Mauri-Obradors, E; Estrugo-Devesa, A; Jané-Salas, E; Viñas, M; López-López, J
Diabetes Mellitus has become a global epidemic and presents many complications, usually proportional to the degree and duration of hyperglycemia. The aim of this systematic review was to investigate the different oral manifestations associated with Diabetes Mellitus. A MEDLINE search for "Diabetes Mellitus and oral manifestations" was performed. A further search was conducted for "diabetes" and its individual oral manifestation. Inclusion criteria were as follows: human clinical studies with a minimum of 30 patients; studies published in relevant scientific journals between January 1998 and January 2016. Nineteen studies fulfilled the inclusion criteria and were analyzed, assessing the strength of scientific evidence according to recommendations made by the Centre for Evidence-Based Medicine, Oxford (OCEBM), which permits adequate assessment of prevalence studies. A total 3,712 patients (2,084 diabetics) were included in the studies reviewed. Of the 19 studies analyzed, 4 were longitudinal studies and 15 cross-sectional studies. Periodontal disease, periapical lesions, xerostomia and taste disturbance were more prevalent among diabetic patients. An association between diabetes and caries and mucosal lesions proved positive in 5 out of 10 studies. Despite multiple oral manifestations associated with DM, awareness of the associations between diabetes, oral health, and general health is inadequate. It is necessary for doctors and dentists to be aware of the various oral manifestations of diabetes in order to make an early diagnosis.
Biernatzki, Lisa; Kuske, Silke; Genz, Jutta; Ritschel, Michaela; Stephan, Astrid; Bächle, Christina; Droste, Sigrid; Grobosch, Sandra; Ernstmann, Nicole; Chernyak, Nadja; Icks, Andrea
The purpose of this study was to identify and analyse currently available knowledge on information needs of people with diabetes mellitus, also considering possible differences between subgroups and associated factors. Twelve databases including MEDLINE, EMBASE and the Cochrane Library were searched up until June 2015. Publications that addressed self-reported information needs of people with diabetes mellitus were included. Each study was assessed by using critical appraisal tools, e.g. from the UK National Institute for Health and Care Excellence. Extraction and content analysis were performed systematically. In total, 1993 publications were identified and 26 were finally included. Nine main categories of information needs were identified, including 'treatment-process', 'course of disease', 'abnormalities of glucose metabolism' and 'diabetes through the life cycle'. Differences between patient subgroups, such as type of diabetes or age, were sparsely analysed. Some studies analysed associations between information needs and factors such as participation preferences or information seeking. They found, for example, that information needs on social support or life tasks were associated with information seeking in Internet forums. Information needs in people with diabetes mellitus, appear to be high, yet poorly investigated. Research is needed regarding differences between diverse diabetes populations, including gender aspects or changes in information needs during the disease course. The review protocol has been registered at Prospero ( CRD42015029610 ).
Gomes, Júnia Maria Geraldo; Costa, Jorge de Assis; Alfenas, Rita de Cássia Gonçalves
In this systematic review we analyzed studies that assessed serum concentrations of lipopolysaccharide (LPS) and/or lipopolysacharide-binding protein (LBP) in diabetic patients compared with healthy people. Articles were selected using PubMed and Scopus. Search terms used were endotoxemia, endotoxins, LPS, LBP, diabetes mellitus (DM), type 1 (T1DM), type 2 (T2DM), insulin resistance, humans, epidemiologic studies, population-based, survey, representative, cross-sectional, case-control studies, observational, and clinical trials. Two authors independently extracted articles using predefined data fields, including study quality indicators. There was a great variability in the estimates of metabolic endotoxemia among the studies. Most of the studies observed higher LPS or LBP concentrations in diabetic subjects than in healthy controls. T1DM and T2DM subjects presented higher mean fasting LPS of 235.7% and 66.4% compared with non-diabetic subjects, respectively. Advanced complications (e.g. macroalbuminuria) and disease onset exacerbate endotoxemia. Antidiabetic medications decrease fasting LPS concentrations. Among these medications, rosiglitazone and insulin present higher and lower effects, respectively, compared with other treatments. T1DM and T2DM seem to increase metabolic endotoxemia. However, some confounders such as diet, age, medication, smoking and obesity influence both diabetes and endotoxemia manifestation. A better understanding of the interaction of these factors is still needed. Copyright © 2016 Elsevier Inc. All rights reserved.
van Leeuwen, M.; Louwerse, M. D.; Opmeer, B. C.; Limpens, J.; Serlie, M. J.; Reitsma, J. B.; Mol, B. W. J.
Background The best strategy to identify women with gestational diabetes mellitus (GDM) is unclear. Objectives To perform a systematic review to calculate summary estimates of the sensitivity and specificity of the 50-g glucose challenge test for GDM. Search strategy Systematic search of MEDLINE,
Oostdam, N.; Poppel, M.N.M. van; Wouters, M.G.A.J.; Mechelen, W. van
Background: The prevalence of gestational diabetes mellitus (GDM) is increasing worldwide. GDM is associated with increased risks for mother and child during pregnancy and in later life. The aim of this article is to systematically review literature on the effectiveness of interventions to prevent
Oostdam, N.; van Poppel, M.N.M.; Wouters, M.G.A.J.; van Mechelen, W.
Background: The prevalence of gestational diabetes mellitus (GDM) is increasing worldwide. GDM is associated with increased risks for mother and child during pregnancy and in later life. The aim of this article is to systematically review literature on the effectiveness of interventions to prevent
Harrison, Anne L; Shields, Nora; Taylor, Nicholas F; Frawley, Helena C
Does exercise improve postprandial glycaemic control in women diagnosed with gestational diabetes mellitus? A systematic review of randomised trials. Pregnant women diagnosed with gestational diabetes mellitus. Exercise, performed more than once a week, sufficient to achieve an aerobic effect or changes in muscle metabolism. Postprandial blood glucose, fasting blood glucose, glycated haemoglobin, requirement for insulin, adverse events and adherence. This systematic review identified eight randomised, controlled trials involving 588 participants; seven trials (544 participants) had data that were suitable for meta-analysis. Five trials scored ≥ 6 on the PEDro scale, indicating a relatively low risk of bias. Meta-analysis showed that exercise, as an adjunct to standard care, significantly improved postprandial glycaemic control (MD -0.33mmol/L, 95% CI -0.49 to -0.17) and lowered fasting blood glucose (MD -0.31 mmol/L, 95% CI -0.56 to -0.05) when compared with standard care alone, with no increase in adverse events. Effects of similar magnitude were found for aerobic and resistance exercise programs, if performed at a moderate intensity or greater, for 20 to 30minutes, three to four times per week. Meta-analysis did not show that exercise significantly reduced the requirement for insulin. All studies reported that complications or other adverse events were either similar or reduced with exercise. Aerobic or resistance exercise, performed at a moderate intensity at least three times per week, safely helps to control postprandial blood glucose levels and other measures of glycaemic control in women diagnosed with gestational diabetes mellitus. PROSPERO CRD42015019106. [Harrison AL, Shields N, Taylor NF, Frawley HC (2016) Exercise improves glycaemic control in women diagnosed with gestational diabetes mellitus: a systematic review.Journal of Physiotherapy62: 188-196]. Copyright © 2016 Australian Physiotherapy Association. Published by Elsevier B.V. All rights
Mwanri, A.W.; Kinabo, J.L.; Ramaiya, K.; Feskens, E.J.M.
Objective We systematically reviewed publications on prevalence and risk factors for gestational diabetes mellitus (GDM) in the 47 countries of sub-Saharan Africa. Methods We conducted a systematic search in PUBMED and reviewed articles published until June 2014 and searched the references of
Zheng, J; Wang, H; Ren, M
Exercise intervention might be a promising approach to prevent gestational diabetes mellitus. However, the results remained controversial. We conducted a systematic review and meta-analysis to explore the effect of exercise intervention on gestational diabetes mellitus. PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases were systematically searched. Randomized controlled trials (RCTs) assessing the effect of exercise intervention on gestational diabetes mellitus were included. Two investigators independently searched articles, extracted data, and assessed the quality of included studies. The primary outcome was the incidence of gestational diabetes mellitus, preterm birth, and gestational age at birth. Meta-analysis was performed using random-effect model. Five RCTs involving 1872 patients were included in the meta-analysis. Overall, compared with control intervention, exercise intervention was found to significantly reduce the risk of gestational diabetes mellitus (std. mean difference 0.62; 95% CI 0.43-0.89; P = 0.01), but demonstrated no influence on preterm birth (OR 0.93; 95% CI 0.44-1.99; P = 0.86), gestational age at birth (std. mean difference -0.03; 95% CI -0.12 to 0.07; P = 0.60), glucose 2-h post-OGTT (std. mean difference -1.02; 95% CI -2.75 to 0.71; P = 0.25), birth weight (std. mean difference -0.10; 95% CI -0.25 to 0.04; P = 0.16), Apgar score less than 7 (OR 0.78; 95% CI 0.21-2.91; P = 0.71), and preeclampsia (OR 1.05; 95% CI 0.53-2.07; P = 0.88). Compared to control intervention, exercise intervention was found to significantly reduce the incidence of gestational diabetes mellitus, but had no significant influence on preterm birth, gestational age at birth, glucose 2-h post-OGTT, birth weight, Apgar score less than 7, and preeclampsia.
Baldoni, Nayara Ragi; Aquino, Jéssica Azevedo; Sanches-Giraud, Cristina; Di Lorenzo Oliveira, Cláudia; de Figueiredo, Roberta Carvalho; Cardoso, Clareci Silva; Santos, Thiago Reis; Alves, Geisa Cristina Silva; Dal Fabbro, Amaury Lelis; Baldoni, André Oliveira
To perform a systematic review and meta-analysis to identify and analyze collective empowerment strategies for patients with Diabetes Mellitus (DM). The systematic review was performed using PubMed/MEDLINE, Science Direct and BVS. The term "Diabetes Mellitus" was used with each of the following describers, along with the connector "AND": "self-care", "health education", "motivation" and "empowerment". Inclusion criteria were: intervention study with control group published between 2004 and 2014. For meta-analysis, RevMan V 5.3 software was used. Among the nine analyzed articles, 66.7% (n=6) were developed in patients diagnosed with DM2. Concerning the indicators for intervention effectiveness evaluation, all articles (n=9) used glycated hemoglobin (HbA1c) and the most used instrument was Summary of Diabetes Self Care Activities Measure, representing 44.4% (n=4) of the studies. The types of strategies used were similar in the articles. There was evidence of a decrease in HbA1c levels in 66.7% (n=6). The meta-analysis found significant evidence indicating beneficial effects of empowerment. Programs based on collective empowerment in DM have shown the interventions lead to improvement in clinical parameters, behavior, increased knowledge about DM, and self-care. Copyright © 2016 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.
Jaqueline Pinheiro de Alencar
Full Text Available Background: The Irisin is a myokine associated with the improvement on insulin resistance caused by diet and increased physical energy expenditure. Recent studies have shown that patients with Type 2 Diabetes Mellitus (T2DM have reduced levels of irisin, showing it as a potential marker for various endocrine and cardiovascular diseases. This study aimed to verify if T2DM patients never treated or without ongoing treatment have reduced levels of irisin when compared to individuals with other metabolic profiles. Methods and Findings: Systematic review of the literature, considering the primary studies published in 2012 to 2016, with the outcome Irisin levels in patients never treated or without current treatment in the ambience of Type 2 Diabetes Mellitus. The search was conducted through the electronic database Scopus (Elsevier, using the key words: "Irisin", "Human" and "Diabetes Mellitus". From the 91 studies found, 8 met the eligibility criteria. Significant differences were found on levels of irisin in patients with T2DM compared to normoglycemic individuals, obese and/or pre-diabetic. On average, there was a reduction of 15 pg/ml in plasma levels of irisin in diabetics. However, a minority of studies says that this relationship does not exist. Conclusion: Irisin reduced levels were found in patients with T2DM and is also related to lipid profile, with the risk of developing endocrine diseases, such as diabetes and obesity, and high risk for cardiovascular diseases because of its relationship with endothelial dysfunction. This generates the need for research in order to explore the isolation and clinical use of irisin for treatment of disorders related to imbalance in energy demand, obesity and diabetes. Descriptors: Irisin, Human, Diabetes Mellitus.
Esteves Lima, Rafael Paschoal; Cyrino, Renata Magalhães; de Carvalho Dutra, Bernardo; Oliveira da Silveira, Juliana; Martins, Carolina Castro; Miranda Cota, Luis Otávio; Costa, Fernando Oliveira
To the best of the authors' knowledge, there is no systematic review of the potential association between periodontitis and gestational diabetes mellitus (GDM) in the current literature. The aim of the present systematic review and meta-analysis is to search for scientific evidence regarding the association between periodontitis and GDM. The present study was conducted in accordance with the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and registered (CRD2014010728) with PROSPERO (International prospective register for systematic reviews, University of York, York, UK). A search was conducted in three electronic databases without restrictions regarding language or date of publication. From 190 studies selected, 15 underwent full-text analysis. Eight studies were eligible (five cross-sectional and three case-control studies), and seven were entered in the meta-analysis. Meta-analysis was performed with tests for sensitivity and statistical heterogeneity. Summary effect measures were calculated by odds ratio (OR) and 95% confidence interval (CI). There was a significant association between periodontitis and GDM in the meta-analyses of four cross-sectional studies (OR 1.67, 95% CI 1.20 to 2.32) and two case-control studies (OR 2.66, 95% CI 1.52 to 4.65). However, sensitivity tests for case-control studies showed a lack of consistency in data; when including one case-control study, the significance was null (meta-analysis of three case-control studies: OR 1.69, 95% CI 0.68 to 4.21). There was substantial clinical, methodologic, and statistical heterogeneity among the studies. The scientific evidence cannot affirm a positive association between periodontitis and GDM. Future studies with different designs in distinct populations should be conducted to investigate this association.
Samah, Syamimi; Ramasamy, Kalavathy; Lim, Siong Meng; Neoh, Chin Fen
To systematically review evidence of probiotic interventions against type 2 diabetes mellitus (T2DM) and analyse the effects of probiotics on glycaemic control among T2DM patients. Electronic search using five electronic databases was performed until October 2015. Relevant studies were identified, extracted and assessed for risk of bias. The primary outcomes of this review were glycated haemoglobin (HbA1c) and fasting blood glucose (FBG). Fasting plasma insulin, homeostasis model assessment-insulin resistance, C-reactive protein, interleukin-6 and malondialdehyde, were identified as the secondary outcomes. Mean differences (MD) between probiotics and control groups for all outcomes were pooled using either Fixed- or Random-Effect Model. Statistical heterogeneity was assessed using I(2) and Chi(2) tests. Six randomised controlled trials (RCTs) were included in the systematic review, whereas only five were included in meta-analysis. Most RCTs were presented with low or unclear risk of bias. When compared to placebo, FBG was significantly lower with probiotic consumption (MD=-0.98mmol/L; 95% CI: -1.17, 0.78, pprobiotics, with a significantly lower FBG was noted. Findings on HbA1c, anti-inflammatory and anti-oxidative effects of probiotics in the clinical setting, however, remain inconsistent. The findings imply the need for well-designed clinical studies to further assess the potential beneficial effects of probiotics in management of T2DM. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
Yang, Yu; Hu, Xinhua; Zhang, Qiang; Zou, Rui
intensive or very loose glycemic control may contribute to the risk of falls in diabetic patients. However, studies on diabetes mellitus and the risk of falls have yielded conflicting results. Our objective was to investigate the effect of diabetes mellitus on the risk of falls in older adults by conducting a systematic review and meta-analysis. the PubMed and Embase databases were searched for relevant studies published until November 2015. Only prospective cohort studies reporting at least age-adjusted risk estimate of falls compared diabetic to non-diabetic individuals were selected. Diabetes mellitus was ascertained by a combination of medical history and laboratory tests or use of anti-diabetic drugs. a total of six studies involving 14,685 participants were identified. The number of falls in diabetic and non-diabetic individuals was 423 of 1,692 (25.0%) and 2,368 of 13,011 (18.2%), respectively. Diabetes mellitus was associated with an increased risk of falls (risk ratio [RR] = 1.64; 95% confidence intervals [CI] 1.27-2.11) in a random-effects model. Subgroup analyses showed that the risk of falls seemed more pronounced among both gender groups (RR = 1.81; 95% CI 1.19-2.76) than among women (RR = 1.52; 95% CI 1.04-2.21). Diabetes increased 94% (RR = 1.94; 95% CI 1.42-2.63) and 27% (RR = 1.27; 95% CI 1.06-1.52) risk of falls in insulin-treated and no-insulin-treated patients, respectively. this meta-analysis reveals that older adults with diabetes mellitus are associated with greater risk of falls, and this association is more pronounced in insulin-treated patients. © The Author 2016. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: email@example.com.
Full Text Available OBJECTIVE: To assess the efficacy and safety of treating pregnant women with gestational diabetes mellitus in comparison to usual antenatal care. METHODS: A systematic review and meta-analysis was conducted by including randomized controlled trials comparing any form of therapeutic intervention in comparison to usual antenatal care. A literature search was conducted using electronic databases together with a hand search of relevant journals and conference proceedings. RESULTS: Ten studies involving 3,881 patients contributed to meta-analysis. Our results indicated that gestational diabetes mellitus treatment significantly reduced the risk for macrosomia (RR, 0.47; 95% CI, 0.38-0.57, large for gestational age births (RR, 0.55; 95% CI, 0.45-0.67, shoulder dystocia (RR, 0.42; 95% CI, 0.23-0.77 and gestational hypertension (RR, 0.68; 95% CI, 0.53-0.87 without causing any significant increase in the risk for small for gestational age babies. However, no significant difference was observed between the two groups regarding perinatal/neonatal mortality, neonatal hypoglycemia, birth trauma, preterm births, pre-eclampsia, caesarean section and labor induction. CONCLUSION: Treating GDM reduces risk for many important adverse pregnancy outcomes and its association with any harm seems unlikely.
Perry, Benjamin I; Salimkumar, Dhanya; Green, Daniel; Meakin, Anne; Gibson, Andrew; Mahajan, Deepali; Tahir, Tayyeb; Singh, Swaran P
We aimed to elucidate whether schizophrenia and type II diabetes mellitus may present with associated illness severity, in light of accumulating evidence to suggest both conditions have important shared inflammatory components with many shared inflammatory genetic factors. We conducted a systematic review employing PRISMA criteria, searching EMBASE, Ovid MEDLINE, PsychInfo, Web of Science and Google Scholar to February 1st, 2017, for clinical studies assessing schizophrenia severity alongside dysglycaemia. A narrative synthesis was employed to discuss and compare findings between studies. Eleven observational studies were included in the analysis. Ten presented evidence in support of an association between schizophrenia severity and dysglycaemia. This association appeared particularly strong regarding negative symptomatology and impaired cognitive function, between which there may be some overlap. Studies examining positive symptomatology returned mixed results. Whilst study design varied amongst the included studies, the results suggest that further work examining the effect of hyperglycaemia on schizophrenia severity may be relevant, particularly longitudinal studies assessing negative symptomatology and cognitive function. To the authors' knowledge, this is the first systematic review conducted to address this question. Copyright © 2017 Elsevier B.V. All rights reserved.
Workneh, Mahteme Haile; Bjune, Gunnar Aksel; Yimer, Solomon Abebe
The dual burden of tuberculosis (TB) and diabetes mellitus (DM) has become a major global public health concern. There is mounting evidence from different countries on the burden of TB and DM comorbidity. The objective of this systematic review was to summarize the existing evidence on prevalence and associated/risk factors of TBDM comorbidity at global and regional levels. Ovid Medline, Embase, Global health, Cochrane library, Web of science and Scopus Elsevier databases were searched to identify eligible articles for the systematic review. Data were extracted using standardized excel form and pilot tested. Median with interquartile range (IQR) was used to estimate prevalence of TBDM comorbidity. Associated/risk factors that were identified from individual studies were thematically analyzed and described. The prevalence of DM among TB patients ranged from 1.9% to 45%. The overall median global prevalence was 16% (IQR 9.0%-25.3%) Similarly, the prevalence of TB among DM patients ranged from 0.38% to 14% and the overall median global prevalence was 4.1% (IQR 1.8%-6.2%). The highest prevalence of DM among TB patients is observed in the studied countries of Asia, North America and Oceania. On the contrary, the prevalence of TB among DM patients is low globally, but relatively higher in the studied countries of Asia and the African continents. Sex, older age, urban residence, tobacco smoking, sedentary lifestyle, poor glycemic control, having family history of DM and TB illness were among the variables identified as associated/risk factors for TBDM comorbidity. This systematic review revealed that there is a high burden of DM among TB patients at global level. On the contrary, the global prevalence of TB among DM patients is low. Assessing the magnitude and risk/associated factors of TBDM comorbidity at country/local level is crucial before making decisions to undertake TBDM integrated services.
Pushparani, D S
Diabetes mellitus has been increasing rapidly worldwide, making it a huge health pressure on society in both the developed and developing countries. During the last thirty years, diabetes mellitus, a chronic metabolic disease characterized by hyperglycemia is proving itself to be fatal. Periodontitis was considered as one of the main, oral health problems encountered in patients with diabetes mellitus. There exists a direct relation between the risk of complications of diabetes and periodontitis over time. The present review gives an outline of the features that govern the interrelationship between zinc and diabetes mellitus with periodontal disease, including the physiologic mechanisms and clinical studies, and presents scientific evidences. The disturbance in the zinc micronutrient and increased oxidative stress in type 2 diabetes may bring about insulin resistance and the creation of diabetic complications. The progression of diabetes mellitus may bring about perturbation in micronutrient metabolism and status.
Sofia M Danna
Full Text Available Depression and diabetes are independent risk factors for one another, and both are associated with increased risk of cognitive decline. Diabetes patients with lower cognitive function are more likely to suffer poorer health outcomes. However, the role of depression in cognitive decline among people with diabetes is not well understood. This systematic review assessed whether adults with comorbid diabetes and depression or depressive symptoms exhibit greater cognitive decline relative to individuals with diabetes alone. Searches were run in CINAHL, the Cochrane Central Register of Controlled Trials, EMBASE, PsycINFO, and PubMed (MEDLINE with no time or language restrictions. Studies were eligible for inclusion if they were of any quantitative study design, included participants aged 18 years or older with diabetes mellitus of which some must have presented with current depression, and measured cognition as an outcome. The Cochrane Collaboration's Risk Of Bias In Non-randomized Studies-of Interventions tool was used for quality assessment of each study and its collected outcome. Fifteen articles were included in the final analysis. The high degree of heterogeneity in exposures, outcomes, and participant characteristics precluded a meta-analysis of any of the studies, and the risk of bias observed in these studies limits the strength of the evidence. Nonetheless, this review found the presence of comorbid depression was associated with poorer cognitive outcomes than for persons with diabetes alone. While large-scale preventive efforts must address epidemic levels of diabetes and its comorbidities, on the patient level healthcare professionals must be cognizant of the added difficulties that depression poses to patients and the extra support required to management diabetes in these cases. This systematic review is registered with the University of York Centre for Reviews and Dissemination under registration number 2015:CRD42015025122.
Danna, Sofia M; Graham, Eva; Burns, Rachel J; Deschênes, Sonya S; Schmitz, Norbert
Depression and diabetes are independent risk factors for one another, and both are associated with increased risk of cognitive decline. Diabetes patients with lower cognitive function are more likely to suffer poorer health outcomes. However, the role of depression in cognitive decline among people with diabetes is not well understood. This systematic review assessed whether adults with comorbid diabetes and depression or depressive symptoms exhibit greater cognitive decline relative to individuals with diabetes alone. Searches were run in CINAHL, the Cochrane Central Register of Controlled Trials, EMBASE, PsycINFO, and PubMed (MEDLINE) with no time or language restrictions. Studies were eligible for inclusion if they were of any quantitative study design, included participants aged 18 years or older with diabetes mellitus of which some must have presented with current depression, and measured cognition as an outcome. The Cochrane Collaboration's Risk Of Bias In Non-randomized Studies-of Interventions tool was used for quality assessment of each study and its collected outcome. Fifteen articles were included in the final analysis. The high degree of heterogeneity in exposures, outcomes, and participant characteristics precluded a meta-analysis of any of the studies, and the risk of bias observed in these studies limits the strength of the evidence. Nonetheless, this review found the presence of comorbid depression was associated with poorer cognitive outcomes than for persons with diabetes alone. While large-scale preventive efforts must address epidemic levels of diabetes and its comorbidities, on the patient level healthcare professionals must be cognizant of the added difficulties that depression poses to patients and the extra support required to management diabetes in these cases. This systematic review is registered with the University of York Centre for Reviews and Dissemination under registration number 2015:CRD42015025122.
Bhati, Pooja; Shenoy, Shweta; Hussain, M Ejaz
Cardiac autonomic neuropathy (CAN) is a common complication of type 2 diabetes mellitus (T2DM). It has been found to independently predict all cause and cardiovascular disease (CVD) mortality. It remains unclear whether exercise training could improve autonomic control in T2DM patients. The purpose of this study was to systematically review the effects of exercise training on cardiac autonomic function in T2DM patients. Electronic databases (MEDLINE, CENTRAL, PEDro, Scopus and Web of science) were systematically searched to retrieve relevant evidence. Clinical trials administering exercise training for at least 4 weeks and examining either heart rate variability (HRV), baroreflex sensitivity (BRS), heart rate recovery (HRR) as outcome measures were eligible. Eighteen articles were found to be relevant and were then assessed for characteristics and quality. Fifteen studies out of 18 found that exercise training leads to positive improvements in autonomic function of T2DM patients. Exercise participation enhances cardiac autonomic function of type 2 diabetics and therefore should be implemented in their management programs. Copyright © 2017 Diabetes India. Published by Elsevier Ltd. All rights reserved.
