dados Cochrane Database of Systematic Reviews (CDCR), a Bibliografia Brasileira de Odontologia (BBO), bem como a Biblioteca Virtual em Saúde em Medicinas Tradicionais, Complementar e Integrativa (BVS MTCI), Biblioteca Virtual em Saúde do Adolescente (ADOLEC) e Physiotherapy Evidence Database (PEDro). Para pesquisar a literatura cinzenta, será consultada a Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES). As buscas nestas fontes indexadas serão realizadas no período entre fevereiro e março de 2022. Espera-se com esta revisão contribuir com o estado da arte acerca da produção e implementação de Práticas Integrativas Complementares.

Neurological Outcome Following Newborn Encephalopathy With and Without Perinatal Infection: A Systematic Review

Background: Studies have suggested that neurological outcome may differ in newborns with encephalopathy with and without perinatal infection. We aimed to systematically review this association.Methods: We conducted this systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Studies were obtained from four databases including Pubmed, Embase, Web of Science, and The Cochrane Database. Newborns with encephalopathy with and without markers of perinatal infection were compared with regard to neurodevelopmental assessments, neurological disorders, and early biomarkers of brain damage. Risk of bias and quality of evidence were assessed by the Newcastle-Ottawa scale and Grading of Recommendations Assessment, Development and Evaluation (GRADE).Results: We screened 4,284 studies of which eight cohort studies and one case-control study met inclusion criteria. A narrative synthesis was composed due to heterogeneity between studies. Six studies were classified as having low risk of bias, while three studies were classified as having high risk of bias. Across all outcomes, the quality of evidence was very low. The neurological outcome was similar in newborns with encephalopathy with and without markers of perinatal infection.Conclusions: Further studies of higher quality are needed to clarify whether perinatal infection may affect neurological outcome following newborn encephalopathy.Systematic Review Registration:https://www.crd.york.ac.uk/prospero/, identifier CRD42020185717.

Comparative Effect of Antihypertensive Drugs in Improving Arterial Stiffness in Hypertensive Adults (RIGIPREV Study). A Protocol for Network Meta-Analysis

(1) Background: Arterial stiffness is closely and bi-directionally related to hypertension and is understood as both a cause and a consequence of hypertension. Several studies suggest that antihypertensive drugs may reduce arterial stiffness. Therefore, effective prescription of antihypertensive drugs should consider both blood pressure and arterial stiffness. The aim of this protocol is to provide a review comparing the effects of different types of antihypertensive drug interventions on the reduction of arterial stiffness in hypertensive subjects. (2) Methods: The literature search will be performed through the MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and Web of Science databases. Randomised clinical trials assessing the effect of antihypertensive drug interventions on arterial stiffness measured in subjects with hypertension will be included. A frequentist network meta-analysis will be performed to determine the comparative effects of different antihypertensive drugs. (3) Results: The findings of this study will be published in a peer-reviewed journal. (4) Conclusions: This study will provide evidence for health care professionals on the efficacy of different antihypertensive drugs in decreasing arterial stiffness; in addition, it will analyse the efficacy of the drugs not only in terms of arterial stiffness but also in terms of blood pressure treatment.

How can clinicians choose between conflicting and discordant systematic reviews? A replication study of the Jadad algorithm

Introduction: The exponential growth of published SRs (SRs) presents challenges for clinicians seeking to answer clinical questions. In 1997, an algorithm was created by Jadad et al. to choose the best SR across multiple but similar SRs with conflicting results. Our study aims to replicate assessments done by authors using the Jadad algorithm to determine: (i) if we chose the same SR as the authors; and (ii) if we would reach the same results.Methods and Analysis: We searched MEDLINE, Epistemonikos, and Cochrane Database of SRs. We included any study using the Jadad algorithm. We used consensus building strategies to operationalise the algorithm and to ensure a consistent approach to interpretation.Results: We identified 21 studies that used the Jadad algorithm to choose one or more SRs. In 62% (13/21) of cases, we were unable to replicate the Jadad assessment and ultimately chose a different SR than the authors. Overall, 18 out of the 21 (86%) independent Jadad assessments agreed in direction of the findings despite 13 having chosen a different SR.Conclusions: Our results suggest that the Jadad algorithm is not reproducible between users as there are no prescriptive instructions about how to operationalise the algorithm. In the absence of a validated algorithm, we recommend that healthcare providers, policy makers, patients and researchers address conflicts between review findings by choosing the SR(s) with meta-analysis of RCTs that most closely resemble their clinical, public health, or policy question, are the most recent, comprehensive (i.e. in terms of number of included RCTs), and at the lowest risk of bias.

