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Zhao Y, Xiao X. Efficacy of ultrasound-guided stellate ganglion block in relieving acute postoperative pain: a systematic review and meta-analysis. J Int Med Res 2024; 52:3000605241252237. [PMID: 38759220 PMCID: PMC11107331 DOI: 10.1177/03000605241252237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 04/15/2024] [Indexed: 05/19/2024] Open
Abstract
OBJECTIVE The efficacy of ultrasound-guided stellate ganglion block (SGB) in alleviating postoperative pain remains unclear. This meta-analysis was performed to determine the efficacy of ultrasound-guided SGB in relieving acute postoperative pain in patients undergoing surgery with general anesthesia. METHODS This systematic review and meta-analysis focused on randomized controlled trials comparing SGB with control or placebo. The primary outcome was the pain score at 24 hours after surgery. A random-effects model was used to calculate the mean difference (MD) or risk ratio with a confidence interval (CI) of 95%. RESULTS Eight studies involving 470 patients were included in the meta-analysis. The results revealed that ultrasound-guided SGB was significantly associated with a lower pain score at 24 hours after surgery (MD = -0.74; 95% CI = -1.39, -0.08; I2 = 86%; low evidence) and at 8 hours after surgery (MD = -0.65; 95% CI = -1.03, -0.28; I2 = 29%; moderate evidence). CONCLUSION Ultrasound-guided SGB is effective in alleviating acute postoperative pain. However, considering the limited number of trials performed to date, more large-scale and high-quality randomized controlled trials are required to confirm these findings.
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Affiliation(s)
- Yan Zhao
- Department of Anesthesiology, Beihai People’s Hospital, Beihai, China
| | - Xiangli Xiao
- Department of Anesthesiology, Beihai People’s Hospital, Beihai, China
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Lin HW, Tam KW, Liou TH, Rau CL, Huang SW, Hsu TH. Efficacy of Platelet-Rich Plasma Injection on Range of Motion, Pain, and Disability in Patients With Adhesive Capsulitis: A Systematic Review and Meta-analysis. Arch Phys Med Rehabil 2023; 104:2109-2122. [PMID: 37119955 DOI: 10.1016/j.apmr.2023.03.032] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 03/28/2023] [Accepted: 03/31/2023] [Indexed: 05/01/2023]
Abstract
OBJECTIVE To investigate the therapeutic effects of platelet-rich plasma (PRP) injection on range of motion, pain, and disability in patients with adhesive capsulitis (AC). DATA SOURCES The authors performed the literature search in the PubMed, Embase, and Cochrane Library databases in February 2023. STUDY SELECTION Prospective studies comparing the outcomes of PRP with other intervention in patients with AC. DATA EXTRACTION The quality of included randomized trials was assessed using the revised Cochrane Risk of Bias (RoB 2.0) tool. The Risk of Bias in Non-Randomized Studies of Interventions tool was applied to assess the quality of nonrandomized trials. The mean difference (MD) or standardized mean difference (SMD) was determined as the effect size for continuous outcomes, and outcome accuracy was determined using 95% confidence intervals (CIs). DATA SYNTHESIS Fourteen studies involving 1139 patients were included. Our meta-analysis revealed that PRP injection can significantly improve passive abduction (MD=3.91; 95% CI, 0.84-6.98), passive flexion (MD=3.90; 95% CI, 0.15-7.84), and disability (SMD=-0.50; 95% CI, -1.29 to -0.74) within 1 month after intervention. Moreover, PRP injection can significantly improve passive abduction (MD=17.19; 95% CI, 12.38-22.01), passive flexion (MD=17.74; 95% CI, 9.89-25.59), passive external rotation (MD=12.95; 95% CI, 10.04-15.87), pain (MD=-8.40; 95% CI, -16.73 to -0.06), and disability (SMD=-1.02; 95% CI, -1.29 to -0.74) 3 months after intervention. PRP injection can also significantly improve pain (MD=-18.98; 95% CI, -24.71 to -13.26), and disability (SMD=-2.01; 95% CI, -3.02 to -1.00) 6 months after intervention. In addition, no adverse effects of PRP injection were reported. CONCLUSIONS PRP injection may serve as an effective and safe treatment for patients with AC.
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Affiliation(s)
- Ho-Wei Lin
- School of Medicine, College of Medicine, Taipei Medical University, Taipei City
| | - Ka-Wai Tam
- Center for Evidence-Based Health Care, Shuang Ho Hospital, Taipei Medical University, New Taipei City; Cochrane Taiwan, Taipei Medical University, Taipei City; Division of General Surgery, Department of Surgery, Shuang Ho Hospital, Taipei Medical University, New Taipei City; Division of General Surgery, Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei City
| | - Tsan-Hon Liou
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, New Taipei City; Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei City, Taiwan
| | - Chi-Lun Rau
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, New Taipei City; Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei City, Taiwan
| | - Shih-Wei Huang
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, New Taipei City; Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei City, Taiwan
| | - Tzu-Herng Hsu
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, New Taipei City; Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei City, Taiwan.