Tanase-Nakao, Kanako; Arata, Naoko; Kawasaki, Maki; Yasuhi, Ichiro; Sone, Hirohito; Mori, Rintaro; Ota, Erika
Lactation may protect women with previous gestational diabetes mellitus (GDM) from developing type 2 diabetes mellitus, but the results of existing studies are inconsistent, ranging from null to beneficial. We aimed to conduct a systematic review to gather available evidence. Databases MEDLINE, CINAHL, PubMed, and EMBASE were searched on December 15, 2015, without restriction of language or publication year. A manual search was also conducted. We included observational studies (cross-sectional, case-control, and cohort study) with information on lactation and type 2 diabetes mellitus incidence among women with previous GDM. We excluded case studies without control data. Data synthesis was conducted by random-effect meta-analysis. Fourteen reports of 9 studies were included. Overall risk of bias using RoBANS ranged from low to unclear. Longer lactation for more than 4 to 12 weeks postpartum had risk reduction of type 2 diabetes mellitus compared with shorter lactation (OR 0.77, 95% CI 0.01-55.86; OR 0.56, 95% CI 0.35-0.89; OR 0.22, 95% CI 0.13-0.36; type 2 diabetes mellitus evaluation time 2 y, 2-5 y, and >5 y, respectively). Exclusive lactation for more than 6 to 9 weeks postpartum also had lower risk of type 2 diabetes mellitus compared with exclusive formula (OR 0.42, 95% CI 0.22-0.81). The findings support the evidence that longer and exclusive lactation may be beneficial for type 2 diabetes mellitus prevention in women with previous GDM. However, the evidence relies only on observational studies. Therefore, further studies are required to address the true causal effect. © 2017 The Authors. Diabetes/Metabolism Research and Reviews Published by John Wiley & Sons Ltd.
Meng, Ding; Chunyan, Wang; Xiaosheng, Dong; Xiangren, Yi
The purpose of this study was to investigate the effects of Qigong on type 2 diabetes mellitus (DM) using the systematic review and meta-analysis. All prospective, randomized, controlled clinical trials published in English or Chinese and involving the use of Qigong by patients with DM were searched in 7 electronic databases from their respective inception to June 2016. The meta-analysis was conducted using the Revman 5.2. The quality of the included trials was assessed using the Jadad rating scale. Two researchers independently completed the inclusion, data extraction, and quality assessment. Twenty-one trials with 1326 patients met the inclusion criteria and were reviewed. The meta-analysis demonstrated that, compared with no exercise, the Qigong had significant effects on fasting blood glucose (MD = -0.99, 95% CI (-1.23, 0.75), P Qigong training can improve the blood glucose status of the type 2 DM patients and has positive effects on the management of type 2 DM. However, future research with better quality still needs to be conducted to address the effects of Qigong on type 2 DM.
Full Text Available Objective. The purpose of this study was to investigate the effects of Qigong on type 2 diabetes mellitus (DM using the systematic review and meta-analysis. Methods. All prospective, randomized, controlled clinical trials published in English or Chinese and involving the use of Qigong by patients with DM were searched in 7 electronic databases from their respective inception to June 2016. The meta-analysis was conducted using the Revman 5.2. The quality of the included trials was assessed using the Jadad rating scale. Two researchers independently completed the inclusion, data extraction, and quality assessment. Results. Twenty-one trials with 1326 patients met the inclusion criteria and were reviewed. The meta-analysis demonstrated that, compared with no exercise, the Qigong had significant effects on fasting blood glucose (MD = −0.99, 95% CI (−1.23, 0.75, P<0.0001, HbA1c (MD = −0.84, 95% CI (−1.02, −0.65, P<0.0001, and postprandial blood glucose (MD = −1.55, 95% CI (−2.19, −0.91, P<0.00001. Conclusion. The Qigong training can improve the blood glucose status of the type 2 DM patients and has positive effects on the management of type 2 DM. However, future research with better quality still needs to be conducted to address the effects of Qigong on type 2 DM.
Flôr, Cristina Rabelo; Baldoni, Nayara Ragi; Aquino, Jéssica Azevedo; Baldoni, André Oliveira; Fabbro, Amaury Lelis Dal; Figueiredo, Roberta Carvalho; Oliveira, Cláudia Di Lorenzo
Social capital has been included as an element that could influence the self-perception of health, mortality and mental diseases. We systematically reviewed papers that studied the influence of social capital in the control of diabetes mellitus (DM). We included studies published up to Feb. 16, 2017, without restriction of time or year of publication. Quantitative studies were included since they presented one well-defined parameter to evaluate DM and specifically measured social capital. We used the PRISMA and STROBE guidelines to perform this review and to evaluate the quality of papers. Only three papers met the inclusion criteria. All studies adopted cross-sectional design. The population, the instruments used to measure social capital, and the statistical analysis were different among the papers. In conclusion, although social capital seems to be related to DM, more studies are necessary to understand which dimensions are more important in this association, if the association is the same at the individual or neighborhood level, and what kind of population in terms of education, poverty and culture would be more influenced by social capital in DM control. Copyright © 2018 Diabetes India. Published by Elsevier Ltd. All rights reserved.
Michaela C. Pascoe
Full Text Available Purpose: A number of studies, including systematic reviews, show beneficial effects of psychosocial interventions for people with diabetes mellitus; however, they have not been assessed using meta-analysis. The purpose of this meta-analysis of randomized controlled trials is to investigate the effects of psychosocial interventions on depressive and anxiety symptoms, quality of life and self-efficacy in individuals with diabetes mellitus.Methods: The databases Pubmed, MEDLINE, CINAHL, PsycINFO, Scopus, Web of Science and SocINDEX were searched with no year restriction. Eligible studies were randomized controlled trials published in English that included individuals diagnosed with diabetes mellitus, aged 18 years or above, who engaged in a psychosocial intervention, with outcome measures addressing depressive or anxiety symptomology, quality of life or self-efficacy. Eligible studies needed to compare the intervention to usual care. Study selection was completed using Covidence and meta-analysis was undertaken using Comprehensive Meta-Analysis software.Results: Seven studies were included in the meta-analysis. Five studies investigated the effects of psychosocial interventions and showed a medium to large benefit for depressive symptoms (SMD: −0.70; CI: −1.27, −0.13 which persisted at follow up (SMD: −1.54, CI: −2.97, −0.12. Similar results were not seen immediately post-intervention in the three studies that assessed anxiety symptoms (SMD: −0.30; CI: −0.69, 0.10; however, a medium beneficial effect was seen at follow up (SMD = −0.61, CI = −0.92 to −0.31. Small benefits were seen in the three studies assessing quality of life outcomes (SMD: 0.30, CI: 0.06, 0.55. No benefit was seen in the two studies assessing self-efficacy (SMD: 0.23, CI: −0.11, 0.57.Conclusions: The results of the current study provide preliminary evidence that psychosocial interventions, compared to usual care, reduce depressive symptoms, and may improve
Dendup, Tashi; Feng, Xiaoqi; Clingan, Stephanie; Astell-Burt, Thomas
Different elements of the environment have been posited to influence type 2 diabetes mellitus (T2DM). This systematic review summarizes evidence on the environmental determinants of T2DM identified in four databases. It proposes a theoretical framework illustrating the link between environment and T2DM, and briefly discusses some methodological challenges and potential solutions, and opportunities for future research. Walkability, air pollution, food and physical activity environment and roadways proximity were the most common environmental characteristics studied. Of the more than 200 reported and extracted relationships assessed in 60 studies, 82 showed significant association in the expected direction. In general, higher levels of walkability and green space were associated with lower T2DM risk, while increased levels of noise and air pollution were associated with greater risk. Current evidence is limited in terms of volume and study quality prohibiting causal inferences. However, the evidence suggests that environmental characteristics may influence T2DM prevention, and also provides a reasonable basis for further investigation with better quality data and longitudinal studies with policy-relevant environmental measures. This pursuit of better evidence is critical to support health-orientated urban design and city planning. PMID:29304014
Full Text Available Different elements of the environment have been posited to influence type 2 diabetes mellitus (T2DM. This systematic review summarizes evidence on the environmental determinants of T2DM identified in four databases. It proposes a theoretical framework illustrating the link between environment and T2DM, and briefly discusses some methodological challenges and potential solutions, and opportunities for future research. Walkability, air pollution, food and physical activity environment and roadways proximity were the most common environmental characteristics studied. Of the more than 200 reported and extracted relationships assessed in 60 studies, 82 showed significant association in the expected direction. In general, higher levels of walkability and green space were associated with lower T2DM risk, while increased levels of noise and air pollution were associated with greater risk. Current evidence is limited in terms of volume and study quality prohibiting causal inferences. However, the evidence suggests that environmental characteristics may influence T2DM prevention, and also provides a reasonable basis for further investigation with better quality data and longitudinal studies with policy-relevant environmental measures. This pursuit of better evidence is critical to support health-orientated urban design and city planning.
Christie Y Jeon
Full Text Available BACKGROUND: Several studies have suggested that diabetes mellitus (DM increases the risk of active tuberculosis (TB. The rising prevalence of DM in TB-endemic areas may adversely affect TB control. We conducted a systematic review and a meta-analysis of observational studies assessing the association of DM and TB in order to summarize the existing evidence and to assess methodological quality of the studies. METHODS AND FINDINGS: We searched the PubMed and EMBASE databases to identify observational studies that had reported an age-adjusted quantitative estimate of the association between DM and active TB disease. The search yielded 13 observational studies (n = 1,786,212 participants with 17,698 TB cases. Random effects meta-analysis of cohort studies showed that DM was associated with an increased risk of TB (relative risk = 3.11, 95% CI 2.27-4.26. Case-control studies were heterogeneous and odds ratios ranged from 1.16 to 7.83. Subgroup analyses showed that effect estimates were higher in non-North American studies. CONCLUSION: DM was associated with an increased risk of TB regardless of study design and population. People with DM may be important targets for interventions such as active case finding and treatment of latent TB and efforts to diagnose, detect, and treat DM may have a beneficial impact on TB control.
Khodaeian, Mehrnoosh; Enayati, Samaneh; Tabatabaei-Malazy, Ozra; Amoli, Mahsa M.
Introduction. Diabetes mellitus as the most prevalent metabolic disease is a multifactorial disease which is influenced by environmental and genetic factors. In this systematic review, we assessed the association between genetic variants and diabetes/its complications in studies with Iranian populations. Methods. Google Scholar, PubMed, Scopus, and Persian web databases were systematically searched up to January 2014. The search terms were “gene,” “polymorphism,” “diabetes,” and “diabetic complications”; nephropathy, retinopathy, neuropathy, foot ulcer, and CAD (coronary artery diseases); and Persian equivalents. Animal studies, letters to editor, and in vitro studies were excluded. Results. Out of overall 3029 eligible articles, 88 articles were included. We found significant association between CTLA-4, IL-18, VDR, TAP2, IL-12, and CD4 genes and T1DM, HNFα and MODY, haptoglobin, paraoxonase, leptin, TCF7L2, calreticulin, ERα, PPAR-γ2, CXCL5, calpain-10, IRS-1 and 2, GSTM1, KCNJ11, eNOS, VDR, INSR, ACE, apoA-I, apo E, adiponectin, PTPN1, CETP, AT1R, resistin, MMP-3, BChE K, AT2R, SUMO4, IL-10, VEGF, MTHFR, and GSTM1 with T2DM or its complications. Discussion. We found some controversial results due to heterogeneity in ethnicity and genetic background. We thought genome wide association studies on large number of samples will be helpful in identifying diabetes susceptible genes as an alternative to studying individual candidate genes in Iranian populations. PMID:26587547
Nacak, Hakan; Bolignano, Davide; Van Diepen, Merel; Dekker, Friedo; Van Biesen, Wim
Diabetes mellitus is a frequent cause of the need for renal replacement therapy (RRT). Historically, RRT was started earlier in patients with diabetes, in an attempt to prevent complications of uraemia and diabetes. We did a systematic review to find support for this earlier start of dialysis in patients with versus without diabetes. The MEDLINE, EMBASE and CENTRAL databases were searched for articles about the timing of dialysis initiation in (subgroups of) patients with diabetes and CKD Stage 5. A total of 340 papers were screened and 11 papers were selected to be reviewed. Only three studies showed data of at least one subgroup of patients with diabetes. Two observational studies concluded that start of dialysis with a higher estimated glomerular filtration rate (eGFR) is beneficial with regard to survival, one did not find a difference and six observational studies concluded that start of dialysis with a lower eGFR is associated with better survival in patients with diabetes. The effect of timing of initiation of dialysis did not differ between patients with versus without diabetes. Lastly, one randomized controlled trial (two papers) reported that there was no difference in survival between start at higher versus lower eGFR overall and a P-value for the interaction with diabetes of P = 0.63, indicating no difference between patients with versus without diabetes with regard to the timing of start of dialysis and subsequent mortality on dialysis. There is no difference between early (eGFR) and late (lower eGFR) start of RRT with regard to mortality in patients with versus without diabetes. RRT should thus be initiated based on the same criteria in all patients, irrespective of the presence or absence of diabetes. © The Author 2016. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.
Yu, Ying; Xie, Rongrong; Shen, Cainuo; Shu, Lianting
Exercise showed some potential in preventing gestational diabetes mellitus. However, the results remained controversial. We conducted a systematic review and meta-analysis to evaluate the impact of exercise during pregnancy on gestational diabetes mellitus. PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases were systematically searched. Randomized controlled trials (RCTs) assessing the influence of exercise during pregnancy on gestational diabetes mellitus were included. Two investigators independently searched articles, extracted data, and assessed the quality of included studies. The primary outcome was the incidence of gestational diabetes mellitus. Meta-analysis was performed using random-effect model. Six RCTs involving 2164 patients were included in the meta-analysis. Compared with control intervention, exercise intervention was associated with significantly decreased incidence of gestational diabetes mellitus (Std. mean difference = 0.59; 95%CI = 0.39-.88; p = .01), but had no effect on gestational age at birth (Std. mean difference = -0.03; 95%CI = -0.12 to 0.07; p = .60), the number of preterm birth (OR = 0.85; 95%CI = 0.43-1.66; p = .63), glucose 2-h post-OGTT (Std. mean difference = -1.02; 95%CI = -2.75 to 0.71; p = .25), birth weight (Std. mean difference = -0.13; 95%CI = -0.26 to 0.01; p = .06), and Apgar score less than 7 (OR = .78; 95%CI = 0.21-2.91; p = .71). Compared to control intervention, exercise intervention could significantly decrease the risk of gestational diabetes mellitus, but showed no impact on gestational age at birth, preterm birth, glucose 2-h post-OGTT, birth weight, and Apgar score less than 7.
Green, J; Casabonne, D; Newton, R
Enteroviruses, in particular Coxsackie B4, have been implicated in the aetiology of Type 1 diabetes mellitus, but the epidemiological evidence has not been systematically evaluated. Systematic review of evidence from published controlled studies of the relationship between Coxsackie B virus serology and incident or prevalent Type 1 diabetes mellitus. Studies were identified through a Medline search (1966 to 2002), supplemented by references from identified papers and hand search of relevant journals. All studies (full papers, abstracts or letters) with data adequate for calculation of unadjusted odds ratios (with 95% confidence intervals) for Type 1 diabetes mellitus in relation to Coxsackie B virus serology were included. The review included 26 case-control studies; no cohort study met the inclusion criteria. Odds ratios for Type 1 diabetes mellitus in serology-positive vs. serology-negative subjects ranged from 0.2 to 22.3. For Coxsackie B (any serotype) 7/13 studies had point estimates significantly greater than 1.0 (P Coxsackie B3, Coxsackie B4 and Coxsackie B5-specific assays, 1/11, 6/17 and 1/11 studies, respectively, had point estimates significantly greater than 1.0. Summary odds ratios were not calculated because of doubts about the validity of individual study estimates, heterogeneity between studies, and the possibility of publication bias. The results of these studies are inconsistent and do not provide convincing evidence for or against an association between Coxsackie B virus infection and Type 1 diabetes mellitus. Better designed studies using effective assays are needed to resolve this important issue.
Abariga, Samuel A; Whitcomb, Brian W
Gestational diabetes mellitus (GDM) is glucose intolerance with first onset during pregnancy and is associated with serious maternal and fetal complications. The etiology of GDM is not well understood, but systemic inflammation effects on insulin signaling and glucose metabolism is suspected. Periodontal disease is a chronic inflammatory condition that induces local and host immune responses and has been evaluated for a potential role in development of GDM. Results from studies evaluating the association between periodontitis and GDM are mixed. We performed a systematic review and meta-analysis to summarize available data regarding the association between periodontitis and GDM. Twelve electronic databases were searched for observational studies of the association between periodontitis and GDM through March 2016. Eligible studies were assessed for quality and heterogeneity. Random effects models were used to estimate summary measures of association. We identified 44 articles from 115 potentially relevant reports of which 10 studies met our eligibility criteria. Clinical diagnostic criteria for periodontitis and GDM varied widely among studies, and moderate heterogeneity was observed. Random effects meta-analysis of all included studies with a total of 5724 participants including 624 cases, showed that periodontitis is associated with an increased risk of GDM by 66 %, (OR = 1.66, 95 % CI: 1.17 to 2.36; p periodontitis (aOR = 2.08, 95 % CI: 1.21 to 3.58, p = 0.009, I 2 = 36.9 %). Meta-analysis suggests that periodontitis is associated with a statistically significant increased risk for GDM compared to women without periodontitis. Robust prospective study designs and uniform definition for periodontitis and GDM definitions are urgently needed to substantiate these findings.
Al-Rifai, Rami H; Pearson, Fiona; Critchley, Julia A; Abu-Raddad, Laith J
The burgeoning epidemic of diabetes mellitus (DM) is one of the major global health challenges. We systematically reviewed the published literature to provide a summary estimate of the association between DM and active tuberculosis (TB). We searched Medline and EMBASE databases for studies reporting adjusted estimates on the TB-DM association published before December 22, 2015, with no restrictions on region and language. In the meta-analysis, adjusted estimates were pooled using a DerSimonian-Laird random-effects model, according to study design. Risk of bias assessment and sensitivity analyses were conducted. 44 eligible studies were included, which consisted of 58,468,404 subjects from 16 countries. Compared with non-DM patients, DM patients had 3.59-fold (95% confidence interval (CI) 2.25-5.73), 1.55-fold (95% CI 1.39-1.72), and 2.09-fold (95% CI 1.71-2.55) increased risk of active TB in four prospective, 16 retrospective, and 17 case-control studies, respectively. Country income level (3.16-fold in low/middle-vs. 1.73-fold in high-income countries), background TB incidence (2.05-fold in countries with >50 vs. 1.89-fold in countries with ≤50 TB cases per 100,000 person-year), and geographical region (2.44-fold in Asia vs. 1.71-fold in Europe and 1.73-fold in USA/Canada) affected appreciably the estimated association, but potential risk of bias, type of population (general versus clinical), and potential for duplicate data, did not. Microbiological ascertainment for TB (3.03-fold) and/or blood testing for DM (3.10-fold), as well as uncontrolled DM (3.30-fold), resulted in stronger estimated association. DM is associated with a two- to four-fold increased risk of active TB. The association was stronger when ascertainment was based on biological testing rather than medical records or self-report. The burgeoning DM epidemic could impact upon the achievements of the WHO "End TB Strategy" for reducing TB incidence.
Upadhyay, Ravi Prakash; Misra, Puneet; Chellaiyan, Vinoth G; Das, Timiresh K; Adhikary, Mrinmoy; Chinnakali, Palanivel; Yadav, Kapil; Sinha, Smita
To estimate the burden of diabetes mellitus and pre-diabetes in tribal populations of India. The authors reviewed studies from 2000 to 2011 that documented the prevalence of diabetes mellitus in various tribal populations of India. The search was performed using electronic and manual methods. Meta-analysis of data on point prevalence was performed. A total of seven studies were retrieved. The prevalence of diabetes mellitus ranged from 0.7% to 10.1%. The final estimate of diabetes prevalence obtained after pooling of data from individual studies, was 5.9% (95% CI; 3.1-9.5%). The prevalence for impaired fasting glucose (IFG) varied from 5.1% to 13.5% and impaired glucose tolerance (IGT), from 6.6% to 12.9%. Chronic disease research in tribal populations is limited. The reported prevalence of IFG/IGT was higher than the prevalence of diabetes and this observation could be suggestive of a potential increase in diabetes in the coming years. Given that lifestyle changes have occurred in the tribal populations, there is a need to synthesize evidence(s) relating to diabetes and other chronic diseases in these marginalized populations and inform policy makers. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.
Gravesande, Janelle; Richardson, Julie
To identify the non-pharmacological risk factors for falling in older adults with type 2 diabetes mellitus (DM2). A systematic review of randomized controlled trials, prospective cohort studies, cross-sectional studies and before/after studies was conducted. Eligible studies identified non-pharmacological risk factors for falling in older adults with DM2. Medline, Embase, Pubmed and CINAHL were searched for relevant studies published through December 2015. Reference lists were also searched for relevant studies. Search terms were DM2, risk factors, falls and falling, older adults, aging, non-insulin dependent diabetes mellitus, accidental falls and trip. Publication language was restricted to English. Thirteen studies met the inclusion criteria: four cross-sectional, six prospective cohorts, two randomized controlled trials and one before/after study. These studies included a total of 13,104 participants, ≥50 years. The most common risk factors for falling were impaired balance, reduced walking velocity, peripheral neuropathy and comorbid conditions. However, lower extremity pain, being overweight and comorbid conditions had the greatest impact on fall risk. Interventions to reduce falling in older adults with type 2 diabetes mellitus should focus on reducing lower extremity pain, reducing body weight and managing comorbid conditions. Implications for Rehabilitation Diabetes mellitus: • Older adults with type 2 diabetes mellitus (DM2) have a higher risk for falling than older adults without. • Older adults with DM2 are more likely to suffer serious injuries when they fall. • Comprehensive risk factor identification is necessary for rehabilitation professionals to accurately determine whether their clients are at risk for falling. • Rehabilitation professionals also need to tailor interventions based on the client's risk factors in order to effectively reduce falls and fall-related injuries.
Pamungkas, Rian Adi; Chamroonsawasdi, Kanittha; Vatanasomboon, Paranee
The rate of type-2 diabetes mellitus (T2D) is dramatically increasing worldwide. Continuing diabetes mellitus (DM) care needs effective self-management education and support for both patients and family members. This study aimed to review and describe the impacts of diabetes mellitus self-management education (DSME) that involve family members on patient outcomes related to patient health behaviors and perceived self-efficacy on self-management such as medication adherence, blood glucose monitoring, diet and exercise changes, health outcomes including psychological well-being and self-efficacy, and physiological markers including body mass index, level of blood pressure, cholesterol level and glycemic control. Three databases, PubMed, CINAHL, and Scopus were reviewed for relevant articles. The search terms were "type 2 diabetes," "self-management," "diabetes self-management education (DSME)," "family support," "social support," and "uncontrolled glycaemia." Joanna Briggs Institute (JBI) guidelines were used to determine which studies to include in the review. Details of the family support components of DSME intervention and the impacts of these interventions had on improving the health outcomes patients with uncontrolled glycaemia patients. A total of 22 intervention studies were identified. These studies involved different DSME strategies, different components of family support provided, and different health outcomes to be measured among T2D patients. Overall, family support had a positive impact on healthy diet, increased perceived support, higher self-efficacy, improved psychological well-being and better glycemic control. This systematic review found evidence that DSME with family support improved self-management behaviors and health outcomes among uncontrolled glycaemia T2D patients. The findings suggest DSME models that include family engagement can be a useful direction for improving diabetes care.
Bos, Manouk; Agyemang, Charles
Diabetes is increasingly becoming a major chronic disease burden all over the world. This requires a shift in healthcare priorities and up-to-date data on the epidemiology and impact of diabetes in all regions of the world to help plan and prioritize health programs. We systematically reviewed the
Full Text Available Introduction: Type 2 diabetes mellitus (T2DM among people aged 60 years and above is a growing public health problem. Regular physical activity is one of the key elements in the management of T2DM. Recommendations suggest that older people with T2DM will benefit from regular physical activity for better disease control and delaying complications. Despite the known benefits, many remain sedentary. Hence, this review assessed interventions for promoting physical activity in persons aged 65 years and older with type 2 diabetes mellitus. Methods: A literature search was conducted using OvidMEDLINE, PubMed, EMBASE, SPORTDiscus and CINAHL databases to retrieve articles published between January 2000 and December 2012. Randomised controlled trials and quasi-experimental designs comparing different strategies to increase physical activity level in persons aged 65 years and older with T2DM were included. The methodological quality of studies was assessed.Results: Twenty-one eligible studies were reviewed, only six studies were rated as good quality and only one study specifically targeted persons aged 65 years and older. Personalised coaching, goal setting, peer support groups, use of technology and physical activity monitors were proven to increase the level of physical activity. Incorporation of health behaviour theories and follow-up supports also were successful strategies. However, the methodological quality and type of interventions promoting physical activity of the included studies in this review varied widely across the eligible studies.Conclusion: Strategies that increased level of physical activity in persons with T2DM are evident but most studies focused on middle-aged persons and there was a lack of well-designed trials. Hence, more studies of satisfactory methodological quality with interventions promoting physical activity in older people are required.
Cai, Hong; Li, Guichen; Zhang, Ping; Xu, Duo; Chen, Li
Diabetic patients tend to have a poor quality of life. A sedentary lifestyle is considered to be a modifiable risk factor for type 2 diabetes and an independent predictor of poor quality of life. Exercise is a key treatment for people living with diabetes. The purpose of this study was to conduct a systematic review to assess the effect of exercise on the quality of life of people with type 2 diabetes. We conducted a systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed, Web of Science, Embase, Cochrane Library, CINAHL and three Chinese databases were searched for studies published until January 2016. The review included all clinical trials that evaluated the effect of exercise on quality of life compared with that of usual care for people with type 2 diabetes. Two reviewers independently assessed the quality of all the included studies, by using the Downs and Black Quality Index (QI). Thirty studies met inclusion criteria, with 2785 participants. We divided the exercise into four modes: aerobic, resistance, a combination of aerobic and resistance and yoga. Aerobic exercise showed a significant effect between groups. Resistance and combined exercise showed mixed results. Yoga also showed good intervention effects on quality of life. The effect of aerobic exercise on the quality of life in people with type 2 diabetes was safe and effective. Then, most of the studies on aerobic exercise were of good methodological quality. The effects of resistance exercise and combined exercise on the quality of life in people with type 2 diabetes were mixed, and the effect of yoga on quality of life still need more research.