Os impactos da pandemia de COVID-19 na mobilidade urbana: uma revisão narrativa de literatura

Introdução: a mobilidade urbana é entendida como a capacidade cotidiana de deslocamento de pessoas e bens no espaço urbano de forma segura e em tempo considerado adequado. Recentemente, a situação pandêmica foi gradualmente amenizada e o plano de recuperação econômica e social foi colocado em pauta pelo governo durante o período pós-epidemia. Nessas circunstâncias, o sistema de transporte urbano desempenha um papel crucial no processo de recuperação social e econômica como garantia básica da cidade. Portanto, maior atenção deve ser dada aos impactos da pandemia de COVID-19 no sistema de transporte urbano, bem como no comportamento de viagem. Objetivo: evidenciar os impactos causados pela pandemia de COVID-19 na mobilidade urbana. Metodologia: trata-se de revisão narrativa da literatura, com estudos acoplados nas seguintes bases de dados: National Library of Medicine (PubMed MEDLINE), Scientific Electronic Library Online (Scielo), Cochrane Database of Systematic Reviews (CDSR), Google Scholar, Biblioteca Virtual em Saúde (BVS) e EBSCO Information Services. Resultados: alguns impactos sobre a mobilidade urbana puderam ser observados devido ao alto grau de contágio do novo coronavírus e, portanto, à necessidade de permanecer em casa e manter um distanciamento mínimo. São impactos a princípio sociais, econômicos ou ambientais, mas que apresentam forte relação com a mobilidade urbana. Em geral houve uma drástica diminuição da locomoção nas cidades, que se encontraram vazias, e há um temor com relação à volta às atividades normais à medida que o isolamento vai sendo flexibilizado. Considerações finais: a pandemia de COVID-19 provocou inúmeras mudanças na vida da população mundial. Na mobilidade urbana não foi diferente. Com o fechamento do comércio considerado não essencial, a suspensão de aulas e a instalação de regimes de teletrabalho, grande parte dos deslocamentos diários foram interrompidos e/ou modificados. Medidas como a instalação de políticas de subsídio do transporte público, de ampliação das ciclovias, de aplicação de ações de desestímulo do uso do transporte individual motorizado, de melhora na segurança pública e de circulação de pedestres e ciclistas etc., se mostraram urgentes durante a quarentena, não apenas para gerar condições mínimas para mobilidade ativa, mas também para melhorar a qualidade de vida da população como um todo.

Practice review: Evidence-based and effective management of fatigue in patients with advanced cancer

Background: Fatigue affects most patients living with advanced cancer and is a symptom that healthcare professionals can find difficult to manage. Aim: To provide healthcare professionals with a pragmatic overview of approaches to management of fatigue in patients with advanced cancer that are commonly recommended by guidelines and to evaluate evidence underpinning them. Design: Scoping review methodology was used to determine the strength of evidence supporting use of interventions recommended in management of fatigue in patients with advanced cancer. Data sources: National or international guidelines were examined if they described the management of fatigue in adult cancer patients and were written within the last 6 years (2015–2021) in English. The Cochrane Database of Systematic Reviews (January 2011–December 2021) was searched for ‘cancer’ AND ‘fatigue’ in title, abstract or keywords. A PubMed search was also made. Results: Evidence indicates physical exercise interventions are effective and patients may benefit from energy conservation tactics. Evidence does not support use of psychostimulants such as methylphenidate. Limited data were found on efficacy of corticosteroids, psychological interventions, nutritional intervention, sleep optimization or complementary therapies for management of fatigue in advanced cancer. Conclusion: We recommend regular assessment, review and acknowledgement of the impact of fatigue. Exercise and energy conservation should be considered. Pharmacological interventions are not endorsed as a routine approach. Many interventions currently recommended by guidelines are not supported by a robust evidence base and further research on their efficacy is required.