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Chen L, Li C, Bai H, Li L, Chen W. Use of modeling and simulation to predict the influence of triazole antifungal agents on the pharmacokinetics of zanubrutinib and acalabrutinib. Front Pharmacol 2022; 13:960186. [PMID: 36299883 PMCID: PMC9588929 DOI: 10.3389/fphar.2022.960186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 09/26/2022] [Indexed: 11/13/2022] Open
Abstract
Background: Bruton’s tyrosine kinase (BTK) inhibitors are commonly used in the targeted therapy of B-cell malignancies. It is reported that myelosuppression and fungal infections might occur during antitumor therapy of BTK inhibitors, therefore a combination therapy with triazole antifungals is usually required. Objective: To evaluate the influence of different triazoles (voriconazole, fluconazole, itraconazole) on the pharmacokinetics of BTK inhibitors (zanubrutinib, acalabrutinib) and to quantify the drug-drug interactions (DDIs) between them. Methods: The physiologically-based pharmacokinetic (PBPK) models were developed based on pharmacokinetic parameters and physicochemical data using Simcyp® software. These models were validated using clinically observed plasma concentrations data which based on existing published studies. The successfully validated PBPK models were used to evaluate and predict potential DDIs between BTK inhibitors and different triazoles. BTK inhibitors and triazole antifungal agents were simulated by oral administration. Results: Simulated plasma concentration-time profiles of the zanubrutinib, acalabrutinib, voriconazole, fluconazole, and itraconazole are consistent with the clinically observed profiles which based on existing published studies, respectively. The exposures of BTK inhibitors increase by varying degrees when co-administered with different triazole antifungals. At multiple doses regimen, voriconazole, fluconazole and itraconazole may increase the area under plasma concentration-time curve (AUC) of zanubrutinib by 127%, 81%, and 48%, respectively, and may increase the AUC of acalabrutinib by 326%, 119%, and 264%, respectively. Conclusion: The PBPK models sufficiently characterized the pharmacokinetics of BTK inhibitors and triazole antifungals, and were used to predict untested clinical scenarios. Voriconazole exhibited the greatest influence on the exposures of BTK inhibitors. The dosage of zanubrutinib or acalabrutinib need to be reduced when co-administered with moderate CYP3A inhibitors.
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Affiliation(s)
- Lu Chen
- Department of Pharmacy, Chongqing University Cancer Hospital, Chongqing, China
| | - Chao Li
- Department of Pharmacy, Chongqing University Cancer Hospital, Chongqing, China
| | - Hao Bai
- Department of Pharmacy, Chongqing University Cancer Hospital, Chongqing, China
| | - Lixian Li
- Department of Pharmacy, Chongqing University Cancer Hospital, Chongqing, China
| | - Wanyi Chen
- Department of Pharmacy, Chongqing University Cancer Hospital, Chongqing, China
- Chongqing University, Chongqing, China
- *Correspondence: Wanyi Chen,
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Tsikopoulos K, Sidiropoulos K, Kitridis D, Moulder E, Ahmadi M, Drago L, Lavalette D. Preventing Staphylococcus aureus stainless steel-associated infections in orthopedics. A systematic review and meta-analysis of animal literature. J Orthop Res 2021; 39:2615-2637. [PMID: 33527485 DOI: 10.1002/jor.24999] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 01/17/2021] [Accepted: 01/25/2021] [Indexed: 02/04/2023]
Abstract
Surgical site infection in the presence of orthopedic implants poses significant healthcare and socioeconomic burden. To assess the potential of various prevention strategies against Staphylococcus-induced stainless steel-associated infections, a review of animal evidence was designed. The databases of PubMed, Embase, and CENTRAL were searched until March 10, 2020, for articles including animal models with stainless steel instrumentation and techniques to prevent Staphylococcus infection. We conducted a random-effects meta-analysis of standardized mean differences (SMD) with subgroup analysis linked to various protection strategies and we recorded complications. Quality was assessed with the SYRCLE's risk of bias tool. Twenty-five studies were included. Combined active coating (featuring organic antibacterial compound release) and degradable passive finishing (lipid- or polymer-based structure modification reducing bacterial adhesion) was favored over untreated controls (SMDs for methicillin-sensitive Staphylococcus aureus [MSSA] and methicillin-resistant Staphylococcus aureus [MRSA] were -3.46, 95% CI [-4.53 to -2.4], p < .001 [n = 4 head-to-head comparisons]; and -6.67, 95% CI [-10.53 to -3], p < .001 [n = 5 head-to-head comparisons], respectively). Systemic vitamin D supplementation and systemic antibiotic administration with or without local antibiotics demonstrated favorable outcomes against MSSA infection. On the contrary, no benefit was seen following vaccination. Of note, no side effects were documented. On the basis of data gathered from eight studies, which comprised 294 animals, a bioresorbable polymer- or lipid-based surface modification supplemented with organic coating yielded improved infection-related outcomes against MSSA and MRSA stainless steel infections, and therefore, this strategy could be further investigated in human research.