Broekstra, Dieuwke C; Groen, Henk; Molenkamp, Sanne; Werker, Paul M N; van den Heuvel, Edwin R
BACKGROUND: The role of diabetes mellitus, liver disease, and epilepsy as risk factors for Dupuytren disease remains unclear. In this systematic review and meta-analysis, the strength and consistency of these associations were examined. METHODS: The MEDLINE, EMBASE, and Web of Science databases were
Broekstra, Dieuwke C; Groen, Henk; Molenkamp, Sanne; Werker, Paul M N; van den Heuvel, Edwin R
Background: The role of diabetes mellitus, liver disease, and epilepsy as risk factors for Dupuytren disease remains unclear. In this systematic review and meta-analysis, the strength and consistency of these associations were examined. Methods: The MEDLINE, EMBASE, and Web of Science databases were
Aguilar Cordero, María José; Baena García, Laura; Rodríguez Blanque, Raquel; Latorre García, Julio; Mur Villar, Norma; Sánchez López, Antonio Manuel
at present, diabetes has become a global health problem. The consequences that entails, both short and long term, do more studies and knowledge necessary for detection, control and treatment. Moreover, its prevalence is increasing in both the general population and pregnant women. Numerous effects and complications have been reported in infants of diabetic mothers, such as fetal macrosomia, hypoglycemia and increased risk of developing obesity. This condition could have negative effects on the neurological development of the child and could affect his intellectual capacity and increase cognitive impairment. to analyze the studies which have investigated in the relationship between diabetes mellitus during pregnancy and its impact on child neurodevelopment short and long-term. we performed a systematic search and 20 specific articles on the subject selected would be selected following the PRISMA guidelines. in the studies consulted include a large methodological variety in both instruments and cognitive assessment scales, as in the age at which the sample is studied. However, most researchers conclude that maternal diabetes can have consequences for the child, both short and long-term. A higher rate of obesity, impaired glucose tolerance, cardiovascular and metabolic disorders and neurodevelopmental impairment is also described, which increase the neurobehavioral disorders and intellectual disability. most of the studies are agree in describing neurodevelopmental disorders in children of diabetic mothers, both in cognition and in the specific areas related to expressive language, social relations, graphical skills and psychomotor development. Other research has linked maternal diabetes with an increased incidence of autism spectrum disorders such as hyperactivity, attention deficits and schizophrenia. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.
Ismail, Ahmad Faisal; McGrath, Colman Patrick; Yiu, Cynthia K Y
This systematic review investigated the oral health status of children with type 1 diabetes. A systematic search was conducted using PubMed/Medline, Web of Knowledge, SCOPUS and EMBASE. The search included all studies published from inception of database to January 2014. A total of 1179 abstracts were analyzed for selection in 2 phases. The first phase selection was based on the title and abstracts alone. The selected abstracts were then included for second phase, where full articles were obtained. The selection was carried out by 2 independent reviewers (Kappa value=0.809). Only 37 articles were included for final analysis in this review. There is conflicting evidence in the caries experience between children with type 1 diabetes and healthy children. For periodontal health, most studies reported significantly greater plaque accumulation and higher gingival index in children with type 1 diabetes. Cohort studies reported no significant differences in perioodontal parameters over time. There is conflicting evidence regarding the caries experience of children with type 1 diabetes, but they exhibit poorer periodontal health status with greater plaque accumulation compared to healthy children. Further studies are warranted to assess the oral health status of children with type 1 diabetes. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Roopan, Subethini; Larsen, Erik Roj
Depression may be difficult to treat and with comorbid diabetes mellitus (DM) it is an even bigger challenge. This article aims to evaluate antidepressants most suitable for patients with depression and comorbid DM. Design and methods Initially we searched for randomised, controlled double-blind trials of treatment with antidepressants in depressed with DM but there were only a few studies and many of them were small trials. Thus, we decided to include studies that were not only randomised-controlled trials. In total, we ended up with 18 articles for our purposes. The combination of depression and DM may be harmful as depression has a strong impact on psychosocial and medical outcomes in patients with DM. Almost all of the trials in this review showed a reduction in depressive symptoms after treatment with an antidepressant in the acute as well as during maintenance phase. It showed that depression improvement had a favourable effect on glycaemic control that was weight independent. Some studies included only subjects with minor depression or with suboptimal-controlled diabetes making it difficult to show an effect. From these data, we will recommend choosing an selective serotonin reuptake inhibitor (SSRI) if possible to treat a depression among patients with diabetes. If treatment with a tricyclic antidepressant is needed, closer glycaemic monitoring is recommended. Bear in mind that there is a possible risk of hypoglycemia when using SSRIs. Agomelatine and bupropion have shown promising results, but need to be investigated in more trials.
Mwanri, Akwilina W; Kinabo, Joyce; Ramaiya, Kaushik; Feskens, Edith J M
We systematically reviewed publications on prevalence and risk factors for gestational diabetes mellitus (GDM) in the 47 countries of sub-Saharan Africa. We conducted a systematic search in PUBMED and reviewed articles published until June 2014 and searched the references of retrieved articles. We explored sources of heterogeneity among prevalence proportions with metaregression analysis. Of 1069 articles retrieved 22 studies were included. Half were from West Africa, specifically Nigeria, five from South Africa and six from East and Central Africa. There were differences in screening methods and diagnosis criteria used, even between studies carried out in the same country and same time period. Metaregression analysis indicated high heterogeneity among the studies (I(2) = 100, P 30 years. There are few studies on prevalence and risk factors for GDM in Sub-Saharan Africa and heterogeneity is high. Prevalence was up to about 14% when high-risk women were studied. Preventive actions should be taken to reduce the short- and long-term complications related to GDM in Sub-Saharan Africa. © 2015 John Wiley & Sons Ltd.
Lautatzis, Maria-Elena; Goulis, Dimitrios G; Vrontakis, Maria
Metformin is an effective oral anti-hyperglycemic agent that is widely used to manage diabetes mellitus type 2 in the general population and more recently, in pregnancy. However, as metformin crosses the placenta, its use during pregnancy raises concerns regarding potential adverse effects on the mother and fetus. (i) To provide background for the use of metformin during pregnancy through a narrative review and (ii) to critically appraise the published evidence on the efficacy and safety of using metformin during pregnancy through a systematic review. Metformin appears to be effective and safe for the treatment of gestational diabetes mellitus (GDM), particularly for overweight or obese women. However, patients with multiple risk factors for insulin resistance may not meet their treatment goals with metformin alone and may require supplementary insulin. Evidence suggests that there are potential advantages for the use of metformin over insulin in GDM with respect to maternal weight gain and neonatal outcomes. Furthermore, patients are more accepting of metformin than insulin. The use of metformin throughout pregnancy in women with polycystic ovary syndrome reduces the rates of early pregnancy loss and preterm labor and protects against fetal growth restriction. There have been no demonstrable teratogenic effects, intra-uterine deaths or developmental delays with the use of metformin. The publications reviewed in this paper support the efficacy and safety of metformin during pregnancy with respect to immediate pregnancy outcomes. Because there are no guidelines for the continuous use of metformin in pregnancy, the duration of treatment is based on clinical judgment and experience on a case-by-case basis. © 2013.
de Morais, Everton Freitas de; Dantas, Afonso Nóbrega; Pinheiro, Juliana Campos; Leite, Rafaella Bastos; Galvao Barboza, Carlos Augusto; de Vasconcelos Gurgel, Bruno Cesar; de Almeida Freitas, Roseana
The objective of this systematic review was to evaluate information on the levels of MMP-8 in patients diagnosed with prediabetes or type 2 diabetes mellitus with periodontal disease, analyzing its validity as a possible biomarker for the diagnosis and progression of periodontal disease (PD). A systematic search of the following databases was performed: PubMed/Medline, CENTRAL (The Cochrane Library), EMBASE and Web of Science. Studies involving the evaluation of MMP-8 in patients with prediabetes or patients presenting type 2 diabetes mellitus concomitantly with PD were selected. The evaluation of the methodological quality of the selected studies was based on the methodological bias risk analysis (QUADAS-2). Eight of the initially identified 2683 articles were selected. In all the selected studies, evaluator calibration and the use of clear methods for patient diagnosis with periodontal disease were present. Studies have demonstrated significantly higher MMP-8 concentrations in PD patients compared to controls, as well as in patients presenting more advanced stages of PD. However, controversies regarding MMP-8 levels in prediabetes/diabetes type 2 patients with PD. Higher MMP-8 levels in patients with PD compared to controls imply the potential use of MMP-8 in the diagnosis of PD. The influence of patient glycemic state, as well as medications these patients make use of, are factors that possibly contribute to the modulation of MMP-8 concentrations in patients with diabetes and should be analyzed, aiming at a better understanding of the relationship between glycemic state and MMP-8 levels in patients with PD. Copyright © 2017 Elsevier Ltd. All rights reserved.
Razmpoosh, Elham; Javadi, Maryam; Ejtahed, Hanieh-Sadat; Mirmiran, Parvin
Probiotics have been suggested to play an important role in the management of diabetes. We conducted a systematic review on the role of probiotics in modulating parameters related to diabetes in animal and human experiments. We searched Pubmed, Scopus and Cochrane central until June 2014, concerning the effects of probiotics on hyperglycemia, hyperinsulinemia and their anti-diabetic efficacies by modulating the activities of proinflammatory and antioxidant factors. Our initial search retrieved 1120 reports. After screening titles and abstracts, 72 full-text articles were reviewed for eligibility. Ultimately, 33 articles met our inclusion criteria consisting of five human and twenty eight animal reports. Lactobacillus strains were, in particular, used in all studies with or without other strains. We found that probiotics have beneficial effects on glycemic controls, as all human studies showed significant reductions in at least one of the primary outcome endpoints which were the levels of fasting plasma glucose, postprandial blood glucose, glycated haemoglobin, insulin, insulin resistance and onset of diabetes; similarly, all the animal reports, except for two, documented significant changes in these parameters. Regarding secondary outcome measures, that is, lipid profiles, pro-inflammatory and anti-oxidant factors, only one human and one animal study failed to show any significant changes in any of these parameters. This systematic review generally demonstrated beneficial effects of the probiotic administration, especially Lactobacillus sub-strains, on the management of diabetes-related blood parameters, although, more evidence, especially from human trials, is needed to confirm these effects and also to conduct a meta-analysis. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.
Tong, Gui-Xian; Cheng, Jing; Chai, Jing; Geng, Qing-Qing; Chen, Peng-Lai; Shen, Xin-Rong; Liang, Han; Wang, De-Bin
This study aimed at summarizing epidemiological evidence of the association between gestational diabetes mellitus (GDM) and subsequent risk of cancer. We searched Medline, Embase, Cancer Lit and CINAHL for epidemiological studies published by February 1, 2014 examining the risk of cancer in patients with history of GDM using highly inclusive algorithms. Information about first author, year of publication, country of study, study design, cancer sites, sample sizes, attained age of subjects and methods used for determining GDM status were extracted by two researchers and Stata version 11.0 was used to perform the meta-analysis and estimate the pooled effects. A total of 9 articles documented 5 cohort and 4 case- control studies containing 10,630 cancer cases and 14,608 women with a history of GDM were included in this review. Taken together, the pooled odds ratio (OR) between GDM and breast cancer risk was 1.01 (0.87-1.17); yet the same pooled ORs of case-control and cohort studies were 0.87 (0.71-1.06) and 1.25 (1.00-1.56) respectively. There are indications that GDM is strongly associated with higher risk of pancreatic cancer (HR=8.68) and hematologic malignancies (HR=4.53), but no relationships were detected between GDM and other types of cancer. Although GDM increases the risk of certain types of cancer, these results should be interpreted with caution becuase of some methodological flaws. The issue merits added investigation and coordinated efforts between researchers, antenatal clinics and cancer treatment and registration agencies to help attain better understanding.
Full Text Available Abstract Diabetes mellitus (DM may adversely affect periodontal tissues during orthodontic tooth movement (OTM. The aim of this review is to systematically analyze and review animal studies investigating the effect of DM on periodontal tissues during OTM. An electronic search was conducted via PubMed/Medline, Google Scholar, Embase, ISI Web of Knowledge, and Cochrane Central Register of Controlled Trials (CONTROL using the keywords “diabetes,” “orthodontics,” and “tooth movement” for studies published between January 2000 and August 2016. After elimination of duplicate items, the primary search resulted in 89 articles. After exclusion of irrelevant articles on the basis of abstract and title, full texts of 25 articles were read to exclude additional irrelevant studies. Seven animal studies were included in this review for qualitative analysis. When compared to healthy animals, more bone resorption and diminished bone remodeling were observed in diabetic animals in all studies. Furthermore, DM decreased the rate of OTM in one study, but in another study, DM accelerated OTM. DM may adversely affect bone remodeling and tooth movement during application of orthodontic forces. However, a number of potential sources of bias and deficiencies in methodology are present in studies investigating the association between OTM and DM. Hence, more long-term and well-designed studies are required before the exact mechanism and impact of DM on outcomes of orthodontic treatment is understood.
Full Text Available Background/Aims: The aim of this study was to assess the association between circulating cell-derived microparticles (MPs and type 2 diabetes mellitus (T2DM. Methods: A literature search was performed systematically in PubMed and Embase to identify available case-control or cross-sectional studies that compared different types of cell-derived MPs in patients with T2DM and non-diabetic controls. Pooled standardized mean differences (SMDs of each MP type were pooled using meta-analysis. Results: Forty-eight studies involving 2,460 patients with T2DM and 1,880 non-diabetic controls were included for systematic review and 34 of which were included for quantitative study by meta-analysis. In the overall analysis, the levels of circulating total MPs (TMPs, platelet-derived MPs (PMPs, monocyte-derived MPs (MMPs and endothelium-derived MPs (EMPs were significantly higher in T2DM patients than those in controls (TMPs: SMD, 0.64; 95%CI, 0.12∼1.15; P=0.02; PMPs: SMD, 1.19; 95%CI, 0.88∼1.50; P Conclusions: The counts of TMPs, PMPs, MMPs and EMPs elevated in patients with T2DM. And cell-derived MPs may play a role in the pathogenesis of T2DM.
Wang, Y; Yeo, Q Q; Ko, Y
To review and evaluate the most recent literature on the economic outcomes of pharmacist-managed services in people with diabetes. The global prevalence of diabetes is increasing. Although pharmacist-managed services have been shown to improve people's health outcomes, the economic impact of these programmes remains unclear. A systematic review was conducted of six databases. Study inclusion criteria were: (1) original research; (2) evaluation of pharmacist-managed services in people with diabetes; (3) an economic evaluation; (4) English-language publication; and (5) full-text, published between January 2006 and December 2014. The quality of the full economic evaluations reviewed was evaluated using the Consolidated Health Economic Evaluation Reporting Standards checklist. A total of 2204 articles were screened and 25 studies were selected. These studies were conducted in a community pharmacy (n = 10), a clinic- /hospital-based outpatient facility (n = 8), or others. Pharmacist-managed services included targeted education (n = 24), general pharmacotherapeutic monitoring (n = 21), health screening or laboratory testing services (n = 9), immunization services (n = 2) and pharmacokinetic monitoring (n = 1). Compared with usual care, pharmacist-managed services resulted in cost savings that varied from $7 to $65,000 ($8 to $85,000 in 2014 US dollars) per person per year, and generated higher quality-adjusted life years with lower costs. Benefit-to-cost ratios ranged from 1:1 to 8.5:1. Among the 25 studies reviewed, 11 were full economic evaluations of moderate quality. Pharmacist-managed services had a positive return in terms of economic viability. With the expanding role of pharmacists in the healthcare sector, alongside increasing health expenditure, future economic studies of high quality are needed to investigate the cost-effectiveness of these services. © 2015 Diabetes UK.
Nansseu, Jobert Richie N; Ngo-Um, Suzanne S; Balti, Eric V
In the absence of existing data, the present review intends to determine the incidence, prevalence and/or genetic determinants of neonatal diabetes mellitus (NDM), with expected contribution to disease characterization. We will include cross-sectional, cohort or case-control studies which have reported the incidence, prevalence and/or genetic determinants of NDM between January 01, 2000 and May 31, 2016, published in English or French languages and without any geographical limitation. PubMed and EMBASE will be extensively screened to identify potentially eligible studies, completed by manual search. Two authors will independently screen, select studies, extract data, and assess the risk of bias; disagreements will be resolved by consensus. Clinical heterogeneity will be investigated by examining the design and setting (including geographic region), procedure used for genetic testing, calculation of incidence or prevalence, and outcomes in each study. Studies found to be clinically homogeneous will be pooled together through a random effects meta-analysis. Statistical heterogeneity will be assessed using the chi-square test of homogeneity and quantified using the I 2 statistic. In case of substantial heterogeneity, subgroup analyses will be undertaken. Publication bias will be assessed with funnel plots, complemented with the use of Egger's test of bias. This systematic review and meta-analysis is expected to draw a clear picture of phenotypic and genotypic presentations of NDM in order to better understand the condition and adequately address challenges in respect with its management. PROSPERO CRD42016039765.
Ruiz-Aragón, Jesús; Villegas Portero, Román; Flores Moreno, Sandra
To compare out-patient determination of HbA(1c) with lab figures, by measuring metabolic control, quality of life and hypoglycaemia episodes, in adults with type-1 or -2 diabetes mellitus. Systematic review. MEDLINE (1966-August 2006), EMBASE (2000-August 2006), bases held by the Center for Reviews and Dissemination (DARE, INAHTA, NHS-EED), Cochrane Library (number 3, 2006), European Medication Agency, Food and Drug Administration and the European Network of Emerging Technologies. A manual search was made in Point of Care and in the register of trials, (ClinicalTrials.gov). Inclusion criteria were studies with type-1 or -2 diabetics who used portable out-patient devices and with comparison with lab references. Studies of minors, of any other kind of diabetes, of patients without a portable device and where the comparator did not include reference methods were excluded. Those that a priori met the criteria were recovered fully. A quality analysis was run according to the CASPe programme criteria and data were extracted with specific formulae. As meta-analysis was not possible, a qualitative synthesis was made. Twenty publications were selected. The values of most devices correlated well (R(2)=0.85 and R(2)=0.059; Ptherapy control was more intense (95% CI, 0.95-1.52) and visits to the doctor decreased. Out-patient evaluations are rapid and comfortable, increasing patients' metabolic control. However, they possess certain limitations.
Hageman, David; Gommans, Lindy Nm; Scheltinga, Marc Rm; Teijink, Joep Aw
Some believe that certain patients with intermittent claudication may be unsuitable for supervised exercise therapy (SET), based on the presence of comorbidities and the possibly increased risks. We conducted a systematic review (MEDLINE, EMBASE and CENTRAL) to summarize evidence on the potential influence of diabetes mellitus (DM) on the response to SET. Randomized and nonrandomized studies that investigated the effect of DM on walking distance after SET in patients with IC were included. Considered outcome measures were maximal, pain-free and functional walking distance (MWD, PFWD and FWD). Three articles met the inclusion criteria ( n = 845). In one study, MWD was 111 meters (128%) longer in the non-DM group compared to the DM group after 3 months of follow-up ( p = 0.056). In a second study, the non-DM group demonstrated a significant increase in PFWD (114 meters, p ⩽ 0.05) after 3 months of follow-up, whereas there was no statistically significant increase for the DM group (54 meters). On the contrary, the largest study of this review did not demonstrate any adverse effect of DM on MWD and FWD after SET. In conclusion, the data evaluating the effects of DM on SET were inadequate to determine if DM impairs the exercise response. While trends in the data do not suggest an impairment, they are not conclusive. Practitioners should consider this limitation when making clinical decisions.
Ziukaite, Laura; Slot, Dagmar E; Van der Weijden, Fridus A
Diabetes mellitus and periodontitis are complex chronic diseases with an established bidirectional relationship. This systematic review evaluated in subjects with professionally diagnosed periodontitis the prevalence and odds of having diabetes. The MEDLINE-PubMed, CENTRAL and EMBASE databases were searched. Prevalence of diabetes mellitus among subjects with periodontitis were extracted or if possible calculated. From the 803 titles and abstracts that came out of the search, 29papers met the initial criteria. Prevalence of diabetes was 9.4% among subjects with periodontitis and 12.8%among subjects without periodontitis. Based on sub-analysis, for subjects with periodontitis, the prevalence of diabetes was 6.5%when diabetes was self-reported, compared to 17.3%when diabetes was clinically assessed. The highest prevalence of diabetes among subjects with periodontitis was observed in studies originating from Asian countries(17.2%,n=16647) and the lowest in studies describing populations from Europe(4.3%(n=7858). The overall odds ratio for diabetes patients to be among subjects with periodontitis as compared to those without periodontitis was 2.59(95%CI[2.12;3.15]). A substantial variability in the definitions of periodontitis, combination of self-reported and clinically assessed diabetes, lack of confounding for diabetes control in included studies introduces estimation bias. The overall prevalence and odds of having diabetes is higher within periodontitis populations compared to people without periodontitis. Self-reported diabetes underestimates the prevalence when compared to this condition assessed clinically. Geographical differences were observed: the highest diabetes prevalence among subjects with periodontitis was observed in studies conducted in Asia and the lowest in studies originating from Europe. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
Full Text Available The effect of practicing yoga for the management of type II Diabetes was assessed in this systematic review through searching related electronic databases and the grey literature to the end of May 2007 using Ovid. All randomized controlled clinical trials (RCTs comparing yoga practice with other type of intervention or with regular practice or both, were included regardless of language or type of publication. Each study was assessed for quality by two independent reviewers. Mean difference was used for summarizing the effect of each study outcomes with 95% confidence intervals. Pooling of the studies did not take place due to the wide clinical variation between the studies. Publication bias was assessed by statistical methods. Five trials with 363 participants met the inclusion criteria with medium to high risk of bias and different intervention characteristics. The studies’ results show improvement in outcomes among patients with diabetes type II. These improvements were mainly among short term or immediate diabetes outcomes and not all were statistically significant. The results were inconclusive and not significant for the long-term outcomes. No adverse effects were reported in any of the included studies. Short-term benefits for patients with diabetes may be achieved from practicing yoga. Further research is needed in this area. Factors like quality of the trials and other methodological issues should be improved by large randomized control trials with allocation concealment to assess the effectiveness of yoga on diabetes type II. A definitive recommendation for physicians to encourage their patients to practice yoga cannot be reached at present.
Qiu, Qihong; Zhang, Fuping; Zhu, Wenjun; Wu, Juan; Liang, Min
Copper (Cu) is an important trace element involved in oxidative stress, which is associated with the onset and progression of diabetes mellitus (DM). However, clinical studies comparing plasma or serum Cu levels in patients with DM and in healthy individuals report conflicting findings. Therefore, in this meta-analysis, we analyzed the circulating levels of Cu associated with DM (including type 1 diabetes mellitus [T1DM] and type 2 diabetes mellitus [T2DM]). We searched the articles indexed in PubMed, OVID, and Cochrane databases, published through January 2016 and meeting our predefined criteria. Requisite data were extracted, and a random-effect model or a fixed-effect model was used to conduct the meta-analysis. Fifteen eligible studies involving a total of 1079 DM patients and 561 healthy controls were identified. Overall, the DM patients showed higher Cu levels than the healthy controls (plasma Cu mean difference [MD] = 1.69 μmol/L, p diabetes also indicated higher levels of Cu in the plasma and serum of DM patients than in healthy controls, respectively. Stratification of DM patients associated with and without complications also revealed similar results. This meta-analysis suggests that DM patients carried higher levels of Cu than healthy individuals. However, international cohort studies are needed to corroborate our findings.
Ranger, Tom A; Wong, Andrea M Y; Cook, Jill L; Gaida, Jamie E
Musculoskeletal symptoms limit adherence to exercise interventions for individuals with type 2 diabetes. People with diabetes may be susceptible to tendinopathy due to chronically elevated blood glucose levels. Therefore, we aimed to investigate this potential association by systematically reviewing and meta-analysing case-control, cross-sectional, and studies that considered both of these conditions. Nine medical databases and hand searching methods were used without year limits to identify all relevant English language articles that considered diabetes and tendinopathy. Two authors applied exclusion criteria and one author extracted data with verification by a second author. Meta-analysis was conducted using a random effects model. Results were expressed as odds ratio (OR), mean difference or standardised mean difference with a confidence intervals (95% CI). Heterogeneity was assessed by I(2). 31 studies were included in the final analysis of which 26 recruited people with diabetes and five recruited people with tendinopathy. Tendinopathy was more prevalent in people with diabetes (17 studies, OR 3·67, 95% CI 2·71 to 4·97), diabetes was more prevalent in people with tendinopathy (5 studies, OR 1·28, 95% CI 1·10 to 1·49), people with diabetes and tendinopathy had a longer duration of diabetes than people with diabetes only (6 studies, mean difference 5·26 years, 95% CI 4·15 to 6·36) and people with diabetes had thicker tendons than controls (9 studies, standardised mean difference 0·79 95% CI 0·47 to 1·12). These findings provide strong evidence that diabetes is associated with higher risk of tendinopathy. This is clinically relevant as tendinopathy may affect adherence to exercise interventions for diabetes. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
Hausenblas, Heather A; Schoulda, Jennifer A; Smoliga, James M
The red wine polyphenol, resveratrol, is highly effective in treating type 2 diabetes mellitus (T2DM) in animal models, but there is no consensus regarding its efficacy in humans. We conducted a systematic review, which included searches in nine scholarly databases and six clinical trial registries, and identified randomized controlled clinical trials whereby resveratrol was used as an adjunct to pharmaceutical interventions in T2DM. Meta-analysis on clinical parameters was performed for available data. Of 764 articles originally identified, data from six unique datasets, examining a total of 196 T2DM patients (104 resveratrol, 92 control/placebo) ultimately met inclusion criteria. Statistically significant (p fasting glucose, homeostatic model assessment of insulin resistance, diastolic blood pressure, insulin, triglycerides, LDL, or HDL cholesterol. No major adverse events were reported and side effects of resveratrol were not different than placebo/control. Though limitations in sample size and treatment duration preclude definitive changes in clinical practice, significant improvements in multiple cardiometabolic biomarkers and an excellent safety profile support resveratrol as a leading candidate as an adjunct to pharmacological management of T2DM. © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.
Li, Sheyu; Wei, Jia; Zhang, Chenghui; Li, Xiaodan; Meng, Wentong; Mo, Xianming; Zhang, Qianying; Liu, Qilin; Ren, Kaiyun; Du, Rong; Tian, Haoming; Li, Jianwei
The aim of this study was to assess the association between circulating cell-derived microparticles (MPs) and type 2 diabetes mellitus (T2DM). A literature search was performed systematically in PubMed and Embase to identify available case-control or cross-sectional studies that compared different types of cell-derived MPs in patients with T2DM and non-diabetic controls. Pooled standardized mean differences (SMDs) of each MP type were pooled using meta-analysis. Forty-eight studies involving 2,460 patients with T2DM and 1,880 non-diabetic controls were included for systematic review and 34 of which were included for quantitative study by meta-analysis. In the overall analysis, the levels of circulating total MPs (TMPs), platelet-derived MPs (PMPs), monocyte-derived MPs (MMPs) and endothelium-derived MPs (EMPs) were significantly higher in T2DM patients than those in controls (TMPs: SMD, 0.64; 95%CI, 0.12∼1.15; P=0.02; PMPs: SMD, 1.19; 95%CI, 0.88∼1.50; P derived MPs (LMPs) level between diabetic and non-diabetic groups (SMD, 0.37; 95%CI, -0.15∼0.89; P=0.17). The counts of TMPs, PMPs, MMPs and EMPs elevated in patients with T2DM. And cell-derived MPs may play a role in the pathogenesis of T2DM. © 2016 The Author(s) Published by S. Karger AG, Basel.
Full Text Available Clinical data regarding the influence of diabetes mellitus (DM on the outcomes of patients undergoing hepatectomy are conflicting. To determine the impact of DM on the clinical outcomes of patients undergoing hepatectomy, we systematically reviewed published studies and carried out a meta-analysis.A systematic literature search of Pubmed, Sciencedirect, Web of Science, and Chinese Biomedical Database was conducted from their inception through February 2, 2016. The combined relative risk (RR or hazard ratio (HR with 95% confidence intervals (95% CI was calculated.A total of 16 observational studies with 15710 subjects were eligible for meta-analysis. The pooled results showed that DM significantly increased the risk of overall postoperative complications (RR 1.34; 95% CI 1.19-1.51; P<0.001, DM-associated complications (RR 1.8; 95% CI 1.29-2.53; P<0.001, liver failure (RR 2.21; 95% CI 1.3-3.76; P = 0.028 and post-operative infections (RR 1.59; 95% CI 1.01-2.5; P = 0.045. In addition, DM was also found to be significantly associated with unfavorable overall survival and disease free survival after liver resection. The pooled HR was 1.63 (95% CI 1.33-1.99; P<0.001 for overall survival and 1.55 (95% CI 1.07-2.25; P = 0.019 for disease free survival.DM is associated with poor outcomes in patients undergoing hepatectomy. DM should be taken into account cautiously in the management of patients undergoing hepatectomy. Further prospective studies are warranted to explore effective interventions to improve the poor outcomes of diabetic patients undergoing hepatectomy.
Full Text Available Background. Controversies on the utility of laparoscopic mini gastric bypass (LMGB in weight loss and type 2 diabetes mellitus (T2DM control still exist. Methods. We conducted a comprehensive literature search of PubMed, EMBASE, and Cochrane Library. Review Manager was used to perform the meta-analysis and the weighted mean difference (WMD and/or odds ratio with 95% confidence interval (95% CI were used to evaluate the overall size effect. Results. The literature search identified 16 studies for systematic review and 15 articles for meta-analysis. Compared with LAGB, LSG, and LRYGB, LMGB showed significant weight loss [WMD, −6.58 (95% CI, −9.37, −3.79, P<0.01 (LAGB; 2.86 (95% CI, 1.40, 5.83, P=0.004 (LSG; 10.33 (95% CI, 4.30, 16.36, P<0.01 (LRYGB] and comparable/higher T2DM remission results [86.2% versus 55.6%, P=0.06 (LAGB; 89.1% versus 76.3%, P=0.004 (LAGB; 93.4% versus 77.6%, P=0.006 (LAGB]; LMGB also had shorter learning curve and less operation time than LRYGB [WMD, −35.2 (95% CI, −46.94, −23.46]. Conclusions. LMGB appeared to be effective in weight loss and T2DM remission and noninferior to other bariatric surgeries. However, clinical utility of LMGB needs to be further validated by future prospective randomized controlled trials.
Goldstuck, Norman D; Steyn, Petrus S
Background. Women with diabetes mellitus type I and type II need effective contraception for personal and medical reasons. Long acting reversible contraceptive (LARC) methods are among the most efficient and cost-effective methods. Study Design. We searched the Popline, PubMed, and clinicaltrials.gov databases from 1961 to March 2013 for studies on the efficacy of the IUD in diabetic women and the possible changes it may produce in laboratory parameters. Studies of at least 30 subjects with DM1 or DM2 who were studied for 6 to 12 months depending on the method of analysis were eligible. Results. The search produced seven articles which gave event rate efficacy evaluable results and three which evaluated the effect of the IUD on laboratory parameters. One of the earlier efficacy studies showed an abnormally high pregnancy rate which sparked a controversy which is discussed in the Introduction section. The remaining 6 studies produced acceptable pregnancy rates. The three laboratory studies showed that the copper and levonorgestrel releasing IUD/IUS do not affect the diabetic state in any way. Conclusions. The copper bearing and levonorgestrel releasing IUDs are safe and effective in women with diabetes type I and diabetes type II although the evidence in the latter is limited.
Feng, Ye; Yang, Huixia
Metformin has been gradually used in the management of gestational diabetes mellitus (GDM). In order to prove the safety and efficacy of metformin used in pregnancy, we searched several databases for the reports of randomized trials comparing insulin and metformin used in GDM and conducted a meta-analysis. Data showed the rates of neonatal large for gestational age, cesarean section, neonatal respiratory distress and preterm birth were similar in both groups. Maternal glycated hemoglobin-% at gestational week 36-37 was significantly lower in metformin group, indicating good glycemic control of metformin. Maternal weight gain since enrollment to gestational week 36-37 was also lower in metformin group, making metformin worth using even when metformin is insufficient and supplementary insulin is needed. Data also showed that metformin significantly reduced the gestational hypertension complications in GDM patients, probably by reducing the endothelial activation and maternal inflammatory response of insulin resistance. Although metformin can cross the placenta, it is less likely to cause severe neonatal hypoglycemia compared with insulin since it neither stimulates pancreatic insulin release nor increases circulating insulin levels. According to most maternal and neonatal outcomes, metformin is an effective and safe alternative to insulin for GDM patients.
Busetto, Loraine; Luijkx, Katrien Ger; Elissen, Arianne Mathilda Josephus; Vrijhoef, Hubertus Johannes Maria
The delivery of integrated care is a priority in many countries' efforts to improve health outcomes for people at risk of or with diabetes. This study aims to provide an overview of the different types of integrated care interventions for type 2 diabetes and to report their outcomes. A systematic literature search was conducted in PubMed and Cochrane for the period 2003-2013. Article selection and data extraction were performed independently by three researchers and results were discussed together. The chronic care model (CCM) was used to describe intervention types. Forty-four articles met the inclusion criteria. Most interventions included all CCM components and a variety of sub-components. Most studies reported positive patient, process and health service utilization measures. The information on costs was limited and inconsistent. The low number of articles reporting comparable outcome measures made it difficult to make meaningful statements about an association between intervention type and outcomes. Future research would benefit from a more uniform understanding of integrated care as well as intermediate outcome measurements that allow for the establishment of a chain of evidence from specific intervention types to specific outcomes achieved. It is expected that such a comprehensive approach will reveal important insights as to which integrated care intervention types and settings are most conducive to successful implementation and would thereby be of relevance to policy makers and practitioners involved in the financing, management and delivery of integrated care. © 2015 John Wiley & Sons, Ltd.
Yang, Jian; Mao, Qun-Xia; Xu, Hong-Xia; Ma, Xu; Zeng, Chun-Yu
Objective Tea has been suggested to decrease blood glucose levels and protect pancreatic β cells in diabetic mice. However, human epidemiological studies showed inconsistent results for the association between tea consumption and type 2 diabetes mellitus (T2DM) risk. The aim of this study was to conduct a meta-analysis to further explore the association between tea consumption and incidence of T2DM. Design Systematic review and meta-analysis. Methods We performed a systematic literature search up to 30 August 2013 in PubMed, EMBASE, Chinese Wanfang Database and CNKI database. Pooling relative risks (RRs) were estimated by random-effect models. Two kinds of subgroup analyses (according to sex and regions) were performed. Sensitive analyses were performed according to types of tea. Results Overall, no statistically significant relationship between tea consumption and risk of T2DM was found based on 12 eligible studies (pooling RR 0.99, 95% CI 0.95 to 1.03). Compared with the lowest/non-tea group, daily tea consumption (≥3 cups/day) was associated with a lower T2DM risk (RR 0.84, 95% CI 0.73 to 0.97). Subgroup analyses showed a difference between men and women. Overall, the RRs (95% CI) were 0.92 (0.84 to 1.00) for men, and 1.00 (0.96 to 1.05) for women, respectively. Tea consumption of ≥3 cups/day was associated with decreased T2DM risk in women (RR 0.84, 95% CI 0.71 to 1.00). Overall, the RRs (95% CIs) were 0.84 (0.71 to 1.00) for Asians, and 1.00 (0.97 to 1.04) for Americans and Europeans, respectively. No obvious change was found in sensitivity analyses. Conclusions The results suggest that daily tea consumption (≥3 cups/day) is associated with a lower T2DM risk. However, further studies are needed to enrich related evidence, especially with regard to types of tea or sex. PMID:25052177
Prioreschi, A; Munthali, R J; Soepnel, L; Goldstein, J A; Micklesfield, L K; Aronoff, D M; Norris, S A
This systematic review aims to investigate the incidence and prevalence of type 2 diabetes mellitus (T2DM) in patients with HIV infection in African populations. Only studies reporting data from Africa were included. A systematic search was conducted using four databases for articles referring to HIV infection and antiretroviral therapy, and T2DM in Africa. Articles were excluded if they reported data on children, animals or type 1 diabetes exclusively. Incidence of T2DM and prevalence of T2DM. Risk ratios were generated for pooled data using random effects models. Bias was assessed using an adapted Cochrane Collaboration bias assessment tool. Of 1056 references that were screened, only 20 were selected for inclusion. Seven reported the incidence of T2DM in patients with HIV infection, eight reported the prevalence of T2DM in HIV-infected versus uninfected individuals and five reported prevalence of T2DM in HIV-treated versus untreated patients. Incidence rates ranged from 4 to 59 per 1000 person years. Meta-analysis showed no significant differences between T2DM prevalence in HIV-infected individuals versus uninfected individuals (risk ratio (RR) =1.61, 95% CI 0.62 to 4.21, p=0.33), or between HIV-treated patients versus untreated patients (RR=1.38, 95% CI 0.66 to 2.87, p=0.39), and heterogeneity was high in both meta-analyses (I 2 =87% and 52%, respectively). Meta-analysis showed no association between T2DM prevalence and HIV infection or antiretroviral therapy; however, these results are limited by the high heterogeneity of the included studies and moderate-to-high risk of bias, as well as, the small number of studies included. There is a need for well-designed prospective longitudinal studies with larger population sizes to better assess incidence and prevalence of T2DM in African patients with HIV. Furthermore, screening for T2DM using gold standard methods in this population is necessary. PROSPERO42016038689. Published by the BMJ Publishing Group Limited. For
Yatan Pal Singh Balhara
Full Text Available Background and Aims: Patients with diabetes mellitus frequently experience erectile dysfunction. This systematic review and meta-analysis were conducted to find efficacy and tolerability of phosphodiesterase 5 (PDE5 inhibitors in patients with diabetes mellitus experiencing erectile dysfunction. Methodology: Electronic searches were carried out to identify English language peer-reviewed randomized controlled trials (RCTs, which reported clinical efficacy of any PDE5 inhibitor in patients with diabetes mellitus having erectile dysfunction. Effect sizes were computed using Cohen′s d, and I 2-test was used to assess heterogeneity. Pooled mean effect sizes were computed using random-effects model. Number needed to treat (NNT, and the adverse event rates were computed. Results: The systematic review included a total of 17 studies yielding 25 comparisons. Three studies were open RCTs while others were double-blind RCTs. The pooled mean effect size of any PDE5 inhibitor over placebo was 0.926 (95% confidence intervals [CI]: 0.864-0.987; I 2 =26.3. The pooled mean effect size for sildenafil was 1.198 (CI: 1.039-1.357; I 2 =, for tadalafil was 0.910 (CI: 0.838-0.981; I 2 =33.6, and for vardenafil was 0.678 (CI: 0.627-0.729; I 2 =. In pooled analysis, the NNT for sildenafil, tadalafil, vardenafil and any PDE5 inhibitor was 2.4, 2.6, 4.1 and 3.0 respectively. The most common side effects were headache, flushing, and nasal congestion. Conclusions: PDE5 inhibitors are effective and safe medications for the treatment of sexual dysfunction in patients with diabetes mellitus experiencing erectile dysfunction.
Singh, Kavita; Chandrasekaran, Ambalam M; Bhaumik, Soumyadeep; Chattopadhyay, Kaushik; Gamage, Anuji Upekshika; Silva, Padmal De; Roy, Ambuj; Prabhakaran, Dorairaj; Tandon, Nikhil
Objectives More than 80% of cardiovascular diseases (CVD) and diabetes mellitus (DM) burden now lies in low and middle-income countries. Hence, there is an urgent need to identify and implement the most cost-effective interventions, particularly in the resource-constraint South Asian settings. Thus, we aimed to systematically review the cost-effectiveness of individual-level, group-level and population-level interventions to control CVD and DM in South Asia. Methods We searched 14 electronic databases up to August 2016. The search strategy consisted of terms related to ‘economic evaluation’, ‘CVD’, ‘DM’ and ‘South Asia’. Per protocol two reviewers assessed the eligibility and methodological quality of studies using standard checklists, and extracted incremental cost-effectiveness ratios of interventions. Results Of the 2949 identified studies, 42 met full inclusion criteria. Critical appraisal of studies revealed 15 excellent, 18 good and 9 poor quality studies. Most studies were from India (n=37), followed by Bangladesh (n=3), Pakistan (n=2) and Bhutan (n=1). The economic evaluations were based on observational studies (n=9), randomised trials (n=12) and decision models (n=21). Together, these studies evaluated 301 policy or clinical interventions or combination of both. We found a large number of interventions were cost-effective aimed at primordial prevention (tobacco taxation, salt reduction legislation, food labelling and food advertising regulation), and primary and secondary prevention (multidrug therapy for CVD in high-risk group, lifestyle modification and metformin treatment for diabetes prevention, and screening for diabetes complications every 2–5 years). Significant heterogeneity in analytical framework and outcome measures used in these studies restricted meta-analysis and direct ranking of the interventions by their degree of cost-effectiveness. Conclusions The cost-effectiveness evidence for CVD and DM interventions in South Asia
Title: Systematic review a method to promote nursing students skills in Evidence Based Practice Background: Department of nursing educate students to practice Evidence Based Practice (EBP), where clinical decisions is based on the best available evidence, patient preference, clinical experience...... and resources available. In order to incorporate evidence in clinical decisions, nursing students need to learn how to transfer knowledge in order to utilize evidence in clinical decisions. The method of systematic review can be one approach to achieve this in nursing education. Method: As an associate lecturer...... I have taken a Comprehensive Systematic Review Training course provide by Center of Clinical Guidelines in Denmark and Jonna Briggs Institute (JBI) and practice in developing a systematic review on how patients with ischemic heart disease experiences peer support. This insight and experience...
Full Text Available Ann D Colosia,1 Roberto Palencia,2 Shahnaz Khan1 1RTI Health Solutions, Research Triangle Park, NC, USA; 2Boehringer Ingelheim GmbH, Ingelheim, Germany Background: Hypertension and obesity are known to contribute, directly or indirectly, to the development of long-term complications of type 2 diabetes mellitus (T2DM. Knowing the prevalence of these comorbidities is important for determining the size of the population that may benefit from strategies that reduce blood pressure and weight while controlling blood glucose. Methods: In this systematic literature review, electronic searches of PubMed, Embase, and the Cochrane Library were conducted to identify observational studies of hypertension and/or obesity prevalence in patients with T2DM throughout the world. The searches were limited to studies reported in English from January 1, 2001 to February 16, 2012. Results: From a total of 2,688 studies, 92 observational studies provided prevalence rates for hypertension and/or obesity specifically in adults with T2DM. Fifteen studies of specific subtypes of hypertension or subpopulations with T2DM were subsequently excluded, leaving 78 studies (in 77 articles for inclusion in this article. Of these, 61 studies reported hypertension prevalence, 44 reported obesity prevalence, and 12 reported the prevalence of hypertension with obesity. Most studies had a low risk of bias regarding diagnosis of T2DM (70/78, hypertension (59/69, or obesity (45/47. The continental regions with the most observational studies of hypertension or obesity prevalence were Europe (n = 30 and Asia (n = 26. Hypertension rates typically were high in all regions; most studies presented rates above 50%, and many presented rates above 75%. Obesity rates exceeded 30% in 38 of 44 studies and 50% in 14 of 44 studies, especially those assessing central obesity (based on waist circumference. Among obese adults, hypertension rates were at or above 70% in Asia and above 80% in Europe; rates
Pérez-Losada, F-L; Jané-Salas, E; Sabater-Recolons, M-M; Estrugo-Devesa, A; Segura-Egea, J-J; López-López, J
Diabetes and periodontal disease share common features in terms of inflammatory responses. Current scientific evidence suggests that treatment of periodontal disease might contribute to glycemic control. The objective of the study is a review of the last three years. A literature search was performed in the MEDLINE (PubMed), Cochrane, and Scopus databases, for articles published between 01-01-2013 and 30-06-2015, applying the key terms "periodontal disease" AND "diabetes mellitus". The review analyzed clinical trials of humans published in English and Spanish. Thirteen clinical trials were reviewed, representing a total of 1,912 patients. Three of them had samples of 40 patients, representing a total of 1,804. Only one article achieved a Jadad score of five. Seven articles (998 patients, 52.3% total), presented a statistically significant decrease in HbA1c (pperiodontal treatment. In the six remaining articles (representing 914 patients, 47.8% of the total), the decrease in HbA1c was not significant. Patient follow-up varied between 3 to 12 months. In three articles, the follow-up was of 3, 4, and 9 months, in two 6 and 12 months. The majority of clinical trials showed that radicular curettage and smoothing, whether associated with antibiotics or not, can improve periodontal conditions in patients with diabetes mellitus. However, few studies suggest that this periodontal treatment improves metabolic control. However, there is no clear evidence of a relation between periodontal treatment and improved glycemic control in patients with type 2 diabetes mellitus.
Tan, Pamela; Chen, Hui-Chen; Taylor, Beverley; Hegney, Desley
To synthesise the evidence on how community-dwelling adults with type 1 and type 2 diabetes mellitus experience hypoglycaemia and the strategies they use to control it. Using a three-step search strategy, all published and unpublished qualitative studies in English from January 2000 to August 2010 were retrieved. Participants diagnosed with type 1 or type 2 diabetes mellitus, experienced in self-managing their hypoglycaemia, and who lived independently in the community and attended primary care or outpatient clinics were included. An initial limited search was conducted in MEDLINE and CINAHL to identify keywords and index terms, which were then used in a second search across the CINAHL, PUBMED, SCOPUS, PsycINFO, PsycARTICLES, Web of Science, JSTOR, EMBASE and MEDNAR databases. Additionally, the reference lists of all retrieved papers were hand-searched for additional studies. Retrieved studies were assessed for methodological validity using the standardised Joanna Briggs Institute-Qualitative Assessment and Review Instrument (JBI-QARI). Data, in terms of research findings, were extracted from included studies using the standardised JBI-QARI data extraction tool. Five studies (six papers) were included in the review. The 20 findings from the six papers were grouped into three categories, which were then synthesised into one overall finding - that is 'People with diabetes mellitus can self-manage their diabetes and thus prevent hypoglycaemic episodes more effectively when health professionals provide psychological, physiological and spiritual support, and an individually targeted education programme'. Within the constraints of this review, it appears that the patient-identified priority is to maintain normality in blood glucose self-management. There is also evidence that some people lack the knowledge to identify and self-manage hypoglycaemia. To enable community-dwelling adults with diabetes mellitus to self-manage hypoglycaemia, healthcare professionals should
Bager, Palle; Chauhan, Usha; Greveson, Kay
OBJECTIVE: Advice lines for patients with inflammatory bowel diseases (IBD) have been introduced internationally. However, only a few publications have described the advice line service and evaluated the efficiency of it with many results presented as conference posters. A systematic synthesis...... of evidence is needed and the aim of this article was to systematically review the evidence of IBD advice lines. MATERIALS AND METHODS: A broad systematic literature search was performed to identify relevant studies addressing the effect of advice lines. The process of selection of the retrieved studies...... congress abstracts were included in the review. The studies were heterogeneous both in scientific quality and in the focus of the study. No rigorous evidence was found to support that advice lines improve disease activity in IBD and correspondingly no studies reported worsening in disease activity. Advice...
Lødrup, Anders Bergh; Reimer, Christina; Bytzer, Peter
in getting off acid-suppressive medication and partly explain the increase in long-term use of PPI. A number of studies addressing this issue have been published recently. The authors aimed to systematically review the existing evidence of clinically relevant symptoms caused by acid rebound following PPI...
Pousinho, Sarah; Morgado, Manuel; Falcão, Amílcar; Alves, Gilberto
Diabetes mellitus is a major health problem that is growing rapidly worldwide. A collaborative and integrated team approach in which pharmacists can play a pivotal role should be sought when managing patients with diabetes. To identify and summarize the main outcomes of pharmacist interventions in the management of type 2 diabetes. PubMed, Cochrane Central Register of Controlled Trials, and Web of Science were searched for randomized controlled trials evaluating the effectiveness of any pharmacist intervention directed at patients with type 2 diabetes in comparison with usual care. Outcome measures of interest included glycosylated hemoglobin (Alc), blood glucose, blood pressure, lipid profile, body mass index (BMI), 10-year coronary heart disease (CHD) risk, medication adherence, health-related quality of life (HRQoL), and economic outcomes. The risk of bias in included studies was assessed using the Cochrane risk of bias tool. Thirty-six studies were included in this systematic review, involving 5,761 participants. The studies evaluated the effects of several pharmacist interventions carried out in various countries and in different health care facilities, such as community pharmacies, primary care clinics, and hospitals. The number of studies reporting each outcome of interest varied. Alc was evaluated in 26 studies, of which 24 reported a greater reduction in this outcome in the intervention group compared with the control group, with the difference in change between groups ranging from -0.18% to -2.1%. Eighteen studies assessed change in systolic blood pressure, of which 17 studies reported a greater improvement in this outcome in the intervention group, with the difference in change between groups varying between -3.3 mmHg and -23.05 mmHg. For diastolic blood pressure, a greater effect was also observed in the intervention group in 14 out of 15 studies, with the difference in change between groups varying between -0.21 mmHg and -9.1 mmHg. Thirteen studies
Liu, Xian-liang; Shi, Yan; Willis, Karen; Wu, Chiung-Jung (Jo); Johnson, Maree
Objectives This umbrella review aimed to identify the current evidence on health education-related interventions for patients with acute coronary syndrome (ACS) or type two diabetes mellitus (T2DM); identify the educational content, delivery methods, intensity, duration and setting required. The purpose was to provide recommendations for educational interventions for high-risk patients with both ACS and T2DM. Design Umbrella review of systematic reviews and meta-analyses. Setting Inpatient and postdischarge settings. Participants Patients with ACS and T2DM. Data sources CINAHL, Cochrane Library, Joanna Briggs Institute, Journals@Ovid, EMBase, Medline, PubMed and Web of Science databases from January 2000 through May 2016. Outcomes measures Clinical outcomes (such as glycated haemoglobin), behavioural outcomes (such as smoking), psychosocial outcomes (such as anxiety) and medical service use. Results Fifty-one eligible reviews (15 for ACS and 36 for T2DM) consisting of 1324 relevant studies involving 2 88 057 patients (15 papers did not provide the total sample); 30 (58.8%) reviews were rated as high quality. Nurses only and multidisciplinary teams were the most frequent professionals to provide education, and most educational interventions were delivered postdischarge. Face-to-face sessions were the most common delivery formats, and many education sessions were also delivered by telephone or via web contact. The frequency of educational sessions was weekly or monthly, and an average of 3.7 topics was covered per education session. Psychoeducational interventions were generally effective at reducing smoking and admissions for patients with ACS. Culturally appropriate health education, self-management educational interventions, group medical visits and psychoeducational interventions were generally effective for patients with T2DM. Conclusions Results indicate that there is a body of current evidence about the efficacy of health education, its content and
Liu, Xian-Liang; Shi, Yan; Willis, Karen; Wu, Chiung-Jung Jo; Johnson, Maree
This umbrella review aimed to identify the current evidence on health education-related interventions for patients with acute coronary syndrome (ACS) or type two diabetes mellitus (T2DM); identify the educational content, delivery methods, intensity, duration and setting required. The purpose was to provide recommendations for educational interventions for high-risk patients with both ACS and T2DM. Umbrella review of systematic reviews and meta-analyses. Inpatient and postdischarge settings. Patients with ACS and T2DM. CINAHL, Cochrane Library, Joanna Briggs Institute, Journals@Ovid, EMBase, Medline, PubMed and Web of Science databases from January 2000 through May 2016. Clinical outcomes (such as glycated haemoglobin), behavioural outcomes (such as smoking), psychosocial outcomes (such as anxiety) and medical service use. Fifty-one eligible reviews (15 for ACS and 36 for T2DM) consisting of 1324 relevant studies involving 2 88 057 patients (15 papers did not provide the total sample); 30 (58.8%) reviews were rated as high quality. Nurses only and multidisciplinary teams were the most frequent professionals to provide education, and most educational interventions were delivered postdischarge. Face-to-face sessions were the most common delivery formats, and many education sessions were also delivered by telephone or via web contact. The frequency of educational sessions was weekly or monthly, and an average of 3.7 topics was covered per education session. Psychoeducational interventions were generally effective at reducing smoking and admissions for patients with ACS. Culturally appropriate health education, self-management educational interventions, group medical visits and psychoeducational interventions were generally effective for patients with T2DM. Results indicate that there is a body of current evidence about the efficacy of health education, its content and delivery methods for patients with ACS or T2DM. These results provide recommendations about the
McCaughey, Euan J; Li, Julie; Badrick, Tony C; Westbrook, Johanna I; Georgiou, Andrew
To evaluate how well general practitioners (GPs) manage and respond to laboratory results for patients with diabetes mellitus (DM) and cardiovascular disease (CVD). MEDLINE, CINAHL, Embase, EBM reviews, ProQuest and Scopus. Peer-reviewed journal articles published between 2000 and 2015 that assessed GPs' management of laboratory results for patients with DM or CVD. Study design and demographics, laboratory tests and key findings relating to GP management of laboratory results were extracted from studies. Thirteen articles were included, comprising seven studies which utilized surveys, four observational studies, one cohort study and one randomized controlled trial. Findings indicate that GPs often overestimate the risk of complications associated with DM and CVD based on laboratory results and have unrealistically high expectations regarding the precision of laboratory tests. Considerable variation existed in the use of repeat testing for diagnostic confirmation and in GPs' identification of the difference between two consecutive results required to indicate a change in patient condition. GPs also often failed to initiate appropriate treatment for patients with DM and CVD based on laboratory results. Feedback to GPs about their test ordering patterns and educational messages on laboratory results improved clinical outcomes. Evidence about how well GPs manage results and its impact on patient outcomes remains weak and inconclusive. This review identified a number of areas where interventions could support GPs to improve the interpretation and management of laboratory test results, including feedback to GPs and educational messages on test result reports. © The Author 2017. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: firstname.lastname@example.org
Anagnostis, Panagiotis; Paschou, Stavroula A; Gkekas, Nifon N; Artzouchaltzi, Aikaterini-Maria; Christou, Konstantinos; Stogiannou, Dimitrios; Vryonidou, Andromachi; Potoupnis, Michael; Goulis, Dimitrios G
Both type 1 (T1DM) and type 2 diabetes mellitus (T2DM) have been associated with bone fragility and increased fracture risk. However, little is known regarding the effect of anti-osteoporotic treatment on bone mineral density (BMD) and/or fracture risk in these patients. We aimed to systematically investigate the efficacy of anti-osteoporotic medications in patients with diabetes in comparison with non-diabetic subjects. MEDLINE and Scopus databases were searched (up to 31st October 2017). Nine studies fulfilled the pre-defined inclusion criteria [patients with T2DM (n = 8) or either T1DM or T2DM (n = 1)]. Regarding fracture risk, five studies were identified. Alendronate demonstrated comparable vertebral anti-fracture efficacy in patients with and without diabetes (n = 2), whereas non-vertebral fracture risk was either the same (n = 1) or higher in diabetic patients (n = 1). Raloxifene also demonstrated comparable vertebral anti-fracture efficacy in both groups (n = 2), without any effect on non-vertebral fractures in either group. In one study, diabetic patients exposed to raloxifene demonstrated the same vertebral and non-vertebral fracture risk with non-diabetic patients. Teriparatide (n = 1) demonstrated the same non-vertebral fracture rates in both patients with and without T2DM. Regarding BMD, equal increases in spine BMD were observed with alendronate (n = 4), risedronate (n = 1), and teriparatide (n = 1). With respect to hip BMD, similar increases were observed with teriparatide (n = 1), whereas data regarding alendronate were controversial (n = 3). No eligible study was found for zoledronic acid, ibandronate, strontium ranelate, denosumab, or bazedoxifene. The presence of diabetes does not alter anti-osteoporotic treatment response, regarding BMD increase and vertebral fracture risk reduction.