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Affiliation(s)
| | | | - Dimitrios Kitridis
- 1st Orthopedic Department, G. Papanikolaou General Hospital, Aristotle University, Thessaloniki, Greece
| | - Elizabeth Moulder
- Orthopedic Department, Hull Limb Reconstruction Unit, Hull Royal Infirmary, Hull, UK
| | - Milad Ahmadi
- Orthopaedic Department, Leeds General Infirmary, Leeds, UK
| | - Lorenzo Drago
- Laboratory of Clinical Microbiology, Department of Biochemical Sciences for Health, University of Milan, Milan, Italy
| | - David Lavalette
- Orthopedic Department, Harrogate and District NHS Foundation Trust, Harrogate, UK
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Tsikopoulos K, Sidiropoulos K, Kitridis D, Drago L, Ebnezar R, Lavalette D. Rationalising animal research synthesis in orthopaedic literature. World J Methodol 2021; 11:75-80. [PMID: 34026580 PMCID: PMC8127423 DOI: 10.5662/wjm.v11.i3.75] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 02/05/2021] [Accepted: 03/12/2021] [Indexed: 02/06/2023] Open
Abstract
Systematic reviews in orthopaedic literature are frequently criticised for offering inconsistent conclusions. On top of that, high-quality randomized human evidence on crucial orthopaedic topics is more often than not lacking. In this situation, pooling animal literature could offer an excellent insight into unanswered critical clinical questions, thus potentially improving healthcare. In this paper, we sought to present the rationale and basic principles governing meta-analysis of animal research. More specifically, we elaborated on the available evidence-based methods to achieve a scientifically sound animal data synthesis. In addition, we discussed result interpretation, strength of recommendations and clinical implications based on the results of these meta-analytic modalities.
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Affiliation(s)
- Konstantinos Tsikopoulos
- Orthopaedic Department, Harrogate and District Foundation Trust, Harrogate HG2 7SX, North Yorkshire, United Kingdom
| | | | - Dimitrios Kitridis
- First Orthopedic Department of Aristotle University, G. Papanikolaou General Hospital, Thessaloniki 55210, Greece
| | - Lorenzo Drago
- Laboratory of Clinical Microbiology, Department of Biochemical Sciences for Health, University of Milan, Milan 20164, Italy
| | - Rakesh Ebnezar
- Orthopaedic Department, Harrogate and District Foundation Trust, Harrogate HG2 7SX, North Yorkshire, United Kingdom
| | - David Lavalette
- Orthopaedic Department, Harrogate and District Foundation Trust, Harrogate HG2 7SX, North Yorkshire, United Kingdom
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Hirt J, Bergmann J, Karrer M. Overlaps of multiple database retrieval and citation tracking in dementia care research: a methodological study. J Med Libr Assoc 2021; 109:275-285. [PMID: 34285670 PMCID: PMC8270360 DOI: 10.5195/jmla.2021.1129] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE We aimed to determine overlaps and optimal combination of multiple database retrieval and citation tracking for evidence synthesis, based on a previously conducted scoping review on facilitators and barriers to implementing nurse-led interventions in dementia care. METHODS In our 2019 scoping review, we performed a comprehensive literature search in eight databases (CENTRAL, CINAHL, Embase, Emcare, MEDLINE, Ovid Nursing Database, PsycINFO, and Web of Science Core Collection) and used citation tracking. We retrospectively analyzed the coverage and overlap of 10,527 retrieved studies published between 2015 and 2019. To analyze database overlap, we used cross tables and multiple correspondence analysis (MCA). RESULTS Of the retrieved studies, 6,944 were duplicates and 3,583 were unique references. Using our search strategies, considerable overlaps can be found in some databases, such as between MEDLINE and Web of Science Core Collection or between CINAHL, Emcare, and PsycINFO. Searching MEDLINE, CINAHL, and Web of Science Core Collection and using citation tracking were necessary to retrieve all included studies of our scoping review. CONCLUSIONS Our results can contribute to enhancing future search practice related to database selection in dementia care research. However, due to limited generalizability, researchers and librarians should carefully choose databases based on the research question. More research on optimal database retrieval in dementia care research is required for the development of methodological standards.