Qiao, Yong-Chao; Shen, Jian; Hong, Xue-Zhi; Liang, Ling; Bo, Chao-Sheng; Sui, Yi; Zhao, Hai-Lu
Regulatory T lymphocyte cells (Treg) associated with interleukin-10 (IL-10) and transforming growth factor-β (TGF-β) have implicated in the development of type 1 diabetes mellitus (T1DM), yet the existing evidence remains unclear. Hereby we performed a systematic review and meta-analysis to characterize the changes in T1DM patients. A total of 1407 T1DM patients and 1373 healthy controls from 40 case-control studies were eventually included in the pooling analysis. Compared with the controls, T1DM patients had decreased frequency of CD4(+)CD25(+)Treg (p=0.0003), CD4(+)CD25(+)Foxp3(+)Treg (p=0.020), and the level of TGF-β (p=0.030). Decrease in IL-10 (p=0.14) was not significant. All the changes remained significant when the studies with low NOS scores and publication bias were excluded. In conclusion, peripheral Treg and serum TGF-β are reduced in type 1 diabetes mellitus whereas changes in serum IL-10 are not significant. Copyright © 2016 Elsevier Inc. All rights reserved.
Christensen, Troels Dreier; Spindler, Karen-Lise Garm; Palshof, Jesper Andreas
Background: Brain metastases (BM) from colorectal cancer (CRC) are a rare event. However, the implications for affected patients are severe, and the incidence has been reported to be increasing. For clinicians, knowledge about the characteristics associated with BM is important and could lead...... to earlier diagnosis and improved survival. Method: In this paper, we describe the incidence as well as characteristics associated with BM based on a systematic review of the current literature, following the PRISMA guidelines. Results: We show that the incidence of BM in CRC patients ranges from 0.6 to 3...... of brain involvement in patients with these characteristics is necessary....
Borup, H; Kirkeskov, L; Hanskov, Dorte Jessing Agerby
: To assess the occurrence of COPD among construction workers. Methods: We performed a systematic search in PubMed and Embase between 1 January 1990 and 31 August 2016 in order to identify epidemiological studies with a risk estimate for either COPD morbidity/mortality or a spirometry-based definition....... Conclusions: This review suggests that COPD occurs more often among construction workers than among workers who are not exposed to construction dust. It is not possible to draw any conclusions on specific subgroups as most studies analysed construction workers as one united group. In addition, no potential...
Snoeijs, S.P.; Boerma, W.G.W.; Baltag, V.; Schellevis, F.G.
Background: Organising effective responses to the growing problem of noncommunicable diseases (NCD) is among the biggest challenges of (primary) health care systems. In particular tackling, cardiovascular diseases (CVDs) and diabetes mellitus type 2 (DM2) requires coordinated approaches close to
Sara L. Borkosky
Full Text Available Diabetes mellitus with peripheral sensory neuropathy frequently results in forefoot ulceration. Ulceration at the first ray level tends to be recalcitrant to local wound care modalities and off-loading techniques. If healing does occur, ulcer recurrence is common. When infection develops, partial first ray amputation in an effort to preserve maximum foot length is often performed. However, the survivorship of partial first ray amputations in this patient population and associated re-amputation rate remain unknown. Therefore, in an effort to determine the actual re-amputation rate following any form of partial first ray amputation in patients with diabetes mellitus and peripheral neuropathy, the authors conducted a systematic review. Only studies involving any form of partial first ray amputation associated with diabetes mellitus and peripheral sensory neuropathy but without critical limb ischemia were included. Our search yielded a total of 24 references with 5 (20.8% meeting our inclusion criteria involving 435 partial first ray amputations. The weighted mean age of patients was 59 years and the weighted mean follow-up was 26 months. The initial amputation level included the proximal phalanx base 167 (38.4% times; first metatarsal head resection 96 (22.1% times; first metatarsal-phalangeal joint disarticulation 53 (12.2% times; first metatarsal mid-shaft 39 (9% times; hallux fillet flap 32 (7.4% times; first metatarsal base 29 (6.7% times; and partial hallux 19 (4.4% times. The incidence of re-amputation was 19.8% (86/435. The end stage, most proximal level, following re-amputation was an additional digit 32 (37.2% times; transmetatarsal 28 (32.6% times; below-knee 25 (29.1% times; and LisFranc 1 (1.2% time. The results of our systematic review reveal that one out of every five patients undergoing any version of a partial first ray amputation will eventually require more proximal re-amputation. These results reveal that partial first ray
Aune, Dagfinn; Sen, Abhijit; Henriksen, Tore; Saugstad, Ola Didrik; Tonstad, Serena
Physical activity has been inconsistently associated with risk of gestational diabetes mellitus in epidemiological studies, and questions remain about the strength and shape of the dose-response relationship between the two. We therefore conducted a systematic review and meta-analysis of cohort studies and randomized trials on physical activity and gestational diabetes mellitus. PubMed, Embase and Ovid databases were searched for cohort studies, and randomized controlled trials of physical activity and risk of gestational diabetes mellitus, up to August 5th 2015. Summary relative risks (RRs) were estimated using a random effects model. Twenty-five studies (26 publications) were included. For total physical activity the summary RR for high versus low activity was 0.62 (95 % CI 0.41-0.94, I 2 = 0 %, n = 4) before pregnancy, and 0.66 (95 % CI 0.36-1.21, I 2 = 0 %, n = 3) during pregnancy. For leisure-time physical activity the respective summary RRs for high versus low activity was 0.78 (95 % CI 0.61-1.00, I 2 = 47 %, n = 8) before pregnancy, and it was 0.80 (95 % CI 0.64-1.00, I 2 = 17 %, n = 17) during pregnancy. The summary RR for pre-pregnancy activity was 0.70 (95 % CI 0.49-1.01, I 2 = 72.6 %, n = 3) per increment of 5 h/week and for activity during pregnancy was 0.98 (95 % CI 0.87-1.09, I 2 = 0 %, n = 3) per 5 h/week. There was evidence of a nonlinear association between physical activity before pregnancy and the risk of gestational diabetes mellitus, p nonlinearity = 0.005, with a slightly steeper association at lower levels of activity although further reductions in risk were observed up to 10 h/week. There was also evidence of nonlinearity for physical activity in early pregnancy, p nonlinearity = 0.008, with no further reduction in risk above 8 h/week. There was some indication of inverse associations between walking (before and during pregnancy) and vigorous activity (before pregnancy) and the risk of
Almeida, Paulo H R F; Silva, Thales B C; de Assis Acurcio, Francisco; Guerra Júnior, Augusto A; Araújo, Vania E; Diniz, Leonardo M; Godman, Brian; Almeida, Alessandra M; Alvares, Juliana
Insulin analog glargine (GLA) has been available as one of the therapeutic options for patients with type 1 diabetes mellitus to enhance glycemic control. Studies have shown that a decrease in the frequency of hypoglycemic episodes improves the quality of life (QoL) of diabetic patients. However, there are appreciable acquisition cost differences between different insulins. Consequently, there is a need to assess their impact on QoL to provide future guidance to health authorities. A systematic review of multiple databases including Medline, LILACS, Cochrane, and EMBASE databases with several combinations of agreed terms involving randomized controlled trials and cohorts, as well as manual searches and gray literature, was undertaken. The primary outcome measure was a change in QoL. The quality of the studies and the risk of bias was also assessed. Eight studies were eventually included in the systematic review out of 634 publications. Eight different QoL instruments were used (two generic, two mixed, and four specific), in which the Diabetes Treatment Satisfaction Questionnaire (DTSQ) was the most used. The systematic review did not consistently show any significant difference overall in QoL scores, whether as part of subsets or combined into a single score, with the use of GLA versus neutral protamine Hagedorn (NPH) insulin. Only in patient satisfaction measured by DTSQ was a better result consistently seen with GLA versus NPH insulin, but not using the Well-being Inquiry for Diabetics (WED) scale. However, none of the cohort studies scored a maximum on the Newcastle-Ottawa scale for quality, and they generally were of moderate quality with bias in the studies. There was no consistent difference in QoL or patient-reported outcomes when the findings from the eight studies were collated. In view of this, we believe the current price differential between GLA and NPH insulin in Brazil cannot be justified by these findings.
Mohammed A Al-Shareef
Full Text Available To assess the clinical value and of metformin as mono-therapy versus other treatments for type 2 diabetes mellitus in children and adolescents. Major electronic databases, the reference lists of relevant articles and databases of ongoing trials were searched. Authors of reviews and metformin manufacturers were contacted in order to obtain more references and reports of unpublished trials. The methodological quality of these reports, included randomised controlled trials (RCTs was assessed using the National Health System Centre for Reviews and Dissemination (NHS CRD checklist. The search identified 1,825 studies. Three RCTs met the inclusion criteria. Two RCTs had been completed and one was still ongoing. In the metformin group there were significant reductions of mean change of HBA1c from baseline. It reduced by -0.71% (P = 0.0002 and in the other trial the result was reduced by -1.10 (95% CI: -1.19 to -1.01. In addition, more patients (48.1% in the metformin group achieved good glycaemic control (<7% at week 24. The mean changes in FPG from baseline were significantly (P < 0.05 different in the metformin group (-16.6%, for week 18 and week 24 20.6%. In the second trial there was a significant (P < 0.001 reduction in the adjusted mean of FPG from baseline in the metformin group, while there was an increase in the placebo group ( -42.9 mg/dl vs. +21.4mg/dl with mean difference of -64.80 in favour of the metformin group. For BMI, significant (P < 0.001 differences were seen at week 12 and week 24 (0.07 and 0.55 kg 2 for metformin and glimepiride respectively. There was no significant difference between the placebo and metformin in the other trials. For lipid value there was a significant decrease in LDL levels in the metformin group. No significant changes were found in the other lipid parameters after adjusting. There were more adverse events in the metformin group but they were not statistically significant. There was a limited but not
Full Text Available This systematic review was aimed at assessing the metabolic effects of testosterone replacement therapy (TRT on hypogonadal men with type 2 diabetes mellitus (T2DM. A literature search was performed using the Cochrane Library, EMBASE and PubMed. Only randomized controlled trials (RCTs were included in the meta-analysis. Two reviewers retrieved articles and evaluated the study quality using an appropriate scoring method. Outcomes including glucose metabolism, lipid parameters, body fat and blood pressure were pooled using a random effects model and tested for heterogeneity. We used the Cochrane Collaboration's Review Manager 5.2 software for statistical analysis. Five RCTs including 351 participants with a mean follow-up time of 6.5-months were identified that strictly met our eligibility criteria. A meta-analysis of the extractable data showed that testosterone reduced fasting plasma glucose levels (mean difference (MD: −1.10; 95% confidence interval (CI (−1.88, −0.31, fasting serum insulin levels (MD: −2.73; 95% CI (−3.62, −1.84, HbA1c % (MD: −0.87; 95% CI (−1.32, −0.42 and triglyceride levels (MD: −0.35; 95% CI (−0.62, −0.07. The testosterone and control groups demonstrated no significant difference for other outcomes. In conclusion, we found that TRT can improve glycemic control and decrease triglyceride levels of hypogonadal men with T2DM. Considering the limited number of participants and the confounding factors in our systematic review; additional large, well-designed RCTs are needed to address the metabolic effects of TRT and its long-term influence on hypogonadal men with T2DM.
Farrer, Olivia; Yaxley, Alison; Walton, Karen; Healy, Erin; Miller, Michelle
A systematic review of the literature was conducted to review and evaluate the evidence supporting a liberalized diet for the management of diabetes mellitus in aged care homes and examine the effect of this on glycaemia, nutritional status and diabetes comorbidity risk factors. A 3 step search of eight databases followed by independent data extraction and quality assessment by two authors was undertaken. Studies which compared therapeutic diets to a liberalized diet or observation studies reviewing the effects of therapeutic diets on glycaemia and nutritional status were included. Of the 546 studies identified, six met the inclusion criteria. Methodological quality of the studies was rated poor and the majority concluded no statistically significant change in diabetes management outcomes with a liberalized diet, but modest increases in glycaemia were observed. Inadequate data was available to determine effects of diet change on nutritional status or diabetes risk factors. Overall studies were in support of a liberalized diet but due to the low quality of the evidence and a lack of significant findings it may not be appropriate to extrapolate these conclusions to inform dietetic practice. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Tegegne, Balewgizie Sileshi; Habtewold, Tesfa Dejenie; Mengesha, Melkamu Merid; Burgerhof, Johannes G M
INTRODUCTION: Multi-drug-resistant tuberculosis (MDR-TB) has emerged as a challenge to global tuberculosis (TB) control and remains a major public health concern in many countries. Diabetes mellitus (DM) is an increasingly recognized comorbidity that can both accelerate TB disease and complicate its
Dong, Qing; Liu, Hua; Yang, Daren; Zhang, Yunyan
Investigators have explored the association between diabetes mellitus and arthritis for a long time; however, there are uncertainties and inconsistencies among various studies. In this study, we tried to explore the relationship between diabetes mellitus and the overall risk of arthritis, as well as the potential modifiers for this relationship. We conducted a comprehensive literature search through PubMed and identified 36 eligible studies. The overall analyses, subgroup analyses, as well as sensitivity analyses, were conducted to illustrate the association between diabetes mellitus and arthritis. Study quality was evaluated using the Newcastle-Ottawa Quality Assessment Scale. All statistical analyses were conducted using STATA SE version 13.0. In our study, 36 eligible studies were identified and involved in the meta-analysis. The overall association between diabetes mellitus and arthritis is 1.61 (95% confidence interval [CI]: 1.14-2.28, P = .007). The association exists only in nongouty arthritis, where we observed the estimated odds ratio (OR) 1.33 (95% CI: 1.05-1.67, P arthritis rather than a risk factor; however, more studies will be helpful to increase the confidence of identifying the association between diabetes and arthritis.
Javed, Fawad; Romanos, George E
Implant treatment is an attractive substitute to traditional fixed/removable prosthetic appliances. In patients with diabetes, dental implant therapy has been considered a contraindication. Hyperglycemia augments the severity of periodontal disease, and glycemic control is an essential variable in determining the success of dental implants in subjects with diabetes. Subjects with well-controlled diabetes may not be significantly compromised and can have high dental implant success rates compared to individuals with poorly controlled diabetes. The focused questions addressed in this systematic review were as follows: Can patients with diabetes be good candidates for dental implant therapy? And how does hyperglycemia and glycemic control influence osseointegration? A systematic literature search of MEDLINE/PubMed articles published from 1982 up to and including July 2009 was independently performed by two investigators. In addition, reference lists of original and review articles were searched. The search strategy was to use the following terms in different combinations: dental implants, immediate implants, osseointegration, periodontal disease, diabetes, hyperglycemia, metabolic control, and glycemic control. The search included studies on humans and diabetes-induced animal models. The selection criteria included all levels of available evidence. Suitable variables included the implant survival rate among individuals with diabetes, effects of hyperglycemia and glycemic control on bone, and maintenance of dental implants in subjects with diabetes. Articles published only in the English language were considered, and unpublished data were not sought. We initially identified 33 studies. Fifteen studies, which did not fulfill the selection criteria, were excluded. The included studies reported that poorly controlled diabetes negatively affects implant osseointegration; however, under optimal serum glycemic control, osseointegration can successfully occur in patients with
Chaudhry, Z W; Doshi, R S; Mehta, A K; Jacobs, D K; Vakil, R M; Lee, C J; Bleich, S N; Kalyani, R R; Clark, J M; Gudzune, K A
We examined the glycemic benefits of commercial weight loss programmes as compared with control/education or counselling among overweight and obese adults with and without type 2 diabetes mellitus (T2DM). We searched MEDLINE, Cochrane Database of Systematic Reviews, and references cited by individual programmes. We included randomized controlled trials of ≥12 weeks duration. Two reviewers extracted information on study design, population characteristics, interventions, and mean changes in haemoglobin A1c and glucose. We included 18 randomized controlled trials. Few trials occurred among individuals with T2DM. In this population, Jenny Craig reduced A1c at least 0.4% more than counselling at 12 months, Nutrisystem significantly reduced A1c 0.3% more than counselling at 6 months, and OPTIFAST reduced A1c 0.3% more than counselling at 6 months. Among individuals without T2DM, few studies evaluated glycemic outcomes, and when reported, most did not show substantial reductions. Few trials have examined whether commercial weight loss programmes result in glycemic benefits for their participants, particularly among overweight and obese individuals without T2DM. Jenny Craig, Nutrisystem and OPTIFAST show promising glycemic lowering benefits for patients with T2DM, although additional studies are needed to confirm these conclusions. © 2016 World Obesity. © 2016 World Obesity.
A systematic review of qualitative research on the contributory factors leading to medicine-related problems from the perspectives of adult patients with cardiovascular diseases and diabetes mellitus.
Al Hamid, A; Ghaleb, M; Aljadhey, H; Aslanpour, Z
To synthesise contributing factors leading to medicine-related problems (MRPs) in adult patients with cardiovascular diseases and/or diabetes mellitus from their perspectives. A systematic literature review of qualitative studies regarding the contributory factors leading to MRPs, medication errors and non-adherence, followed by a thematic synthesis of the studies. We screened Pubmed, EMBASE, ISI Web of Knowledge, PsycInfo, International Pharmaceutical Abstract and PsycExtra for qualitative studies (interviews, focus groups and questionnaires of a qualitative nature). Thematic synthesis was achieved by coding and developing themes from the findings of qualitative studies. The synthesis yielded 21 studies that satisfied the inclusion and exclusion criteria. Three themes emerged that involved contributing factors to MRPs: patient-related factors including socioeconomic factors (beliefs, feeling victimised, history of the condition, lack of finance, lack of motivation and low self-esteem) and lifestyle factors (diet, lack of exercise/time to see the doctor, obesity, smoking and stress), medicine-related factors (belief in natural remedies, fear of medicine, lack of belief in medicines, lack of knowledge, non-adherence and polypharmacy) and condition-related factors (lack of knowledge/understanding, fear of condition and its complications, and lack of control). MRPs represent a major health threat, especially among adult patients with cardiovascular diseases and/or diabetes mellitus. The patients' perspectives uncovered hidden factors that could cause and/or contribute to MRPs in these groups of patients. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Zhai, Yun-kai; Zhu, Wei-jun; Cai, Yan-ling; Sun, Dong-xu; Zhao, Jie
Abstract Emerging telemedicine programs offer potential low-cost solutions to the management of chronic disease. We sought to evaluate the clinical effectiveness and cost effectiveness of telemedicine approaches on glycemic control in patients with type 2 diabetes mellitus. Using terms related to type 2 diabetes and telemedicine, MEDLINE, Cochrane, EMBASE, and CINAHL Plus were searched to identify relevant studies published through February 28, 2014. Data from identified clinical trials were ...
Ziad G Nasr
Full Text Available Sodium-glucose cotransporter - 2 (SGLT2 inhibitors are a novel class of anti-diabetics proven to reduce blood pressure, blood glucose and body weight. However, the long-term cardiovascular (CV safety implications of these agents remain unclear. This systematic review aimed to evaluate the available clinical trial evidence pertaining to long-term cardiovascular safety of SGLT2 inhibitors. The databases EMBASE and MEDLINE were searched. Randomized controlled trials assessing CV safety of SGLT2 inhibitors compared with placebo or anti-diabetic medications were included. Two investigators independently extracted study data and completed risk of bias assessments (sequence generation, allocation concealment, blinding, incomplete outcome data, or selective outcome reporting and other biases. Outcomes included CV death, myocardial infarction, and stroke. A total of 464 studies were identified in the electronic search and 14 from other sources. Sixteen randomized clinical trials were included after full-text review. All studies reported at least one of the pre-defined outcomes (CV death, myocardial infarction, and stroke. Nineteen CV deaths were reported in SGLT2 inhibitors groups versus 10 CV deaths in placebo or other comparator arms; numerically higher in the dapagliflozin arms. The number of CV events was numerically higher in SGLT2 inhibitor groups than in other arms. Risk of bias assessment showed mixed results, with overall quality assessments deemed unclear for 6 of 16 studies (37.5%. Findings showed CV outcomes do occur in patients taking SGLT2 inhibitors yet the clinical significance remains unclear. These results can be considered hypothesis generating, as studies were limited by inadequate power and/or follow-up time. Future longitudinal studies are needed to further assess the efficacy and safety profiles of these new agents before they become widely adopted in clinical practice.
Sapunar Z, Jorge; Muñoz N, Sergio; Vásquez A, Tatiana
Atypical antipsychotic drugs have less extra pyramidal side effects and are more effective to control the clinical manifestations of schizophrenia. However, their use may be associated to a higher incidence of weight gain, dyslipidemia, metabolic syndrome, glucose intolerance and type 2 diabetes mellitus. We performed a systematic literature search to evaluate the risk of type 2 diabetes mellitus incidence associated to the use of atypical antipsychotic drugs, compared to conventional treatment. If users of all types of atypical antipsychotic drugs are compared with users of conventional treatment, no significant differences in the incidence of type 2 diabetes mellitus were observed. If individual drugs are evaluated, clozapine and risperidone are associated with a higher risk of diabetes than haloperidol. Quetiapine is associated with a lower risk of diabetes than conventional treatment. The quality of the evidence found was low; therefore, new studies should been performed.
Fleur E P van Dooren
Full Text Available OBJECTIVE: To examine the association between depression and all-cause and cardiovascular mortality in people with diabetes by systematically reviewing the literature and carrying out a meta-analysis of relevant longitudinal studies. RESEARCH DESIGN AND METHODS: PUBMED and PSYCINFO were searched for articles assessing mortality risk associated with depression in diabetes up until August 16, 2012. The pooled hazard ratios were calculated using random-effects models. RESULTS: Sixteen studies met the inclusion criteria, which were pooled in an overall all-cause mortality estimate, and five in a cardiovascular mortality estimate. After adjustment for demographic variables and micro- and macrovascular complications, depression was associated with an increased risk of all-cause mortality (HR = 1.46, 95% CI = 1.29-1.66, and cardiovascular mortality (HR = 1.39, 95% CI = 1.11-1.73. Heterogeneity across studies was high for all-cause mortality and relatively low for cardiovascular mortality, with an I-squared of respectively 78.6% and 39.6%. Subgroup analyses showed that the association between depression and mortality not significantly change when excluding three articles presenting odds ratios, yet this decreased heterogeneity substantially (HR = 1.49, 95% CI = 1.39-1.61, I-squared = 15.1%. A comparison between type 1 and type 2 diabetes could not be undertaken, as only one study reported on type 1 diabetes specifically. CONCLUSIONS: Depression is associated with an almost 1.5-fold increased risk of mortality in people with diabetes. Research should focus on both cardiovascular and non-cardiovascular causes of death associated with depression, and determine the underlying behavioral and physiological mechanisms that may explain this association.
Li, Wenzhen; Ruan, Wenyu; Peng, Ying; Wang, Dongming
Increasing studies have focused on the relationship between soy intake and type 2 diabetes mellitus risk, but the results are inconsistent. We conduct a meta-analysis to evaluate the relationship. The databases of PubMed, Web of Science and Embase were searched up to Dec 2016. A random-effect model was used to pool the results of included studies. Eight studies with 19 reports met the inclusion criteria. A significant inverse association was shown between soy intake and type 2 diabetes mellitus risk with an overall RR of 0.77 (95% CI = 0.66-0.91) with high heterogeneity. Besides, there was an obvious relationship between soy protein and isoflavones intake and risk of T2DM with the summary RR was 0.88 (95% CI = 0.80-0.97) with no heterogeneity. In the subgroup analysis, a statistically significant protective effect of soy consumption was observed in women (RR = 0.65; 95% CI = 0.49-0.87), cross-sectional studies (RR = 0.45; 95% CI = 0.30-0.67), and Asian populations (RR = 0.73; 95% CI = 0.61-0.88). Soy products and soy constituents (soy protein and soy isoflavones) may be associated with a lower risk of type 2 diabetes mellitus. Future studies should focus on the dose-response effect and the mechanism. Copyright © 2018 Elsevier B.V. All rights reserved.
Chapman, Anna; Meyer, Claudia; Renehan, Emma; Hill, Keith D; Browning, Colette J
Falls as a complication of diabetes mellitus (DM) can have a major impact on the health of older adults. Previous reviews have demonstrated that certain exercise interventions are effective at reducing falls in older people; however, no studies have quantified the effectiveness of exercise interventions on falls-related outcomes among older adults with DM. A systematic search for all years to September 2015 identified available literature. Eligibility criteria included: appropriate exercise intervention/s; assessed falls-related outcomes; older adults with DM. Effect sizes were pooled using a random effects model. Positive effect sizes favoured the intervention. Ten RCTs were eligible for the meta-analyses. Exercise interventions were more effective than the control condition for static balance (0.53, 95% CI: 0.13 to 0.93), lower-limb strength (0.63, 95% CI: 0.09 to 1.18), and gait (0.59, 95% CI: 0.22 to 0.96). No RCTs assessed falls-risk; one RCT reported 12month falls-rate, with no differential treatment effect observed. Exercise interventions can improve certain falls-related outcomes among older adults with DM. Substantial heterogeneity and limited numbers of studies should be considered when interpreting results. Among older adults, where DM burden is increasing, exercise interventions may provide promising approaches to assist the improvement of falls-related outcomes. Copyright © 2016 Elsevier Inc. All rights reserved.
Singh, Siddharth; Singh, Preet Paul; Singh, Abha Goyal; Murad, M Hassan; McWilliams, Robert R; Chari, Suresh T
Several preclinical and observational studies have shown that anti-diabetic medications (ADMs) may modify the risk of pancreatic cancer (PaC). We performed a systematic review and meta-analysis evaluating the effect of metformin, sulfonylureas (SUs), thiazolidinediones (TZDs), and insulin on the risk of PaC in patients with diabetes mellitus (DM). We conducted a systematic search of Medline, EMBASE, and Web of Science, up to June 2012, and published abstracts from major gastroenterology and oncology meetings from 2003 to 2012. Studies were included if they (1) evaluated and clearly defined exposure to metformin, SU, TZDs, and/or insulin, (2) reported PaC outcomes in patients with DM and (3) reported relative risks or odds ratio (OR) or provided data for their estimation. Summary OR estimates with 95% confidence intervals (CIs) were estimated using the random-effects model. Eleven studies (6 cohort, 3 case-control, and 2 randomized controlled trials (RCTs)) reported 1770 cases of PaC in 730,664 patients with DM. Meta-analysis of observational studies showed no significant association between metformin (n=9 studies; adjusted OR 0.76, 95% CI 0.57-1.03, P=0.073), insulin (n=7 studies; adjusted OR 1.59, 95% CI 0.85-2.96, P=0.144), or TZD (n=4 studies; adjusted OR 1.02, 95% CI 0.81-1.30, P=0.844) use and risk of developing PaC. Use of SU was associated with a 70% increase in the odds of PaC (n=8 studies; adjusted OR 1.70, 95% CI 1.27-2.28, Ppatients with DM. There was considerable heterogeneity across studies, and future, well-designed, prospective studies would be required to understand this association better.
Nie, Shu-Ping; Chen, Hui; Zhuang, Mao-Qiang; Lu, Ming
Several preclinical and observational studies have shown that anti-diabetic medications (ADMs) may modify the risk of lung cancer. We performed a systematic review and meta-analysis evaluating the effect of metformin, sulfonylureas (SUs), thiazolidinediones (TZDs), and insulin on the risk of lung cancer in patients with diabetes mellitus (DM). We conducted a systematic search of Pubmed and Web of Science, up to August 20, 2013. We also searched the Conference Proceedings Citation Index (CPCI) and China National Knowledge Infrastructure (CNKI) for abstracts from major meetings. Fixed or random effect pooled measures were selected based on heterogeneity among studies, which was evaluated using Q test and the I2 of Higgins and Thompson. Meta-regression was used to explore the sources of between-study heterogeneity. Publication bias was analyzed by Begg's funnel plot and Egger's regression test. Associations were assessed by odds ratios (ORs) with 95% confidence intervals (CIs). A total of 15 studies (11 cohort, 4 case-control) were included in this meta-analysis. In observational studies no significant association between metformin (n=11 studies; adjusted OR=0.99, 95%CI: 0.87-1.12), SUs (n=5 studies; adjusted OR=0.98, 95%CI: 0.79-1.22), or TZDs (n=7 studies; adjusted OR=0.92, 95%CI: 0.75-1.13), insulin (n=6 studies; adjusted OR=1.13, 95%CI: 0.79-1.62) use and risk of developing lung cancer was noted. There was considerable inherent heterogeneity between studies not explained by study design, setting, or location. Meta-analysis of existing studies does not support a protective or harmful association between ADMs use and risk of lung cancer in patients with DM. There was considerable heterogeneity across studies, and future, well-designed, prospective studies would be required for better understanding of any association.
Concert, Catherine M; Burke, Robert E; Eusebio, Anny M; Slavin, Eileen A; Shortridge-Baggett, Lillie M
The objective of this systematic review is to synthesize the best available evidence on the effects of motivational interviewing (MI) interventions (including adaptions of motivational interviewing [AMIs]) on the improvement of glycemic control in adults with type 2 diabetes. Worldwide, 346 million people have diabetes. With the growing prevalence of diabetes, controlling modifiable risk factors is essential to preventing complications and disease progression. The prevalence of type 2 diabetes is estimated to be double the present rate and by the year 2034 nearly 44 million Americans will have this preventable disease. In the United States (US), nearly 13 percent of adults aged 20 years and older have diabetes; this includes 25.8 million people, adults and children . Type 2 diabetes is more common in ethnic groups inclusive of African Americans, Latinos, Native Americans, and Asian Americans, Native Hawaiians and other Pacific Islanders. Diabetes is especially common in the elderly, 10.9 million or 26.9% of those aged 65 years and older have the disease. The US Centers for Disease Control and Prevention (CDC) estimates that 26% of US adults have impaired fasting glucose (IFG) of 100-125mg/dl and that 34% of adults meet the criteria for metabolic syndrome. An additional 35 % of adults have pre-diabetes, a condition marked by elevated blood sugar that is not yet in the diabetic range.Type 2 diabetes occurs when people have insulin resistance and insulin cannot be appropriately utilized for blood sugar regulation. Type 2 diabetes is characterised by impaired glucose tolerance. It can be defined by the criteria derived from the World Health Organization [WHO] that uses a single fasting glucose value of ≥ 126mg/dl or a single two hour glucose value of ≥ 200mg/dl. A laboratory blood test examining levels of glycosylated haemoglobin (HgbA1c) provides an estimated average blood glucose level over the past two-three months. An HbA1C level of 6.5% or higher can indicate
Santos, Tamsin; Lovell, Janaka; Shiell, Kerrie; Johnson, Marilyn; Ibrahim, Joseph E
Self-management is integral to effective chronic disease management. Cognitive impairments (CogImp) associated with dementia have not previously been reviewed in diabetes mellitus (DM) self-care. (i) Whether CogImp associated with dementia impact self-care. (ii) Whether specific CogImp affects key DM self-care processes. A systematic literature search with a narrative review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. This review examined studies published from January, 2000 to February, 2016 describing the relationship between cognition and DM self-care domains in community dwelling older adults with dementia/CogImp. Eight studies met inclusion criteria. Decrements in all self-care domains were associated with CogImp. Problem solving was related to reduced disease knowledge (OR 0.87, 95% CI=0.49-1.55), resulting in poorer glycemic control. Decision-making impairments manifested as difficulties in adjusting insulin doses, leading to more hospital admissions. People without CogImp were better able to find/utilize resources by adhering to recommended management (OR 1.03, 95% CI=1.02-1.05). A lack of interaction with health care providers was demonstrated through reduced receipt of important routine investigation including eye examinations (ARR=0.85, 95% CI=0.85-0.86), HbA1c testing (ARR=0.96, 95% CI=0.96-0.97) and LDL-C testing (ARR=0.91, 95% CI=0.901-0.914). People without CogImp had better clinic attendance (OR 2.17, 95% CI=1.30-3.70). Action taking deficits were apparent through less self-testing of blood sugar levels (20.2% vs 24.4%, p=0.1) resulting in poorer glycemic control, self-care and more frequent micro/macrovascular complications. Persons with diabetes and CogImp, particularly in domains of learning, memory and executive function, were significantly impaired in all self-care tasks. This article is protected by copyright. All rights reserved.
Vanstone, Meredith; Rewegan, Alex; Brundisini, Francesca; Dejean, Deirdre; Giacomini, Mita
Patients with uncontrolled type 1 diabetes mellitus may be candidates for pancreatic islet cell transplantation. This report synthesizes qualitative research on how patients with uncontrolled type 1 diabetes perceive their quality of life. The objective of this analysis was to examine the perceptions of patients with uncontrolled type 1 diabetes on how it affects their lived experience and quality of life. This report synthesizes 31 primary qualitative studies to examine quality of life from the perspectives of adult patients with type 1 diabetes mellitus and their families or partners. We performed a qualitative meta-synthesis to integrate findings across primary research studies. Long- and short-term negative consequences of uncontrolled type 1 diabetes affect all aspects of patients' lives: physical, emotional, practical, and social. The effect on each domain is far-reaching, and effects interact across domains. Uncontrolled blood sugar levels lead to substantial psychological distress, negative moods, cognitive difficulties, irritable or aggressive behaviour, and closely associated problems with relationships, self-image, and confidence. Emotional distress is pervasive and under-addressed by health care providers. Patients live in fear of complications from diabetes over the long term. In the shorter term, they are anxious about the personal, social, and professional consequences of hypoglycemic episodes (e.g., injury, humiliation), and may curtail normal activities such as driving or socializing because they are worried about having an episode. The quality of life for patients' family members is also negatively impacted by uncontrolled type 1 diabetes. Uncontrolled type 1 diabetes has significant negative impacts on the quality of life of both people with the disease and their families.
Yan, Yong; Sha, Yanhua; Yao, Guoxiang; Wang, Shiguang; Kong, Fanzhi; Liu, Haijun; Zhang, Guangjun; Zhang, Haiqing; Hu, Cheng; Zhang, Xueli
The aim of the study is to compare Roux-en-Y gastric bypass (RYGB) surgery versus medical treatment for type 2 diabetes mellitus (T2DM) in obese patients.Bariatric surgery can achieve remission of T2DM in obese patients. RYGB surgery has been performed as one of the most common surgical treatment options for obese patients with T2DM, but the efficacy of RYGB surgery comparing with medical treatment alone has not been conclusively determined.A systematic literature search identified randomized controlled trials (RCTs) evaluating RYGB surgery versus medical treatment for T2DM in obese patients was conducted in PubMed, Embase, Cochrane Database, and Cochrane Clinical Trials Registry. This systematic review and meta-analysis were performed according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. The primary outcome was T2DM remission. Additional analyses comprised hemoglobin A1c (HbA1c), fasting plasma glucose (FPG), body mass index (BMI), waist circumference, serum lipid level, blood pressure, medication use, and adverse events. Random-effects meta-analyses were calculated and presented as weighted odds ratio (OR) or mean difference (MD) with 95% confidence intervals (CI).Six RCTs concerning 410 total obese T2DM patients were included. Follow-up ranged from 12 to 60 months. RYGB surgery was associated with a higher T2DM remission rate (OR: 76.37, 95% CI: 20.70-281.73, P RYGB surgery. However, FPG (MD: -1.58 mmol/L, 95% CI: -3.58 to 0.41 mmol/L, P = 0.12), total cholesterol (MD: -0.40 mmol/L, 95% CI: -0.92 to 0.12 mmol/L, P = 0.13), and diastolic blood pressure (MD: 0.28 mm Hg, 95% CI: -1.89 to 2.45 mm Hg, P = 0.80) were not significantly different between the 2 treatment groups. The medicine use and quality of life were solely improved in the surgical group. Nutritional deficiencies and anemia were noted more frequently in the RYGB group.RYGB surgery is superior to medical treatment for short- to
Aldekhail, N M; Logue, J; McLoone, P; Morrison, D S
Orlistat is an effective adjunctive treatment to lifestyle modifications in the treatment of obesity. While the majority of current evidence is on the effect of orlistat in obese patients without diabetes, some studies suggest that patients who are obese and have diabetes mellitus lose more weight and have greater improvements in diabetic outcomes when treated with orlistat plus a lifestyle intervention than when treated by lifestyle interventions alone. The aim of this study was to review the evidence of the effects of orlistat on glycaemic control in overweight and obese patients with type 2 diabetes. A systematic review of randomized controlled trials of orlistat in people with type 2 diabetes reporting diabetes outcomes in studies published between January 1990 and September 2013 was conducted. We searched for articles published in English in MEDLINE and EMBASE. Inclusion criteria included all randomized controlled trials of orlistat carried out on adult participants with a body mass index of 25 kg m(-2) or over diagnosed with type 2 diabetes, which reported weight change and at least one diabetic outcome. A total of 765 articles were identified out of which 12 fulfilled the inclusion criteria. The overall mean weight reduction (3, 6 and 12 months) in the orlistat group was -4.25 kg (95% CI: -4.5 to -3.9 kg). The mean weight difference between treatment and control groups was -2.10 kg (95% CI: -2.3 to -1.8 kg, P overweight and obese patients with type 2 diabetes compared with lifestyle intervention alone. © 2015 World Obesity.
Bonoto, Bráulio Cezar; de Araújo, Vânia Eloisa; Godói, Isabella Piassi; de Lemos, Lívia Lovato Pires; Godman, Brian; Bennie, Marion; Diniz, Leonardo Mauricio; Junior, Augusto Afonso Guerra
Diabetes Mellitus (DM) is a chronic disease that is considered a global public health problem. Education and self-monitoring by diabetic patients help to optimize and make possible a satisfactory metabolic control enabling improved management and reduced morbidity and mortality. The global growth in the use of mobile phones makes them a powerful platform to help provide tailored health, delivered conveniently to patients through health apps. The aim of our study was to evaluate the efficacy of mobile apps through a systematic review and meta-analysis to assist DM patients in treatment. We conducted searches in the electronic databases MEDLINE (Pubmed), Cochrane Register of Controlled Trials (CENTRAL), and LILACS (Latin American and Caribbean Health Sciences Literature), including manual search in references of publications that included systematic reviews, specialized journals, and gray literature. We considered eligible randomized controlled trials (RCTs) conducted after 2008 with participants of all ages, patients with DM, and users of apps to help manage the disease. The meta-analysis of glycated hemoglobin (HbA1c) was performed in Review Manager software version 5.3. The literature search identified 1236 publications. Of these, 13 studies were included that evaluated 1263 patients. In 6 RCTs, there were a statistical significant reduction (Papps without significant heterogeneity. The use of apps by diabetic patients could help improve the control of HbA1c. In addition, the apps seem to strengthen the perception of self-care by contributing better information and health education to patients. Patients also become more self-confident to deal with their diabetes, mainly by reducing their fear of not knowing how to deal with potential hypoglycemic episodes that may occur. ©Bráulio Cezar Bonoto, Vânia Eloisa de Araújo, Isabella Piassi Godói, Lívia Lovato Pires de Lemos, Brian Godman, Marion Bennie, Leonardo Mauricio Diniz, Augusto Afonso Guerra Junior
Kimberley L. Way
Full Text Available The purpose of this study was to examine the effect of regular exercise training on insulin sensitivity in adults with type 2 diabetes mellitus (T2DM using the pooled data available from randomised controlled trials. In addition, we sought to determine whether short-term periods of physical inactivity diminish the exercise-induced improvement in insulin sensitivity. Eligible trials included exercise interventions that involved ≥3 exercise sessions, and reported a dynamic measurement of insulin sensitivity. There was a significant pooled effect size (ES for the effect of exercise on insulin sensitivity (ES, –0.588; 95% confidence interval [CI], –0.816 to –0.359; P<0.001. Of the 14 studies included for meta-analyses, nine studies reported the time of data collection from the last exercise bout. There was a significant improvement in insulin sensitivity in favour of exercise versus control between 48 and 72 hours after exercise (ES, –0.702; 95% CI, –1.392 to –0.012; P=0.046; and this persisted when insulin sensitivity was measured more than 72 hours after the last exercise session (ES, –0.890; 95% CI, –1.675 to –0.105; P=0.026. Regular exercise has a significant benefit on insulin sensitivity in adults with T2DM and this may persist beyond 72 hours after the last exercise session.
Tegegne, Balewgizie Sileshi; Habtewold, Tesfa Dejenie; Mengesha, Melkamu Merid; Burgerhof, Johannes G M
Multi-drug-resistant tuberculosis (MDR-TB) has emerged as a challenge to global tuberculosis (TB) control and remains a major public health concern in many countries. Diabetes mellitus (DM) is an increasingly recognized comorbidity that can both accelerate TB disease and complicate its treatment. The aim of this study is to summarize available evidence on the association of DM and MDR-TB among TB patients and to provide a pooled estimate of risks. All studies published in English before October 2016 will be searched using comprehensive search strings through PubMed, EMBASE, Web of Science, and WHO Global Health Library databases which have reported the association of DM and MDR-TB in adults with TB (age > =15). Two authors will independently collect detailed information using structured data abstraction form. The quality of studies will be checked using Newcastle-Ottawa Scale for cohort and case-control studies and the Agency for Healthcare Research and Quality tool for cross-sectional studies. Heterogeneity between included studies will be assessed using the I 2 statistic. We will check potential publication bias by visual inspection of the funnel plot and Egger's regression test statistic. We will use the random effects model to compute a pooled estimate. Increases in the burden of non-communicable diseases and aging populations are changing the importance of different risk factors for TB, and the profile of comorbidities and clinical challenges for people with TB. Although classic risk factors and comorbidities such as overcrowding, under-nutrition, silicosis, and HIV infection are crucial to address, chronic conditions like diabetes are important factors that impair host defenses against TB. Thus, undertaking integrated multifaceted approach is remarkably necessary for reducing the burden of DM and successful TB treatment outcome. PROSPERO CRD42016045692 .
Hirst, Jennifer A; Farmer, Andrew J; Feakins, Benjamin G; Aronson, Jeffrey K; Stevens, Richard J
Aims Although there are reports that β-adrenoceptor antagonists (beta-blockers) and diuretics can affect glycaemic control in people with diabetes mellitus, there is no clear information on how blood glucose concentrations may change and by how much. We report results from a systematic review to quantify the effects of these antihypertensive drugs on glycaemic control in adults with established diabetes. Methods We systematically reviewed the literature to identify randomized controlled trials in which glycaemic control was studied in adults with diabetes taking either beta-blockers or diuretics. We combined data on HbA1c and fasting blood glucose using fixed effects meta-analysis. Results From 3864 papers retrieved, we found 10 studies of beta-blockers and 12 studies of diuretics to include in the meta-analysis. One study included both comparisons, totalling 21 included reports. Beta-blockers increased fasting blood glucose concentrations by 0.64 mmol l−1 (95% CI 0.24, 1.03) and diuretics by 0.77 mmol l−1 (95% CI 0.14, 1.39) compared with placebo. Effect sizes were largest in trials of non-selective beta-blockers (1.33, 95% CI 0.72, 1.95) and thiazide diuretics (1.69, 95% CI 0.60, 2.69). Beta-blockers increased HbA1c concentrations by 0.75% (95% CI 0.30, 1.20) and diuretics by 0.24% (95% CI −0.17, 0.65) compared with placebo. There was no significant difference in the number of hypoglycaemic events between beta-blockers and placebo in three trials. Conclusions Randomized trials suggest that thiazide diuretics and non-selective beta-blockers increase fasting blood glucose and HbA1c concentrations in patients with diabetes by moderate amounts. These data will inform prescribing and monitoring of beta-blockers and diuretics in patients with diabetes. PMID:25377481
Hirst, Jennifer A; Farmer, Andrew J; Feakins, Benjamin G; Aronson, Jeffrey K; Stevens, Richard J
Although there are reports that β-adrenoceptor antagonists (beta-blockers) and diuretics can affect glycaemic control in people with diabetes mellitus, there is no clear information on how blood glucose concentrations may change and by how much. We report results from a systematic review to quantify the effects of these antihypertensive drugs on glycaemic control in adults with established diabetes. We systematically reviewed the literature to identify randomized controlled trials in which glycaemic control was studied in adults with diabetes taking either beta-blockers or diuretics. We combined data on HbA1c and fasting blood glucose using fixed effects meta-analysis. From 3864 papers retrieved, we found 10 studies of beta-blockers and 12 studies of diuretics to include in the meta-analysis. One study included both comparisons, totalling 21 included reports. Beta-blockers increased fasting blood glucose concentrations by 0.64 mmol l(-1) (95% CI 0.24, 1.03) and diuretics by 0.77 mmol l(-1) (95% CI 0.14, 1.39) compared with placebo. Effect sizes were largest in trials of non-selective beta-blockers (1.33, 95% CI 0.72, 1.95) and thiazide diuretics (1.69, 95% CI 0.60, 2.69). Beta-blockers increased HbA1c concentrations by 0.75% (95% CI 0.30, 1.20) and diuretics by 0.24% (95% CI -0.17, 0.65) compared with placebo. There was no significant difference in the number of hypoglycaemic events between beta-blockers and placebo in three trials. Randomized trials suggest that thiazide diuretics and non-selective beta-blockers increase fasting blood glucose and HbA1c concentrations in patients with diabetes by moderate amounts. These data will inform prescribing and monitoring of beta-blockers and diuretics in patients with diabetes. © 2014 The British Pharmacological Society.
Adeloye, Davies; Ige, Janet O; Aderemi, Adewale V; Adeleye, Ngozi; Amoo, Emmanuel O; Auta, Asa; Oni, Gbolahan
There is not yet a comprehensive evidence-based epidemiological report on type 2 diabetes mellitus (T2DM) in Nigeria. We aimed to estimate country-wide and zonal prevalence, hospitalisation and mortality rates of T2DM in Nigeria. We searched MEDLINE, EMBASE, Global Health, Africa Journals Online (AJOL) and Google Scholar for population and hospital-based studies on T2DM in Nigeria. We conducted a random-effects meta-analysis on extracted crude estimates, and applied a meta-regression epidemiological model, using the United Nations demographics for Nigeria in 1990 and 2015 to determine estimates of diabetes in Nigeria for the two years. 42 studies, with a total population of 91 320, met our selection criteria. Most of the studies selected were of medium quality (90.5%). The age-adjusted prevalence rates of T2DM in Nigeria among persons aged 20-79 years increased from 2.0% (95% CI 1.9% to 2.1%) in 1990 to 5.7% (95% CI 5.5% to 5.8%) in 2015, accounting for over 874 000 and 4.7 million cases, respectively. The pooled prevalence rate of impaired glucose tolerance was 10.0% (95% CI 4.5% to 15.6%), while impaired fasting glucose was 5.8% (95% CI 3.8% to 7.8%). Hospital admission rate for T2DM was 222.6 (95% CI 133.1 to 312.1) per 100 000 population with hyperglycaemic emergencies, diabetic foot and cardiovascular diseases being most common complications. The overall mortality rate was 30.2 (95% CI 14.6 to 45.8) per 100 000 population, with a case fatality rate of 22.0% (95% CI 8.0% to 36.0%). Our findings suggest an increasing burden of T2DM in Nigeria with many persons currently undiagnosed, and few known cases on treatment. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Smith, Andrea D; Crippa, Alessio; Woodcock, James; Brage, Søren
Inverse associations between physical activity (PA) and type 2 diabetes mellitus are well known. However, the shape of the dose-response relationship is still uncertain. This review synthesises results from longitudinal studies in general populations and uses non-linear models of the association between PA and incident type 2 diabetes. A systematic literature search identified 28 prospective studies on leisure-time PA (LTPA) or total PA and risk of type 2 diabetes. PA exposures were converted into metabolic equivalent of task (MET) h/week and marginal MET (MMET) h/week, a measure only considering energy expended above resting metabolic rate. Restricted cubic splines were used to model the exposure-disease relationship. Our results suggest an overall non-linear relationship; using the cubic spline model we found a risk reduction of 26% (95% CI 20%, 31%) for type 2 diabetes among those who achieved 11.25 MET h/week (equivalent to 150 min/week of moderate activity) relative to inactive individuals. Achieving twice this amount of PA was associated with a risk reduction of 36% (95% CI 27%, 46%), with further reductions at higher doses (60 MET h/week, risk reduction of 53%). Results for the MMET h/week dose-response curve were similar for moderate intensity PA, but benefits were greater for higher intensity PA and smaller for lower intensity activity. Higher levels of LTPA were associated with substantially lower incidence of type 2 diabetes in the general population. The relationship between LTPA and type 2 diabetes was curvilinear; the greatest relative benefits are achieved at low levels of activity, but additional benefits can be realised at exposures considerably higher than those prescribed by public health recommendations.
Helgstrand, John Thomas; Berg, Kasper Drimer; Lippert, Solvej
trials have challenged this dogma. The aim of this study was to evaluate how endocrine therapy (ET) affects survival in different clinical settings of PCa. Materials and methods A review of published phase II, III and IV studies evaluating the effect of ET on survival was performed. Results In localized...
Thangavel Mahalingam Vijayakumar, M.Pharm, PhD
Implications: From this updated review, it was found that metformin was the most widely used component of FDCs with other OHAs. Studies on the safety and efficacy of newly approved OHAs such as sodium glucose cotransporter inhibitors were limited. An increasing number of randomized trials on the safety and efficacy of newly emerging FDCs suggests that they would be better treatment options for T2DM patients.