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Affiliation(s)
- Julian Hirt
- , Center for Dementia Care, Institute of Applied Nursing Sciences, FHS St.Gallen, University of Applied Sciences, Department of Health, Rosenbergstrasse 59, 9000 St.Gallen, Switzerland and International Graduate Academy, Institute for Health and Nursing Science, Medical Faculty, Martin Luther University Halle-Wittenberg, Magdeburger Strasse 8, 06112 Halle (Saale), Germany
| | - Johannes Bergmann
- , German Centre for Neurodegenerative Diseases (DZNE), Stockumer Strasse 12, 58453 Witten, Germany and University Witten/Herdecke, Faculty of Health, Department for Nursing Science, Stockumer Strasse 12, 58453 Witten, Germany
| | - Melanie Karrer
- , Center for Dementia Care, Institute of Applied Nursing Sciences, FHS St.Gallen, University of Applied Sciences, Department of Health, Rosenbergstrasse 59, 9000 St.Gallen, Switzerland
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7
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Bjørseth B, Simensen JO, Bjørnethun A, Griffiths MD, Erevik EK, Leino T, Pallesen S. The Effects of Responsible Gambling Pop-Up Messages on Gambling Behaviors and Cognitions: A Systematic Review and Meta-Analysis. Front Psychiatry 2021; 11:601800. [PMID: 33569015 PMCID: PMC7868407 DOI: 10.3389/fpsyt.2020.601800] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 12/31/2020] [Indexed: 12/12/2022] Open
Abstract
Pop-up messages utilized by gambling operators are normally presented to gamblers during gambling sessions in order to prevent excessive gambling and/or to help in the appraisal of maladaptive gambling cognitions. However, the effect of such messages on gambling behavior and gambling cognitions has not previously been synthesized quantitatively. Consequently, a meta-analysis estimating the efficacy of pop-up messages on gambling behavior and cognitions was conducted. A systematic literature search with no time constraints was performed on Web of Science, PsychInfo, Medline, PsychNET, and the Cochrane Library. Search terms included "gambling," "pop-up," "reminder," "warning message," and "dynamic message." Studies based on randomized controlled trials, quasi-experimental designs and pre-post studies reporting both pre- and post-pop-up data were included. Two authors independently extracted data using pre-defined fields including quality assessment. A total of 18 studies were included and data were synthesized using a random effects model estimating Hedges' g. The effects of pop-ups were g = 0.413 for cognitive measures (95% CI = 0.115-0.707) and g = 0.505 for behavioral measures (95% CI = 0.256-0.746). For both outcomes there was significant between-study heterogeneity which could not be explained by setting (laboratory vs. naturalistic) or sample (gambler vs. non-gamblers). It is concluded that pop-up messages provide moderate effects on gambling behavior and cognitions in the short-term and that such messages play an important role in the gambling operators' portfolio of responsible gambling tools.
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Affiliation(s)
- Benjamin Bjørseth
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
| | | | - Aina Bjørnethun
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
| | - Mark D. Griffiths
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, United Kingdom
| | - Eilin K. Erevik
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
- Norwegian Competence Center for Gambling and Gaming Research, University of Bergen, Bergen, Norway
| | - Tony Leino
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
| | - Ståle Pallesen
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
- Norwegian Competence Center for Gambling and Gaming Research, University of Bergen, Bergen, Norway
- Optentia, The Vaal Triangle Campus of the North-West University, Vanderbijlpark, South Africa
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8
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Kristensen JH, Pallesen S, King DL, Hysing M, Erevik EK. Problematic Gaming and Sleep: A Systematic Review and Meta-Analysis. Front Psychiatry 2021; 12:675237. [PMID: 34163386 PMCID: PMC8216490 DOI: 10.3389/fpsyt.2021.675237] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 05/04/2021] [Indexed: 01/20/2023] Open
Abstract
Problematic gaming has been linked to poor sleep outcomes; however, these associations have not yet been synthesized quantitatively. This review employed a meta-analysis to investigate the relationship between problematic gaming and sleep-related outcomes. A search of Medline, Embase, Web of Science, PsycINFO, and Google Scholar identified a total of 763 studies, including 34 studies (n = 51,901 participants) eligible for inclusion. Papers were included if available in any European language, addressed problematic gaming, contained original data, and provided sufficient data for calculation of effect sizes. Two researchers independently extracted data using pre-defined fields including quality assessment. Sleep-related outcomes were meta-analyzed for sleep parameters that were reported by 5 or more papers. Significant overall effects were found for sleep duration (g = -0.238, 95% CI = -0.364, -0.112), poor sleep quality (OR = 2.02, 95% CI = 1.47, 2.78), daytime sleepiness (OR = 1.57, 95% CI = 1.00, 2.46) and sleep problems (OR = 2.60, 95% CI = 1.94, 3.47). Between-study heterogeneity was detected for all meta-analyses. Subgroup analyses showed a higher inverse effect size for adolescent samples compared to adult or non-specific age samples in terms of sleep duration. For daytime sleepiness, a larger effect size was found for studies based on single-item sleep measures compared to multi-item sleep measures. For sleep problems, the subgroup analysis showed the opposite with a higher effect size for studies based on single-item sleep measures than multi-item sleep measures. Across all sleep parameters, problematic gamers consistently reported a more adverse sleep status than non-problematic gamers. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/; record ID: CRD42020158955.