Rys, P; Wojciechowski, P; Siejka, S; Małecki, P; Hak, L; Malecki, M T
It is uncertain whether the addition of biphasic insulin analogues to oral antidiabetic drugs (OADs) is as effective and safe as basal insulin in patients with type 2 diabetes mellitus (T2DM). We performed a systematic review to compare glycaemic control and selected clinical outcomes in T2DM patients inadequately controlled with OADs whose treatment was intensified by adding biphasic insulin aspart (BIAsp 30) or insulin glargine (IGlar). The analysis included randomised controlled trials (RCTs) identified by a systematic literature search in medical databases (MEDLINE, EMBASE, The Cochrane Library and other sources) up to March 2013. Studies met the inclusion criteria if they compared BIAsp 30 vs. IGlar added to at least one OAD in T2DM patients. Trials applying different OADs in both treatment arms were also included. Results were presented as weighted mean difference (WMD) or odds ratio (OR) with a 95% confidence interval (CI). Five trials, including a total number of 1758 patients followed up from 24 to 28 weeks, were identified. Quantitative synthesis demonstrated that BIAsp 30 reduced HbA1c level more efficiently than IGlar [5 RCTs; WMD (95% CI): -0.21% (-0.35%, -0.08%)]. Differences were observed in favour of BIAsp for lower mean prandial glucose increment [3 RCTs; WMD (95% CI): -14.70 mg/dl (-20.09, -9.31)]; no difference was observed for fasting plasma glucose [3 RCTs; WMD (95% CI): 7.09 mg/dl (-15.76, 29.94)]. We found no evidence for higher risk of overall [2 RCTs; 63% vs. 51%; OR = 1.77 (0.91; 3.44)] and severe hypoglycaemic episodes [4 RCTs; 0.98% vs. 1.12%; OR (95% CI) = 0.88 (0.31, 2.53)] in the BIAsp 30 group as compared with IGlar group. Twice-daily administration of BIAsp 30 resulted in larger weight gain [2 RCTs; WMD (95% CI) = 1.78 kg (1.04; 2.52)]. BIAsp 30 added to OAD therapy results in a better glycaemic control as compared with IGlar in T2DM patients. BIAsp 30 use is associated with slightly larger weight gain but no rise in risk
Background To compare the first-in-class sodium glucose co-transporter 2 (SGLT2) inhibitor, dapagliflozin, with existing type 2 diabetes mellitus (T2DM) treatment options available within the European Union (EU) for add-on therapy to sulfonylureas (SUs). Methods A systematic review was conducted to identify randomised controlled trials (RCTs) in T2DM patients inadequately controlled by SU monotherapy. Direct meta-analysis, Bucher indirect comparisons and Bayesian network meta-analysis (NMA) were conducted on studies meeting predefined inclusion criteria. Sufficient data were available to assess three clinical endpoints at 24 (+/- 6) weeks follow-up: mean change in HbA1c from baseline, mean change in weight from baseline, and the proportion of patients experiencing at least one episode of hypoglycaemia. The effect of confounding baseline factors was explored through covariate analyses. Results The search identified 1,901 unique citations, with 1,870 excluded based on title/abstract. From reviewing full-texts of the remaining 31 articles, 5 studies were considered eligible for analysis. All studies were comparable in terms of baseline characteristics, including: HbA1c, age and body mass index (BMI). In addition to dapagliflozin, sufficient data for meta-analysis was available for three dipeptidyl peptidase-4 (DPP-4) inhibitors and one glucagon-like peptide-1 (GLP-1) analogue. Based on fixed-effect NMA, all treatment classes resulted in statistically significant decreases in HbA1c at follow-up compared to placebo. Dapagliflozin treatment resulted in significantly decreased weight at follow-up compared to placebo (-1.54 kg; 95% CrI -2.16, -0.92), in contrast to treatment with GLP-1 analogues (-0.65 kg; 95% CrI -1.37, 0.07) and DPP-4 inhibitors (0.57 kg; 95% CrI 0.09, 1.06). The odds of hypoglycaemia were similar to placebo for dapagliflozin and DPP-4 inhibitor add-on treatment, but significantly greater than placebo for GLP-1 analogue add-on treatment (10.89; 95% Cr
Quirk, H; Blake, H; Tennyson, R; Randell, T L; Glazebrook, C
To synthesize evidence from randomized and non-randomized studies of physical activity interventions in children and young people with Type 1 diabetes so as to explore clinically relevant health outcomes and inform the promotion of physical activity. We conducted a search of CINAHL Plus, the Cochrane Library, EMBASE, MEDLINE, PsycINFO, SCOPUS, SportDiscus and Web of Science between October and December 2012. Eligible articles included subjects aged ≤18 years with Type 1 diabetes and a physical activity intervention that was more than a one-off activity session. Physiological, psychological, behavioural or social outcomes were those of interest. A total of 26 articles (10 randomized and 16 non-randomized studies), published in the period 1964-2012, were reviewed. Although there was heterogeneity in study design, methods and reporting, 23 articles reported at least one significant beneficial health outcome at follow-up. Meta-analyses of these studies showed potential benefits of physical activity on HbA1c (11 studies, 345 participants, standardized mean difference -0.52, 95% CI -0.97 to -0.07; P = 0.02), BMI (four studies, 195 participants, standardized mean difference -0.41, 95% CI -0.70 to -0.12; P = 0.006) and triglycerides (five studies, 206 participants, standardized mean difference -0.70, 95% CI -1.25 to -0.14; P = 0.01).The largest effect size was for total cholesterol (five studies, 206 participants, standardized mean difference -0.91, 95% CI -1.66 to -0.17; P = 0.02). Physical activity is important for diabetes management and has the potential to delay cardiovascular disease, but there is a lack of studies that are underpinned by psychological behaviour change theory, promoting sustained physical activity and exploring psychological outcomes. There remains a lack of knowledge of how to promote physical activity in people with Type 1 diabetes. © 2014 The Authors. Diabetic Medicine published by John Wiley & Sons Ltd on behalf of Diabetes UK.
Full Text Available The epidemiological evidence for a dose-response relationship between magnesium intake and risk of type 2 diabetes mellitus (T2D is sparse. The aim of the study was to summarize the evidence for the association of dietary magnesium intake with risk of T2D and evaluate the dose-response relationship. We conducted a systematic review and meta-analysis of prospective cohort studies that reported dietary magnesium intake and risk of incident T2D. We identified relevant studies by searching major scientific literature databases and grey literature resources from their inception to February 2016. We included cohort studies that provided risk ratios, i.e., relative risks (RRs, odds ratios (ORs or hazard ratios (HRs, for T2D. Linear dose-response relationships were assessed using random-effects meta-regression. Potential nonlinear associations were evaluated using restricted cubic splines. A total of 25 studies met the eligibility criteria. These studies comprised 637,922 individuals including 26,828 with a T2D diagnosis. Compared with the lowest magnesium consumption group in the population, the risk of T2D was reduced by 17% across all the studies; 19% in women and 16% in men. A statistically significant linear dose-response relationship was found between incremental magnesium intake and T2D risk. After adjusting for age and body mass index, the risk of T2D incidence was reduced by 8%–13% for per 100 mg/day increment in dietary magnesium intake. There was no evidence to support a nonlinear dose-response relationship between dietary magnesium intake and T2D risk. The combined data supports a role for magnesium in reducing risk of T2D, with a statistically significant linear dose-response pattern within the reference dose range of dietary intake among Asian and US populations. The evidence from Europe and black people is limited and more prospective studies are needed for the two subgroups.
van der Feltz-Cornelis, Christina M; Nuyen, Jasper; Stoop, Corinne; Chan, Juliana; Jacobson, Alan M; Katon, Wayne; Snoek, Frank; Sartorius, Norman
Comorbid depression in diabetes is highly prevalent, negatively impacting well-being and diabetes control. How depression in diabetes is best treated is unknown. This systematic review and meta-analysis aims to establish the effectiveness of existing anti-depressant therapies in diabetes. PubMed, Psycinfo, Embase and Cochrane library. Study eligibility criteria, participants, interventions: randomized controlled trials (RCTs) evaluating the outcome of treatment by psychotherapy, pharmacotherapy or collaborative care of depression in persons with Type 1 and Type 2 diabetes mellitus. risk of bias assessment; data extraction. Synthesis methods: data synthesis, random model meta analysis and publication bias analysis. Meta analysis of 14 RCTs with a total of 1724 patients show that treatment is effective in terms of reduction of depressive symptoms: -0.512; 95% CI -0.633 to -0.390. The combined effect of all interventions on clinical impact is moderate, -0.370; 95% CI -0.470 to -0.271; it is large for psychotherapeutic interventions that are often combined with diabetes self management: -0.581; 95% CI -0.770 to -0.391, n=310 and moderate for pharmacological treatment: -0.467; 95% CI -0.665 to -0.270, n=281. Delivery of collaborative care, which provided a stepped care intervention with a choice of starting with psychotherapy or pharmacotherapy, to a primary care population, yielded an effect size of -0.292; 95% CI -0.429 to -0.155, n=1133; indicating the effect size that can be attained on a population scale. Pharmacotherapy and collaborative care aimed at and succeeded in the reduction of depressive symptoms but, apart from sertraline, had no effect on glycemic control. amongst others, the number of RCTs is small. The treatment of depression in people with diabetes is a necessary step, but improvement of the general medical condition including glycemic control is likely to require simultaneous attention to both conditions. Further research is needed. Copyright 2010
Non classical risk factors for gestational diabetes mellitus: a systematic review of the literature Fatores de risco não clássicos para diabetes mellitus gestacional: uma revisão sistemática da literatura
Maria Alice Souza de Oliveira Dode
Full Text Available Age, obesity and family history of diabetes are well known risk factors for gestational diabetes mellitus. Others are more controversial. The objective of this review is to find evidence in the literature that justifies the inclusion of these other conditions among risk factors. The MEDLINE, Cochrane, LILACS and Pan American Health Organization databases were searched, covering articles dating from between 1992 and 2006. Keywords were used in combination (AND with gestational diabetes mellitus separately and with each one of the risk factors studied. The methodological quality of the studies included was assessed, resulting in the selection of 41 papers. Most studies investigating maternal history of low birth weight, low stature, and low level of physical activity have found positive associations with gestational diabetes mellitus. Low socioeconomic levels, smoking during pregnancy, high parity, belonging to minority groups, and excessive weight gain during pregnancy presented conflicting results. Publication bias cannot be ruled out. Standardization of techniques, cutoff points for screening and diagnosis, as well as studies involving larger sample sizes would allow future meta-analyses.Idade, obesidade e história familiar de diabetes são fatores de risco bem conhecidos para diabetes mellitus gestacional. Outros são controversos. O objetivo desta revisão é encontrar evidências na literatura que justifiquem a inclusão dessas condições entre os fatores de risco. Bases de dados MEDLINE, Cochrane, LILACS e Organização Pan-Americana da Saúde foram procuradas. A revisão incluiu artigos de 1992 a 2006. Palavras-chave foram usadas em combinação com diabetes mellitus gestacional separadamente e com cada um dos fatores de risco estudados. A qualidade metodológica dos estudos incluídos foi medida, totalizando 41 estudos. A maioria dos trabalhos que investigaram história materna de baixo peso, baixa estatura e baixa atividade f
Systematic reviews, a cornerstone of evidence-based medicine, are not produced quickly enough to support clinical practice. The cost of production, availability of the requisite expertise and timeliness are often quoted as major contributors for the delay. This detailed survey of the state of the art of information systems designed to support or automate individual tasks in the systematic review, and in particular systematic reviews of randomized controlled clinical trials, reveals trends that see the convergence of several parallel research projects. We surveyed literature describing informatics systems that support or automate the processes of systematic review or each of the tasks of the systematic review. Several projects focus on automating, simplifying and/or streamlining specific tasks of the systematic review. Some tasks are already fully automated while others are still largely manual. In this review, we describe each task and the effect that its automation would have on the entire systematic review process, summarize the existing information system support for each task, and highlight where further research is needed for realizing automation for the task. Integration of the systems that automate systematic review tasks may lead to a revised systematic review workflow. We envisage the optimized workflow will lead to system in which each systematic review is described as a computer program that automatically retrieves relevant trials, appraises them, extracts and synthesizes data, evaluates the risk of bias, performs meta-analysis calculations, and produces a report in real time. PMID:25005128
van den Berg, Esther; Kloppenborg, Raoul P.; Kessels, Roy P. C.; Kappelle, L. Jaap; Biessels, Geert Jan
Vascular risk factors, such as type 2 diabetes mellitus, hypertension, dyslipidemia and obesity, have been associated with an increased risk of cognitive dysfunction, particularly in the elderly. The aim of this systematic review was to compare these risk factors with regard to the nature and
Wu, Yi-Cheng; Su, Ting-Wei; Zhang, Jian-Feng; Shen, Wei-Feng; Ning, Guang; Kong, Ye
A comprehensive meta-analysis was performed to evaluate the comparative benefits of coronary artery bypass grafting (CABG) versus drug-eluting stents (DES) in patients with diabetes mellitus and severe coronary artery disease (CAD). A comprehensive literature search of PubMed, Embase, and ScienceDirect was undertaken. References cited with the papers were also checked to identify relevant articles. In all, four randomized controlled trials, two prospective registries, and 11 retrospective studies were identified for review. Pooled analysis demonstrated that DES was associated with lower all-cause mortality at Day 30. However, there was no significant difference between CABG and DES in mortality at 12 months and at maximum follow-up. Furthermore, DES was associated with lower overall and major adverse cardiac and cerebrovascular events (MACCE)-free survival, as well as a higher incidence of myocardial infarction and repeat revascularization. In contrast, CABG was associated with an increased risk of stroke. For patients with diabetes mellitus and severe CAD, CABG is superior to DES in that it significantly improves overall and MACCE-free survival and reduces the incidence of myocardial infarction and repeat revascularization in the long term, although it is associated with greater perioperative risk and a higher incidence of stroke. Therefore, CABG should remain the gold standard for these patients. © 2014 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and Wiley Publishing Asia Pty Ltd.
Full Text Available Metformin is an effective insulin sensitizer treating type 2 diabetes mellitus. However, the functional consequences of metformin administration throughout pregnancy on gestational diabetes mellitus (GDM with polycystic ovary syndrome (PCOS have not been assessed. We therefore performed a meta-analysis and system review to determine the effect of metformin on GDM in PCOS. A meta-analysis was performed on the published studies before December, 2013. Meta-analysis examined whether metformin could reduce GDM occurrence in PCOS with a fixed effect model. The odds ratio (OR with 95% confidence interval (95% CI was calculated to estimate the strength of association. A total of 13 studies including 5 RCTs and 8 non-RCTs were enrolled. Ultimately, effectiveness analysis demonstrated that, in total, there was no significant availability of metformin on GDM in PCOS in contrast to placebo (OR = 1.07, 95% CI 0.60–1.92 in RCTs and significant availability of metformin on GDM (OR = 0.19, 95% CI 0.13–0.27 was indicated in non-RCTs. In summary, according to the results of our meta-analysis, strictly, metformin did not significantly effect on GDM with PCOS, though more multicenters RCTs still need to be investigated.
Zhuo, Zhihong; Wang, Aiming; Yu, Huimin
Metformin is an effective insulin sensitizer treating type 2 diabetes mellitus. However, the functional consequences of metformin administration throughout pregnancy on gestational diabetes mellitus (GDM) with polycystic ovary syndrome (PCOS) have not been assessed. We therefore performed a meta-analysis and system review to determine the effect of metformin on GDM in PCOS. A meta-analysis was performed on the published studies before December, 2013. Meta-analysis examined whether metformin could reduce GDM occurrence in PCOS with a fixed effect model. The odds ratio (OR) with 95% confidence interval (95% CI) was calculated to estimate the strength of association. A total of 13 studies including 5 RCTs and 8 non-RCTs were enrolled. Ultimately, effectiveness analysis demonstrated that, in total, there was no significant availability of metformin on GDM in PCOS in contrast to placebo (OR = 1.07, 95% CI 0.60-1.92) in RCTs and significant availability of metformin on GDM (OR = 0.19, 95% CI 0.13-0.27) was indicated in non-RCTs. In summary, according to the results of our meta-analysis, strictly, metformin did not significantly effect on GDM with PCOS, though more multicenters RCTs still need to be investigated.
Shen, Yanjue; Cai, Rongrong; Sun, Jie; Dong, Xue; Huang, Rong; Tian, Sai; Wang, Shaohua
Diabetes mellitus is a strong risk factor for chronic kidney disease and end-stage renal disease. Whether sex differences in chronic kidney disease and end-stage renal disease incidence exist among diabetic patients remains unclear. This systematic review and meta-analysis was conducted to evaluate the relative effect of diabetes on chronic kidney disease and end-stage renal disease risk in women compared with men. We systematically searched Embase, PubMed, and the Cochrane Library for both cohort and case-control studies until October 2015. Studies were selected if they reported a sex-specific relationship between diabetes mellitus and chronic kidney disease or end-stage renal disease. We generated pooled estimates across studies using random-effects meta-analysis after log transformation with inverse variance weighting. Ten studies with data from more than 5 million participants were included. The pooled adjusted risk ratio of chronic kidney disease associated with diabetes mellitus was 3.34 (95 % CI 2.27, 4.93) in women and 2.84 (95 % CI 1.73, 4.68) in men. The data showed no difference in diabetes-related chronic kidney disease risk between the sexes (pooled adjusted women-to-men relative risk ratio was 1.14 [95 % CI 0.97, 1.34]) except for end-stage renal disease-the pooled adjusted women-to men relative risk ratio was 1.38 (95 % CI 1.22, 1.55; p = 0.114, I² = 38.1 %). The study found no evidence of a sex difference in the association between diabetes mellitus and chronic kidney disease. However, the excess risk for end-stage renal disease was higher in women with diabetes than in men with the same condition, from which we assume that the female gender could accelerate the disease progression. Further studies are needed to support this notion and elucidate the underlying mechanisms.
Barnard, K. D.; Lloyd, C. E.; Skinner, T. C.
Aim: To review systematically the published literature addressing whether continuous subcutaneous insulin infusion (CSII) provides any quality of life benefits to people with Type 1 diabetes. Methods: Electronic databases and published references were searched and a consultation with two professi...
C.A. De Sá
Conclusion: It is concluded that there are benefits of aerobic exercise of moderate intensity practiced regularly often more than three times a week on waist circumference, glycemia and diastolic blood pressure in diabetes mellitus type 2.
Bahreini, Mehdi; Ramezani, Amir-Hossein; Shishehbor, Farideh; Mansoori, Anahita
Whether consumption of omega-3 affects circulating adiponectin has not been established. The objective of this study was to evaluate the effect of omega-3 (food or supplement) on circulating adiponectin in patients with type 2 diabetes through a systematic review of meta-analyses of randomized controlled trials. PubMed, Scopus and Web of Science were searched for relevant studies through May 2016. Two researchers screened and abstracted the literature independently. Pooled estimates were obtained using the random-effects models. Overall, omega-3 increased adiponectin by 0.57 µg/mL (95% confidence interval [CI] 0.15 to 1.31; p=0.01, I-square=74.2% p for heterogeneity omega-3 for more than 8 weeks. This systematic review and meta-analysis of randomized, placebo-controlled clinical trials suggests that omega-3 in patients with type 2 diabetes increases circulating adiponectin. These findings support the potentially beneficial effects of dietary omega-3 in patients with type 2 diabetes on pathways related to adiponectin metabolism. Copyright © 2017 Diabetes Canada. Published by Elsevier Inc. All rights reserved.
Toma, Tania; Athanasiou, Thanos; Harling, Leanne; Darzi, Ara; Ashrafian, Hutan
Social networking services (SNS) can facilitate real-time communication and feedback of blood glucose and other physiological data between patients and healthcare professionals. This systematic review and meta-analysis aims to summarise the current evidence surrounding the role of online social networking services in diabetes care. We performed a systematic literature review of the Medline, EMBASE and PsychINFO databases of all studies reporting HbA1c (glycated haemoglobin) as a measure of glycaemic control for social networking services in diabetes care. HbA1c, clinical outcomes and the type of technology used were extracted. Study quality and publication bias were assessed. SNS interventions beneficially reduced HbA1c when compared to controls, which was confirmed by sensitivity analysis. SNS interventions also significantly improved systolic and diastolic blood pressure, triglycerides and total cholesterol. Subgroup analysis according to diabetes type demonstrated that Type 2 diabetes patients had a significantly greater reduction in HbA1c than those with Type 1 diabetes. Online SNS provide a novel, feasible approach to improving glycaemic control, particularly in patients with Type 2 diabetes. Further mechanistic and cost-effectiveness studies are required to improve our understanding of SNS and its efficacy in diabetes care. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
Caro-Bautista, Jorge; Martín-Santos, Francisco Javier; Morales-Asencio, Jose Miguel
To determine the psychometric properties and theoretical grounding of instruments that evaluate self-care behaviour or barriers in people with type 2 diabetes. There are many instruments designed to evaluate self-care behaviour or barriers in this population, but knowledge about their psychometric validation processes is lacking. Systematic review. We conducted a search for psychometric or validation studies published between January 1990-December 2012. We carried out searches in Pubmed, CINAHL, PsycINFO, ProQuolid, BibliPRO and Google SCHOLAR to identify instruments that evaluated self-care behaviours or barriers to diabetes self-care. We conducted a systematic review with the following inclusion criteria: Psychometric or clinimetric validation studies that included patients with type 2 diabetes (exclusively or partially) and which analysed self-care behaviour or barriers to self-care and proxies like self-efficacy or empowerment, from a multidimensional approach. Language: Spanish or English. Two authors independently assessed the quality of the studies and extracted data using Terwee's proposed criteria: psychometrics properties, dimensionality, theoretical ground and population used for validation through each included instrument. Sixteen instruments achieved the inclusion criteria for the review. We detected important methodological flaws in many of the selected instruments. Only the Self-management Profile for Type 2 Diabetes and Problem Areas in Diabetes Scale met half of Terwee's quality criteria. There are no instruments for identifying self-care behaviours or barriers elaborated with a strong validation process. Further research should be carried out to provide patients, clinicians and researchers with valid and reliable instruments that are methodologically solid and theoretically grounded. © 2013 John Wiley & Sons Ltd.
Background Gestational diabetes mellitus (GDM) – a transitory form of diabetes first recognised during pregnancy complicates between diabetes in mother and offspring, timely detection, optimum treatment, and preventive postpartum care and follow-up is necessary. However the area remains grossly under-prioritised. Methods To investigate determinants and barriers to GDM care from initial screening and diagnosis to prenatal treatment and postpartum follow-up, a PubMed database search to identify quantitative and qualitative studies on the subject was done in September 2012. Fifty-eight relevant studies were reviewed. Results Adherence to prevailing GDM screening guidelines and compliance to screening tests seems sub-optimal at best and arbitrary at worst, with no clear or consistent correlation to health care provider, health system or client characteristics. Studies indicate that most women express commitment and motivation for behaviour change to protect the health of their unborn baby, but compliance to recommended treatment and advice is fraught with challenges, and precious little is known about health system or societal factors that hinder compliance and what can be done to improve it. A number of barriers related to health care provider/system and client characteristics have been identified by qualitative studies. Immediately following a GDM pregnancy many women, when properly informed, desire and intend to maintain healthy lifestyles to prevent future diabetes, but find the effort challenging. Adherence to recommended postpartum screening and continued lifestyle modifications seems even lower. Here too, health care provider, health system and client related determinants and barriers were identified. Studies reveal that sense of self-efficacy and social support are key determinants. Conclusions The paper identifies and discusses determinants and barriers for GDM care, fully recognising that these are highly dependent on the context. PMID:24450389
Abduljabbar, Tariq; Javed, Fawad; Shah, Altaf; Samer, Mazin Saleh; Vohra, Fahim; Akram, Zohaib
The aim of the study was to assess the efficacy of adjunctive use of laser therapy (LT) alone or antimicrobial photodynamic therapy (aPDT) to improve clinical periodontal and HbA1c levels in patients with both chronic periodontitis (CP) and type 2 diabetes mellitus (T2DM). Electronic search of the MEDLINE, PubMed, EMBASE, Science Direct, and SCOPUS databases were combined with hand searching of articles published from 1975 up to and including March 2016 using relevant MeSH terms. Six studies were selected for this review. In these six studies, laser treatment was applied, after scaling and root planing (SRP), in two ways: Three studies used laser alone and three studies used laser with photosensitizer. All the six included studies reporting clinical periodontal and glycemic parameters showed that LT and aPDT were effective in the treatment of CP in T2DM subjects at follow-up. Two studies showed significantly better periodontal outcomes for LT as an adjunct to SRP as compared to SRP alone, whereas four studies showed comparable periodontal outcomes among adjunctive LT or aPDT with SRP. Two studies showed significant reduction of HbA1c levels in LT and aPDT as compared to SRP, whereas three studies showed comparable percentage levels at follow-up. It remains debatable whether LT or aPDT as adjunct to SRP is more effective as compared to SRP alone in the improvement of clinical periodontal and glycemic control in patients with both CP and T2DM, given that the scientific evidence is weak.
Starup-Linde, Jakob; Karlstad, Øystein; Eriksen, Stine Aistrup; Vestergaard, Peter; Bronsveld, Heleen K.; de Vries, Frank; Andersen, Morten; Auvinen, Anssi; Haukka, Jari; Hjellvik, Vidar; Bazelier, Marloes T.; de Boer, Anthonius; Furu, Kari; De Bruin, Marie L.