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Affiliation(s)
- Joakim H Kristensen
- Department of Psychosocial Science, University of Bergen, Bergen, Norway.,Norwegian Competence Centre for Gambling and Gaming Research, University of Bergen, Bergen, Norway
| | - Ståle Pallesen
- Department of Psychosocial Science, University of Bergen, Bergen, Norway.,Norwegian Competence Centre for Gambling and Gaming Research, University of Bergen, Bergen, Norway.,Optentia, Vaal Triangle Campus of the North-West University, Vanderbijlpark, South Africa.,Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway
| | - Daniel L King
- College of Education, Psychology, & Social Work, Flinders University, Adelaide, SA, Australia
| | - Mari Hysing
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
| | - Eilin K Erevik
- Department of Psychosocial Science, University of Bergen, Bergen, Norway.,Norwegian Competence Centre for Gambling and Gaming Research, University of Bergen, Bergen, Norway
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Wang X, Lin C, Lan L, Liu J. Perioperative intravenous S-ketamine for acute postoperative pain in adults: A systematic review and meta-analysis. J Clin Anesth 2020; 68:110071. [PMID: 33007645 DOI: 10.1016/j.jclinane.2020.110071] [Citation(s) in RCA: 80] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Revised: 08/16/2020] [Accepted: 09/20/2020] [Indexed: 01/08/2023]
Abstract
STUDY OBJECTIVE To evaluate the effectiveness and safety of S-ketamine for pain relief and analgesic consumption in surgical patients. DESIGN Systematic review and meta-analysis of randomized controlled trials (RCTs). SETTING Perioperative setting. PATIENTS A total of 905 adult patients undergoing surgery using general anesthesia: 504 patients in the S-ketamine group and 401 patients in the placebo group. INTERVENTION Intravenous S-ketamine as an adjuvant to general anesthesia compared with placebo. MEASUREMENTS The primary outcomes were resting and movement pain scores (VAS/NRS 0-10) and morphine consumption within 4, 12, 24 and 48 h after surgery. The secondary outcomes included postoperative complications such as nausea, vomiting, and psychotomimetic adverse events. We used the guidelines of the Recommendation Assessment, Development, and Evaluation (GRADE) system to evaluate the level of certainty for the main results. MAIN RESULTS A total of 12 studies were included. The types of surgery included abdominal surgery, thoracotomy, gynecologic surgery, arthroscopic anterior cruciate ligament repair, cardiac surgery, laparoscopic cholecystectomy, lumbar spinal fusion surgery, radical prostatectomy, and hemorrhoidectomy. There were significant improvements in resting pain scores at 4, 12 and 24 h with S-ketamine versus placebo [4 h: standardized mean difference (SMD) -1.11; 95% confidence interval (CI): -1.53, -0.68, p < 0.00001; GRADE = moderate; 12 h: SMD -0.88; 95%CI: -1.42, -0.34, p = 0.001; GRADE = moderate; 24 h: SMD -0.39; 95%CI: -0.73, -0.06, p = 0.02; GRADE = moderate]. The incidence of pain scores at 48 h showed no statistical difference between the two groups (SMD -0.27; 95%CI: -1.12, 0.58, p = 0.53, GRADE = moderate). The movement pain scores were not significantly different between the two groups at each time point (4 h: SMD -0.34; 95%CI: -0.73, 0.05, p = 0.09, GRADE = moderate; 12 h: SMD -0.42; 95%CI: -1.46, 0.63, p = 0.44, GRADE = low; 24 h: SMD -0.58; 95%CI: -1.25, 0.09, p = 0.09, GRADE = moderate; 48 h: SMD -0.49; 95%CI: -1.11, 0.14, p = 0.13, GRADE = low). At 4 and 12 h after surgery, the consumption of morphine was significantly reduced in the S-ketamine group (4 h: SMD -0.98; 95%CI: -1.37, -0.06, p < 0.00001, GRADE = moderate; 12 h: SMD -1.36; 95%CI: -2.26, -0.46, p = 0.003, GRADE = low). There were no significant differences in morphine use at 24 and 48 h between the two groups (24 h: SMD -0.70; 95%CI: -1.42, 0.02, p = 0.06, GRADE = low; 48 h: SMD -0.79; 95%CI: -2.26, 1.03, p = 0.39, GRADE = low). The risk for nausea [relative risk (RR) = 1.04; 95%CI: 0.83, 1.30, p = 0.73], vomiting (RR = 1.07; 95%CI: 0.84, 1.38, p = 0.57), and psychotomimetic adverse events (RR = 1.57; 95%CI: 0.82, 2.99, p = 0.17) showed no significant increase in the S-ketamine group. CONCLUSIONS Intravenous S-ketamine as an adjunct to general anesthesia is effective for assisting analgesia and decreases the intensity of pain and opioid requirements in a short period of time after surgery, but it may increase the psychotomimetic adverse event rate. Overall, the level of certainty is moderate to low.
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Affiliation(s)
- Xuemei Wang
- Department of Anesthesiology, the First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530021, China
| | - Cheng Lin
- Department of Anesthesiology, the First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530021, China
| | - Lifang Lan
- Department of Anesthesiology, the First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530021, China
| | - Jingchen Liu
- Department of Anesthesiology, the First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530021, China.
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Gaudino M, Fremes S, Bagiella E, Bangalore S, Demetres M, D'Ascenzo F, Biondi-Zoccai G, Di Franco A. Systematic Reviews and Meta-Analyses in Cardiac Surgery: Rules of the Road - Part 1. Ann Thorac Surg 2020; 111:754-761. [PMID: 32717235 DOI: 10.1016/j.athoracsur.2020.05.148] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Accepted: 05/21/2020] [Indexed: 02/08/2023]
Abstract
The number of cardiac surgical meta-analyses and systematic reviews published in the last decades has constantly increased, paralleling the exponential growth observed in virtually all other medical fields. Meta-analyses are open to methodological flaws, however, if best practices are not strictly followed. Assessment of the appropriateness of the research question is a crucial first step. Once a protocol has been developed, this should be registered before the work is initiated. The cornerstone of any systematic review or meta-analysis is a rigorous, comprehensive, and most of all reproducible, search that follows a prespecified and clear strategy. Eligibility criteria must be discussed and agreed upon in advance to guide final study selection, which ultimately lays the foundation for subsequent data extraction. In case of missing or partially reported data, the authors of the original papers should be contacted. Adherence to rigorous methodological rules at each of these stages will warrant availability of good quality data for formal statistical analyses. The aim of the first part of this expert review is to discuss the limits and pitfalls of the meta-analytic approach and provide guidance on how to perform trial-level meta-analyses, with particular reference to the identification of an appropriate research question, the definition and registration of the protocol, the search strategy, the study selection, and the data abstraction.
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Affiliation(s)
- Mario Gaudino
- Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, New York.
| | - Stephen Fremes
- Division of Cardiac Surgery, Schulich Heart Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Emilia Bagiella
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Sripal Bangalore
- New York University Grossman School of Medicine, New York, New York
| | - Michelle Demetres
- Samuel J. Wood Library and C.V. Starr Biomedical Information Center, Weill Cornell Medicine, New York, New York
| | - Fabrizio D'Ascenzo
- Division of Cardiology, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Giuseppe Biondi-Zoccai
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University, Rome, Italy; Mediterranea Cardiocentro, Naples, Italy
| | - Antonino Di Franco
- Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, New York
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Hirt J, Brinkmann S, Cadima R, Dichter MN, Golla A, Kaap-Fröhlich S, Kachler M, Lauer N, Meiling C, Messer M, Paulicke D, Saal S, Schmidt S, Schwarz C, Tholen R, Ulrich G, Warnke A, Abraham J. [Database indexing of health science journals from the German-speaking area: A journal analysis]. ZEITSCHRIFT FUR EVIDENZ FORTBILDUNG UND QUALITAET IM GESUNDHEITSWESEN 2020; 150-152:20-28. [PMID: 32439423 DOI: 10.1016/j.zefq.2020.04.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 04/07/2020] [Accepted: 04/07/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Journal hand searching offers the possibility to complement a literature search as part of systematic reviews and other evidence syntheses. Hand searching is indicated in cases where scientific journals with potentially relevant publications addressing the research question are not indexed in a literature database. However, it is often unclear whether these journals are actually indexed, and when they are, in which literature databases. In many cases, it is also unknown which journals should be searched by hand in addition to systematic literature search after databases to be searched have been specified. Therefore, the project aimed to investigate the indexation of selected scientific health science journals and to provide an overview of indexation in order to facilitate the hand search planning process. METHODS Journals from German-speaking countries covering eight professional fields (medical laboratory assistance, occupational therapy, midwifery, logopedics, nursing, physiotherapy, public health and rehabilitation) were considered that publish original research papers or systematic reviews or other review types in German and/or English. Two researchers per field identified relevant journals and independently analyzed the indexing locations using the journal websites. In case of missing information, we contacted the editors. RESULTS A total of 70 journals were included: from 1 to 17 journals per field. These journals are indexed in 1 to 29 databases. Twelve journals are not indexed or do not offer information concerning indexation. Indexation is distributed across n=74 different literature databases. Most journals are indexed in LIVIVO (n=55) and bibnet.org (n=33). Other common indexing databases are Scopus (n=18), Web of Science Core Collection (n=16), PSYNDEX (n=13), and Embase (n=10). CONCLUSIONS The results indicate a heterogeneous indexation of the included journals. Only a small number is indexed in common international literature databases such as MEDLINE or CINAHL. On the other hand, only a few journals are not indexed in any database. The results can be used as a basis to define databases for literature searches as part of systematic reviews. In addition, the findings might guide the selection of journals for hand searching after literature databases have been defined.
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Affiliation(s)
- Julian Hirt
- Institut für Angewandte Pflegewissenschaft, Fachbereich Gesundheit, FHS St.Gallen, Hochschule für Angewandte Wissenschaften, St.Gallen, Schweiz; Internationale Graduiertenakademie, Institut für Gesundheits- und Pflegewissenschaft, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Deutschland; Fachbereich Gesundheitsfachberufe, Deutsches Netzwerk Evidenzbasierte Medizin e.V. (EbM-Netzwerk), Berlin, Deutschland.
| | - Sabine Brinkmann
- Fakultät Wirtschafts- und Sozialwissenschaften, Hochschule Osnabrück, Osnabrück, Deutschland
| | - Ricardo Cadima
- Fachbereich Gesundheitswesen, Hochschule Niederrhein, Krefeld, Deutschland
| | - Martin N Dichter
- Institut für Pflegewissenschaft, Universitätsklinikum Köln, Köln, Deutschland
| | - André Golla
- Institut für Rehabilitationsmedizin, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Deutschland
| | | | - Marco Kachler
- Fachbereich Gesundheitsfachberufe, Deutsches Netzwerk Evidenzbasierte Medizin e.V. (EbM-Netzwerk), Berlin, Deutschland; Campus Spittal, Fachhochschule Kärnten, Klagenfurt am Wörthersee, Österreich
| | - Norina Lauer
- Fakultät Angewandte Sozial- und Gesundheitswissenschaften, Ostbayerische Technische Hochschule Regensburg, Regensburg, Deutschland
| | - Claudia Meiling
- Fachbereich Gesundheitsfachberufe, Deutsches Netzwerk Evidenzbasierte Medizin e.V. (EbM-Netzwerk), Berlin, Deutschland; Referat Standards und Qualität, Deutscher Verband der Ergotherapeuten, Karlsbad, Deutschland
| | - Melanie Messer
- Fachbereich Gesundheitsfachberufe, Deutsches Netzwerk Evidenzbasierte Medizin e.V. (EbM-Netzwerk), Berlin, Deutschland; Sektion externe Lehrende, APOLLON Hochschule der Gesundheitswirtschaft, Bremen, Deutschland
| | - Denny Paulicke
- Internationale Graduiertenakademie, Institut für Gesundheits- und Pflegewissenschaft, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Deutschland; Fachbereich Gesundheitsfachberufe, Deutsches Netzwerk Evidenzbasierte Medizin e.V. (EbM-Netzwerk), Berlin, Deutschland; Dorothea Erxleben Lernzentrum, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Deutschland
| | - Susanne Saal
- Fachbereich Gesundheitsfachberufe, Deutsches Netzwerk Evidenzbasierte Medizin e.V. (EbM-Netzwerk), Berlin, Deutschland; Institut für Gesundheits- und Pflegewissenschaft, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Deutschland
| | - Stefanie Schmidt
- Institut für Rehabilitationsmedizin, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Deutschland
| | | | - Reina Tholen
- Physio Deutschland, Deutscher Verband für Physiotherapie (ZVK) e.V., Köln, Deutschland
| | - Gert Ulrich
- Careum Bildungsentwicklung, Careum Stiftung, Zürich, Schweiz
| | - Andrea Warnke
- Fachbereich Gesundheitsfachberufe, Deutsches Netzwerk Evidenzbasierte Medizin e.V. (EbM-Netzwerk), Berlin, Deutschland; Fachrichtung Public Health & Health Education, Pädagogische Hochschule Freiburg, Freiburg, Deutschland
| | - Jens Abraham
- Fachbereich Gesundheitsfachberufe, Deutsches Netzwerk Evidenzbasierte Medizin e.V. (EbM-Netzwerk), Berlin, Deutschland; Institut für Gesundheits- und Pflegewissenschaft, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Deutschland
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12
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Budrionis A, Plikynas D, Daniušis P, Indrulionis A. Smartphone-based computer vision travelling aids for blind and visually impaired individuals: A systematic review. Assist Technol 2020; 34:178-194. [PMID: 32207640 DOI: 10.1080/10400435.2020.1743381] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Given the growth in the numbers of visually impaired (VI) people in low-income countries, the development of affordable electronic travel aid (ETA) systems employing devices, sensors, and apps embedded in ordinary smartphones becomes a potentially cost-effective and reasonable all-in-one solution of utmost importance for the VI. This paper offers an overview of recent ETA research prototypes that employ smartphones for assisted orientation and navigation in indoor and outdoor spaces by providing additional information about the surrounding objects. Scientific achievements in the field were systematically reviewed using PRISMA methodology. Comparative meta-analysis showed how various smartphone-based ETA prototypes could assist with better orientation, navigation, and wayfinding in indoor and outdoor environments. The analysis found limited interest among researchers in combining haptic interfaces and computer vision capabilities in smartphone-based ETAs for the blind, few attempts to employ novel state-of-the-art computer vision methods based on deep neural networks, and no evaluations of existing off-the-shelf navigation solutions. These results were contrasted with findings from a survey of blind expert users on their problems in navigating in indoor and outdoor environments. This revealed a major mismatch between user needs and academic development in the field.
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Affiliation(s)
- Andrius Budrionis
- Department of Business Technologies and Entrepreneurship, Vilnius Gediminas Technical University, Vilnius, Lithuania.,Norwegian Centre for E-health Research, University Hospital of North Norway, Tromsø, Norway
| | - Darius Plikynas
- Department of Business Technologies and Entrepreneurship, Vilnius Gediminas Technical University, Vilnius, Lithuania
| | - Povilas Daniušis
- Department of Business Technologies and Entrepreneurship, Vilnius Gediminas Technical University, Vilnius, Lithuania
| | - Audrius Indrulionis
- Department of Business Technologies and Entrepreneurship, Vilnius Gediminas Technical University, Vilnius, Lithuania
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13
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Tran L, Nhu Y M, Le Ba Nghia T, Hendam A, Vuong NL, Alzalal E, Sayed AM, Hussain MM, Sharma A, Tieu T, Mathenge PG, Hirayama K, Alexander N, Huy NT. Frequent inappropriate use of unweighted summary statistics in systematic reviews of pathogen genotypes or genogroups. J Clin Epidemiol 2019; 119:26-35. [PMID: 31740320 DOI: 10.1016/j.jclinepi.2019.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 10/11/2019] [Accepted: 11/12/2019] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Our study aimed to systematically assess and report the methodological quality used in epidemiological systematic reviews (SRs) and meta-analysis (MA) of pathogen genotypes/genogroups. STUDY DESIGN AND SETTING Nine electronic databases and manual search of reference lists were used to identify relevant studies. The method types were divided into three groups: 1) with weighted pooling analysis (which we call MA), (2) unweighted analysis of the study-level measures (which we call summary statistics), and (3) without any data pooling (which we call SR only). Characteristics were evaluated using Assessment of Multiple Systematic Reviews (AMSTAR), Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA), and Risk Of Bias In Systematic reviews (ROBIS) tools. The protocol was registered in PROSPERO with CRD42017078146. RESULTS Among 36 included articles, 5 (14%) studies conducted SR only, 16 (44%) performed MA, and 15 (42%) used summary statistics. The univariable and multivariable linear regression of AMSTAR and PRISMA scores showed that MA had higher quality compared with those with summary statistics. The SR only and summary statistics groups had approximately equal scores among three scales of AMSTAR, PRISMA, and ROBIS. The methodological quality of epidemiological studies has improved from 1999 to 2017. CONCLUSION Despite the frequent use of unweighted summary statistics, MA remains the most suitable method for reaching rational conclusions in epidemiological studies of pathogen genotypes/genogroups.
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Affiliation(s)
- Linh Tran
- Institute of Research and Development, Duy Tan University, Danang 550000, Vietnam
| | - Mai Nhu Y
- Online Research Club (http://www.onlineresearchclub.org/), Nagasaki, Japan; Faculty of Medicine, Vo Truong Toan University, Hau Giang, Vietnam
| | - Thai Le Ba Nghia
- Online Research Club (http://www.onlineresearchclub.org/), Nagasaki, Japan; Faculty of Medicine, Vo Truong Toan University, Hau Giang, Vietnam
| | - Abdulrahman Hendam
- Online Research Club (http://www.onlineresearchclub.org/), Nagasaki, Japan; Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Nguyen Lam Vuong
- Online Research Club (http://www.onlineresearchclub.org/), Nagasaki, Japan; Department of Medical Statistics and Informatics, Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Ebrahim Alzalal
- Online Research Club (http://www.onlineresearchclub.org/), Nagasaki, Japan; Faculty of Medicine, Menofia University, Shebin Elkom, Egypt
| | - Ahmed M Sayed
- Online Research Club (http://www.onlineresearchclub.org/), Nagasaki, Japan; Faculty of Pharmacy, Al-Azhar University, Cairo, Egypt
| | - Mustafa Mushtaq Hussain
- Online Research Club (http://www.onlineresearchclub.org/), Nagasaki, Japan; Department of Neurosurgery, Aga Khan University Hospital, Karachi, Pakistan
| | - Akash Sharma
- Online Research Club (http://www.onlineresearchclub.org/), Nagasaki, Japan; University College of Medical Sciences and Guru Teg Bahadur Hospital, Dilshad Garden, Delhi, India
| | - Thuan Tieu
- Online Research Club (http://www.onlineresearchclub.org/), Nagasaki, Japan; Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Peterson Gitonga Mathenge
- Online Research Club (http://www.onlineresearchclub.org/), Nagasaki, Japan; Department of Immunogenetics, Institute of Tropical Medicine (NEKKEN), Graduate School of Biomedical Sciences, Nagasaki University, Sakamoto, Nagasaki, Japan
| | - Kenji Hirayama
- Department of Immunogenetics, Institute of Tropical Medicine (NEKKEN), Graduate School of Biomedical Sciences, Nagasaki University, Sakamoto, Nagasaki, Japan
| | - Neal Alexander
- MRC Tropical Epidemiology Group, London School of Hygiene and Tropical Medicine, London, UK.
| | - Nguyen Tien Huy
- Evidence Based Medicine Research Group, Ton Duc Thang University, Ho Chi Minh City, 70000, Vietnam; Faculty of Applied Sciences, Ton Duc Thang University, Ho Chi Minh City, 70000, Vietnam; Department of Clinical Product Development, Institute of Tropical Medicine (NEKKEN), School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki 852-8523, Japan.
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