Background: Patients suffering from diabetes mellitus (DM) may experience an increased risk of cancer; however, it is not certain whether this effect is due to diabetes per se. Objective: To examine the association between DM and cancers by a systematic review and meta-analysis according to the PRISMA guidelines. Data Sources: The systematic literature search includes Medline at PubMed, Embase, Cinahl, Bibliotek.dk, Cochrane library, Web of Science and SveMed+ with the search terms: “Diabetes mellitus”, “Neoplasms”, and “Risk of cancer”. Study Eligibility Criteria: The included studies compared the risk of cancer in diabetic patients versus non-diabetic patients. All types of observational study designs were included. Results: Diabetes patients were at a substantially increased risk of liver (RR=2.1), and pancreas (RR=2.2) cancer. Modestly elevated significant risks were also found for ovary (RR=1.2), breast (RR=1.1), cervix (RR=1.3), endometrial (RR=1.4), several digestive tract (RR=1.1-1.5), kidney (RR=1.4), and bladder cancer (RR=1.1). The findings were similar for men and women, and unrelated to study design. Meta-regression analyses showed limited effect modification of body mass index, and possible effect modification of age, gender, with some influence of study characteristics (population source, cancer- and diabetes ascertainment). Limitations: Publication bias seemed to be present. Only published data were used in the analyses. Conclusions: The systematic review and meta-analysis confirm the previous results of increased cancer risk in diabetes and extend this to additional cancer sites. Physicians in contact with patients with diabetes should be aware that diabetes patients are at an increased risk of cancer. PMID:24215312
Full Text Available OBJECTIVES: To find the existing clinical evidence on interventions for leptospirosis. The objective is to evaluate the effectiveness and safety of any intervention on leptospirosis through systematic reviews of randomized controlled trials (RCTs. DATA SOURCE: The sources of studies used (where there were no limitations concerning language, date, or other restrictions were: EMBASE, LILACS, MEDLINE, the Cochrane Controlled Clinical Trials Database, and the Cochrane Hepato-Biliary Group Randomized Trials register. SELECTION OF STUDIES: Type of Study: All systematic reviews of randomized controlled trials. Participants: patients with clinical and/or laboratorial diagnosis of leptospirosis, and subjects potencially exposed to leptospirosis as defined by the authors Interventions: any intervention for leptospirosis (as antibiotics or vaccines for prevention or treatment. DATA COLLECTION: The assessment will be independently made by the reviewers and cross-checked. The external validity was assessed by analysis of: studies, interventions, and outcomes. DATA SYNTHESIS: Located 163 studies using the search strategy described above, at the electronic databases above. Only 2 hits were selected, which are protocols of systematic reviews of Cochrane Collaboration, and not full reviews. One of the protocols evaluates antibiotics for treatment, and the other evaluates antibiotics for prevention of leptospirosis. CONCLUSIONS: There were not complete systematic reviews on interventions for leptospirosis. Any interventions for leptospirosis, such as prevention and treatment remains unclear for guidelines and practice.
Ghali William A
Full Text Available Abstract Background Aspirin has been recommended for the prevention of major adverse cardiovascular events (MACE, composite of non-fatal myocardial infarction, non-fatal stroke, and cardiovascular death in diabetic patients without previous cardiovascular disease. However, recent meta-analyses have prompted re-evaluation of this practice. The study objective was to evaluate the relative and absolute benefits and harms of aspirin for the prevention of incident MACE in patients with diabetes. Methods We performed a systematic review and meta-analysis on seven studies (N = 11,618 reporting on the use of aspirin for the primary prevention of MACE in patients with diabetes. Two reviewers conducted a systematic search of electronic databases (MEDLINE, EMBASE, the Cochrane Library, and BIOSIS and hand searched bibliographies and clinical trial registries. Reviewers extracted data in duplicate, evaluated the quality of the trials, and calculated pooled estimates. Results A total of 11,618 participants were included in the analysis. The overall risk ratio (RR for MACE was 0.91 (95% confidence intervals, CI, 0.82-1.00 with little heterogeneity among trials (I2 0.0%. Secondary outcomes of interest included myocardial infarction (RR, 0.85; 95% CI, 0.66-1.10, stroke (RR, 0.84; 95% CI, 0.64-1.11, cardiovascular death (RR, 0.95; 95% CI, 0.71-1.27, and all-cause mortality (RR, 0.95; 95% CI, 0.85-1.06. There were higher rates of hemorrhagic and gastrointestinal events. In absolute terms, these relative risks indicate that for every 10,000 diabetic patients treated with aspirin, 109 MACE may be prevented at the expense of 19 major bleeding events (with the caveat that the relative risk for the latter is not statistically significant. Conclusions The studies reviewed suggest that aspirin reduces the risk of MACE in patients with diabetes without cardiovascular disease, while also causing a trend toward higher rates of bleeding and gastrointestinal complications
Rys, P; Pankiewicz, O; Łach, K; Kwaskowski, A; Skrzekowska-Baran, I; Malecki, M T
Insulin aspart (IAsp) is one of the three rapid-acting insulin analogues (RAAs) registered for the treatment of diabetes. However, there is an ongoing debate concerning the efficacy and safety of RAAs. For this reason, a systematic review-based study was performed to compare clinical outcomes of treatment with IAsp and regular human insulin (RHI) as well as biphasic insulin aspart and premixed human insulin in type 1 and type 2 diabetes (T1DM, T2DM) patients. Relevant articles were identified by a systematic search through the electronic medical databases (MEDLINE, EMBASE, CENTRAL) up to July 2009. A total of 28 trials fulfilled the inclusion criteria, including 17 studies of T1DM, 10 of T2DM and one study of both. For T1DM, pooled data for HbA(1c) (13 studies) demonstrated lower levels with IAsp than with RHI (WMD=-0.11%; 95% CI: -0.16 to -0.06). In addition, meta-analysis revealed statistically significant differences in favour of IAsp for postprandial glucose (PPG) after breakfast, lunch and dinner, but not for fasting glucose (FG). The Diabetes Treatment Satisfaction Questionnaire evaluating treatment flexibility showed IAsp benefits compared with RHI (WMD=0.31; 95% CI: 0.15 to 0.47). Safety analyses (three studies) showed a significant reduction in nocturnal hypoglycaemia risk with IAsp (RR=0.67; 95% CI: 0.54 to 0.83), and no difference in severe hypoglycaemias and a slight increase in any hypoglycaemic episodes with RAAs (RR=1.06; 95% CI: 1.01 to 1.10). For T2DM, a meta-analysis of nine studies revealed no significant differences between IAsp and RHI in HbA(1c) (WMD=-0.04%; 95% CI: -0.10 to 0.03), whereas PPG was significantly lower in the IAsp group (WMD=-1.18 mmol/L; 95% CI: -1.88 to -0.47). No studies of treatment satisfaction or quality of life were identified. Analyses based on a systematic review showed that treatment with IAsp in T1DM patients resulted in moderately better metabolic control and treatment satisfaction than RHI. In T2DM patients, meta
Full Text Available Abstract Background Diabetes self-management education (DSME can be delivered in many forms. Group based DSME is widespread due to being a cheaper method and the added advantages of having patient meet and discuss with each other. assess effects of group-based DSME compared to routine treatment on clinical, lifestyle and psychosocial outcomes in type-2 diabetes patients. Methods A systematic review with meta-analysis. Computerised bibliographic database were searched up to January 2008 for randomised controlled trials evaluating group-based DSME for adult type-2 diabetics versus routine treatment where the intervention had at least one session and =/>6 months follow-up. At least two reviewers independently extracted data and assessed study quality. Results In total 21 studies (26 publications, 2833 participants were included. Of all the participants 4 out of 10 were male, baseline age was 60 years, BMI 31.6, HbA1c 8.23%, diabetes duration 8 years and 82% used medication. For the main clinical outcomes, HbA1c was significantly reduced at 6 months (0.44% points; P = 0.0006, 13 studies, 1883 participants, 12 months (0.46% points; P = 0.001, 11 studies, 1503 participants and 2 years (0.87% points; P Conclusions Group-based DSME in people with type 2 diabetes results in improvements in clinical, lifestyle and psychosocial outcomes.
van Sleuwen, Bregje E.; Engelberts, Adèle C.; Boere-Boonekamp, Magdalena M.; Kuis, Wietse; Schulpen, Tom W.J.
Swaddling was an almost universal child-care practice before the 18th century. It is still tradition in certain parts of the Middle East and is gaining popularity in the United Kingdom, the United States, and the Netherlands to curb excessive crying. We have systematically reviewed all articles on
van Sleuwen, Bregje E.; Engelberts, Adele C.; Boere-Boonekamp, Magda M.; Kuis, Wietse; Schulpen, Tom W. J.; L'Hoir, Monique P.
Swaddling was an almost universal child-care practice before the 18th century. It is still tradition in certain parts of the Middle East and is gaining popularity in the United Kingdom, the United States, and the Netherlands to curb excessive crying. We have systematically reviewed all articles on
Effect of Sodium-Glucose Cotransport-2 Inhibitors on Blood Pressure in People With Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis of 43 Randomized Control Trials With 22 528 Patients.
Mazidi, Mohsen; Rezaie, Peyman; Gao, Hong-Kai; Kengne, Andre Pascal
The sodium-glucose cotransporter 2 (SGLT2) inhibitors are a class of oral hypoglycemic agents. We undertake a systematic review and meta-analysis of prospective studies to determine the effect of SGLT2 on blood pressure (BP) among individuals with type 2 diabetes mellitus. PubMed-Medline, Web of Science, Cochrane Database, and Google Scholar databases were searched to identify trial registries evaluating the impact of SGLT2 on BP. Random-effects models meta-analysis was used for quantitative data synthesis. The meta-analysis indicated a significant reduction in systolic BP following treatment with SGLT2 (weighted mean difference -2.46 mm Hg [95% CI -2.86 to -2.06]). The weighted mean differences for the effect on diastolic BP was -1.46 mm Hg (95% CI -1.82 to -1.09). In these subjects the weighted mean difference effects on serum triglycerides and total cholesterol were -2.08 mg/dL (95% CI -2.51 to -1.64) and 0.77 mg/dL (95% CI 0.33-1.21), respectively. The weighted mean differences for the effect of SGLT2 on body weight was -1.88 kg (95% CI -2.11 to -1.66) across all studies. These findings were robust in sensitivity analyses. Treatment with SGLT2 glucose cotransporter inhibitors therefore has beneficial off-target effects on BP in patients with type 2 diabetes mellitus and may also be of value in improving other cardiometabolic parameters including lipid profile and body weight in addition to their expected effects on glycemic control. However, our findings should be interpreted with consideration for the moderate statistical heterogeneity across the included studies. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.
Alharbi, Nouf Sahal; Alsubki, Nada; Jones, Simon; Khunti, Kamlesh; Munro, Neil; de Lusignan, Simon
Information technology-based interventions are increasingly being used to manage health care. However, there is conflicting evidence regarding whether these interventions improve outcomes in people with type 2 diabetes. The objective of this study was to conduct a systematic review and meta-analysis of clinical trials, assessing the impact of information technology on changes in the levels of hemoglobin A 1c (HbA 1c ) and mapping the interventions with chronic care model (CCM) elements. Electronic databases PubMed and EMBASE were searched to identify relevant studies that were published up until July 2016, a method that was supplemented by identifying articles from the references of the articles already selected using the electronic search tools. The study search and selection were performed by independent reviewers. Of the 1082 articles retrieved, 32 trials (focusing on a total of 40,454 patients) were included. A random-effects model was applied to estimate the pooled results. Information technology-based interventions were associated with a statistically significant reduction in HbA 1c levels (mean difference -0.33%, 95% CI -0.40 to -0.26, Ptechnology-based interventions were, the more improvements there were in HbA 1c levels. Information technology strategies combined with the other elements of chronic care models are associated with improved glycemic control in people with diabetes. No clinically relevant impact was observed on low-density lipoprotein levels and blood pressure, but there was evidence that the cost of care was lower. ©Nouf Sahal Alharbi, Nada Alsubki, Simon Jones, Kamlesh Khunti, Neil Munro, Simon de Lusignan. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 25.11.2016.
van der Heijden, M M P; van Dooren, F E P; Pop, V J M; Pouwer, F
Psychological problems are relatively common in people with type 2 diabetes. It is unclear whether exercise training exerts an effect on quality of life, symptoms of depression, symptoms of anxiety and emotional well-being in people with type 2 diabetes. The aim of this study was to conduct a systematic review to assess the effects of exercise training on these outcomes in people with type 2 diabetes. MEDLINE, PsycINFO, Embase and ClinicalTrials.gov databases were searched. The review included randomised controlled trials (RCTs) of at least 4 weeks' duration in people with type 2 diabetes that evaluated the effect of exercise training on quality of life, symptoms of depression, symptoms of anxiety and/or emotional well-being compared with usual care. Of 1,261 retrieved articles, 20 RCTs were included with a total of 1,719 participants. Quality of life was assessed in 16 studies. Between-group comparisons showed no significant results for aerobic training with the exception of one study, and mixed results for resistance and combined training. Symptoms of depression were assessed in four studies. In only one study did the intervention decrease symptoms of depression. Emotional well-being was evaluated in four studies, which also showed conflicting results. Symptoms of anxiety were evaluated in one study, which showed a significant improvement. The effects of exercise training on psychological outcomes in people with type 2 diabetes are conflicting. Therefore, there is a need for further high-quality RCTs in order to gain greater insight into the role of exercise training in people with type 2 diabetes.
Meng, Yan; Bai, Hao; Wang, Shijun; Li, Zhaoping; Wang, Qian; Chen, Liyong
The objective of this systematic review and meta-analysis is to assess the efficacy of Low Carbohydrate Diet (LCD) compared with a normal or high carbohydrate diet in patients with type 2 diabetes. We searched MEDLINE, EMBASE, and Cochrane Library database for randomized controlled trials. Researches which reported the change in weight loss, blood glucose, and blood lipid levels were included. A total of 9 studies with 734 patients with diabetes were included. Pooled results suggested that LCD had a significantly effect on HbA1c level (WMD: -0.44; 95% CI: -0.61, -0.26; P=0.00). For cardiovascular risk factors, the LCD intervention significantly reduced triglycerides concentration (WMD: -0.33; 95% CI: -0.45, -0.21; P=0.00) and increased HDL cholesterol concentration (WMD: 0.07; 95% CI: 0.03, 0.11; P=0.00). But the LCD was not associated with decreased level of total cholesterol and LDL cholesterol. Subgroup analyses indicated that short term intervention of LCD was effective for weight loss (WMD: -1.18; 95% CI: -2.32, -0.04; P=0.04). The results suggested a beneficial effect of LCD intervention on glucose control in patients with type 2 diabetes. The LCD intervention also had a positive effect on triglycerides and HDL cholesterol concentrations, but without significant effect on long term weight loss. Copyright © 2017. Published by Elsevier B.V.
Guidugli, Fabio; Castro, Aldemar Araujo [UNIFESP; Atallah, Álvaro Nagib [UNIFESP
OBJECTIVES: To find the existing clinical evidence on interventions for leptospirosis. The objective is to evaluate the effectiveness and safety of any intervention on leptospirosis through systematic reviews of randomized controlled trials (RCTs). DATA SOURCE: The sources of studies used (where there were no limitations concerning language, date, or other restrictions) were: EMBASE, LILACS, MEDLINE, the Cochrane Controlled Clinical Trials Database, and the Cochrane Hepato-Biliary Group Ra...
Full Text Available The aim of this study was used meta-analysis to investigate changes of serum tumor necrosis factor-alpha (TNF-α in patients with type 1 diabetes mellitus (T1DM.Relevant literatures were identified from PubMed, Cochrane Library, CNKI, WanFang and Chinese-Cqvip databases (published from January 1, 1999 to September 30, 2016. Eligible reports were included for pooled analysis of serum TNF-α level and subgroup analysis was performed in relation with age, disease duration and ethnicity.A total of 23 articles (1631 T1DM cases, 1429 healthy controls were included for this meta-analysis. Compared with the controls, the patients had significantly increased serum TNF-α level (P < 0.001. Similar results were also found among all subgroup analysis of different age, disease duration and ethnicity (with the exception of Asian (all P < 0.05. Regression analysis indicated that age (P = 0.680, disease duration (P = 0.957, and ethnicity (P = 0.526 of patients were not significant impact factors for the high heterogeneity. The results were stable according to the sensitivity analysis and no publication bias existed in this meta-analysis.Serum TNF-α level in T1DM patients has significantly elevated among all age, disease duration and ethnicity groups.
Yan, Wenmao; Bai, Rixing; Yan, Ming; Song, Maomin
The study evaluated the predictive role of preoperative fasting C-peptide, hemoglobin (Hb)A1c, fasting plasma glucose (FPG), and body mass index (BMI) levels on diabetes remission in patients with type 2 diabetes following bariatric surgery. Medline, PubMed, Central, and Google Scholar databases of up to September 7, 2016 were searched using the following terms: type 2 diabetes mellitus, gastric bypass, Roux-en-Y, anastomosis, C-peptide, weight loss, HbA/HbA1c, predictive/predictor. Meta-analysis of the pooled data indicated that fasting C-peptide was predictive of increased chance of remission of type 2 diabetes (pooled difference in means = 0.93, 95% confidence interval [CI] = 0.61 to 1.25, p fasting plasma C-peptide was associated with increased type 2 diabetes remission after bariatric surgery, whereas baseline HbA1c and FPG levels were associated with reduced chance of remission. These parameters may be used as a guideline in weighing the risks and benefits for surgical intervention in patients with type 2 diabetes.
Full Text Available Objective. The aim of this study was to investigate the changes of regulatory T cells (Treg, interleukin-6 (IL-6, IL-10, transforming growth factor-β (TGF-β, and tumor necrosis factor-alpha (TNF-α in patients with type 2 diabetes mellitus (T2DM. Methods. We performed a comprehensive search up to July 2016 for all clinical studies about the changes of Treg, IL-6, IL-10, IL-17, TGF-β, and TNF-α in T2DM patients versus healthy controls. Results. A total of 91 articles (5642 cases and 7378 controls were included for this meta-analysis. Compared with the controls (all p<0.001, the patients had increased serum levels of IL-6, TGF-β, and TNF-α but decreased the percentage of peripheral CD4+CD25+Foxp3+Treg and serum IL-10 level. Furthermore, the percentage of peripheral CD4+CD25+Foxp3+Treg (p<0.001 and serum IL-10 level (p=0.033 were significantly lower in the patients with complication and in the patients without complication, respectively. No significant changes about the percentage of CD4+CD25+Treg (p=0.360 and serum IL-17 level (p=0.459 were found in T2DM patients. Conclusions. T2DM patients have decreased the percentage of peripheral CD4+CD25+Foxp3+Treg and levels of serum IL-10 but elevated serum levels of IL-6, TGF-β, and TNF-α. Presence of diabetic complications further lowers the peripheral CD4+CD25+Foxp3+Treg number.
This paper offers a discussion of the reading and writing practices that define systematic review. Although increasingly popular, systematic review has engendered a critique of the claims made for it as a more objective method for summing up research findings than other kinds of reviews. An alternative understanding of systematic review is as a highly subjective, albeit disciplined, engagement between resisting readers and resistant texts. Reviewers of research exemplify the resisting reader when they exclude reports on grounds of relevance, quality, or methodological difference. Research reports exemplify resistant texts as they do not simply yield their findings, but rather must be made docile to review. These acts of resistance make systematic review possible, but challenge claims of its greater capacity to control bias. An understanding of the reading and writing practices that define systematic review still holds truth and objectivity as regulative ideals, but is aware of the reading and writing practices that both enable and challenge those ideals.
Fagerlund, Anders; Lewin, Richard; Rufolo, Guglielmo; Elander, Anna; Santanelli di Pompeo, Fabio; Selvaggi, Gennaro
Gynecomastia is a common medical problem presenting in nearly a third of the male population. Treatment for gynecomastia can be either pharmacological or surgical. Patients with gynecomastia often experience affected quality-of-life. The aim of this systematic review was to analyze the quality of evidence of the current literature in relation to different treatment modalities and Quality-of-Life in patients with gynecomastia. A systematic search of the literature was performed in PubMed, Medline, Scopus, The Cochrane Library, and SveMed+ in accordance with the PRISMA statement. All searches were undertaken between September-November 2014. The PICOS (patients, intervention, comparator, outcomes, and study design) approach was used to specify inclusion criteria. Methodological quality was graded according to MINORS. Quality of evidence was rated according to GRADE. Data from the included studies were extracted based on study characteristics, participants specifics, type of intervention/treatment, and type of outcome measures into data extraction forms. A total of 134 abstracts were identified in the literature search. Seventeen studies met inclusion criteria, 14 concerning treatment and three concerning Quality-of-Life. All studies were non-randomised with a high risk of bias and very low quality of evidence according to GRADE. Several different surgical methods have been described with good results, minimal scars, and various levels of complications. Traditional surgical excision of glandular tissue combined with liposuction provides most consistent results and a low rate of complications. Pubertal gynecomastia may safely be managed by pharmacological anti-oestrogen treatment.
Pedro Iván Arias-Vázquez
Full Text Available A review was conducted in databases (PubMed, PEDro of type studies clinical trial, cohort study, systematic reviews, meta-analysis and clinical practice guidelines based on evidence they have studied the benefits of physical activity in the prevention , treatment and decreased risk of complications and death in patients with Type II Diabetes Mellitus. Realization regular physical activity is associated with a decreased risk of developing Diabetes Mellitus; likewise was associated with decrease in glycated hemoglobin percentage A1C values. Diabetic patients undergoing high levels of physical activity had decreased risk of complications and death from cardiovascular disease and all causes. At present the scientific evidence on the impact of physical activity in the prevention and treatment of Diabetes Mellitus is solid, so it must be emphasized promoting physical activity as a fundamental part of the therapeutic regimens for this disease.
Adverse Drug Events Associated with Low-Dose (10 mg) Versus High-Dose (25 mg) Empagliflozin in Patients Treated for Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
Dai, Xia; Luo, Zu-Chun; Zhai, Lu; Zhao, Wen-Piao; Huang, Feng
Empagliflozin is a new, emerging oral hypoglycemic agent (OHA) which has shown significant benefits in type 2 diabetes mellitus (T2DM) patients with cardiovascular disease. In this analysis, our aim was to systematically compare the adverse drug events (ADEs) associated with a low (10 mg) versus a high (25 mg) dose of empagliflozin as (1) monotherapy, (2) as an add-on to other OHAs, and (3) as an add-on specifically to metformin, in patients who were treated for T2DM. This was a systematic review and meta-analysis of randomized controlled trials that compared empagliflozin 10 mg versus 25 mg in patients who were treated for T2DM and which reported adverse drug reactions as their clinical endpoints. Statistical analysis was carried out using the latest version of the RevMan software (ver. 5.3) whereby odds ratios (OR) and 95% confidence intervals (CI) were generated. Eight trials with a total number of 8514 patients treated for T2DM were included in this meta-analysis and systematic review, of whom 4261 patients received 10 mg empagliflozin and 4253 patients received 25 mg empagliflozin. Our results showed that there were no significant differences between the patients with T2DM receiving 10 empagliflozin and those receiving 25 mg empagliflozin in terms of drug-related adverse effects (OR 1.06, 95% CI 0.93-1.21; P = 0.40, I 2 = 0%), adverse events leading to drug discontinuation (OR 0.99, 95% CI 0.86-1.14; P = 0.87, I 2 = 0%), and serious adverse events (OR 1.06, 95% CI 0.95-1.18; P = 0.31, I 2 = 0%) when empagliflozin was provided as monotherapy or as an add-on to other anti-diabetic medications. The same results were obtained when empagliflozin was used as an add-on to metformin or as monotherapy. The duration of the follow-up periods did not affect the results. However, the incidence of genital and urinary tract infections (UTIs) was significantly higher in female patients than in male patients with 10 or 25 mg empagliflozin. The
Farimani, Azam Rezaei; Hariri, Mitra; Azimi-Nezhad, Mohsen; Borji, Abasalt; Zarei, Sadegh; Hooshmand, Elham
N-3 PUFAs can potentially influence levels of inflammatory and non-inflammatory adipokines. Given the contradictory effects of n-3 PUFAs on serum levels of adipokines in type 2 diabetes, we conducted a systematic review and meta-analysis study of randomized placebo-controlled clinical trials that examined the effects of n-3 PUFAs on serum levels of leptin and adiponectin in patients with type 2 diabetes. The electronic databases, without regard to language restrictions including PubMed/Medline, Google Scholar, SCOPUS and ISI Web of Science until August 2017, were used to identify randomized controlled trials that assessed the effect of n-3 PUFAs on serum leptin and adiponectin concentrations in type 2 diabetes. Outcomes were extracted based on the mean ± SD as effect size at baseline and end of the intervention. Between-study heterogeneity was evaluated by the I 2 estimates and their 95% CIs. Funnel plot asymmetry was used to investigate the existence of publication bias. Stata software and Review Manager were used for statistical data analysis. Data from 10 eligible articles involved 494 subjects with type 2 diabetes mellitus (intervention groups = 254 and control groups = 240), with age between 44 and 70 years, treated with doses of 0.52-7.4 g/day n-3 PUFAs. Adiponectin concentration nonsignificantly increased by a MD = 0.17 µg/mL (95% CI - 0.11, 0.44). Also, leptin concentration nonsignificantly reduced by a MD = - 0.31 ng/mL (95% CI - 0.69, 0.07). Plant and marine sources of n-3 PUFAs can modify serum leptin and adiponectin levels by increasing adiponectin and decreasing leptin levels in patients with type 2 diabetes. Due to some limitations in this study, further studies are needed to reach a definitive conclusion about the effect of n-3 PUFAs on the levels of leptin and adiponectin in T2DM.
... strongly associated with diabetes mellitus including limited joint mobility, specific arthropathies of the hand (carpal tunnel syndrome, Dupytrens contracture, flexor tenosynovitis and diabetic sclerodactyly), shoulder (adhesive capsulitis-frozen shoulder, and calcific periarthritis) and spontaneous infarction of skeletal muscle.
Shaun W. H. Lee
Full Text Available Importance: Telemedicine has been shown to be an efficient and effective means of providing care to patients with chronic disease especially in remote and undeserved regions, by improving access to care and reduce healthcare cost. However, the evidence surrounding its applicability in type 1 diabetes remains scarce and conflicting.Objective: To synthesize evidence and quantify the effectiveness of telemedicine interventions for the management of glycemic and clinical outcomes in type 1 diabetes patients, relative to comparator conditions.Data Sources: MEDLINE, EMBASE, Cochrane Library, Web of Science, PsycINFO, and CINAHL were searched for published articles since inception until December 2016.Study Selection: Original articles reporting the results of randomized controlled studies on the effectiveness of telemedicine in people with type 1 diabetes were included.Data Extraction and Synthesis: Two reviewers independently extracted data, assessed quality, and strength of evidence. Interventions were categorized based upon the telemedicine focus (monitoring, education, consultation, case-management, and peer mentoring.Main Outcome and Measure: Absolute change in glycosylated hemoglobin A1c (HbA1c from baseline to follow-up assessment.Results: A total of 38 studies described in 41 articles were identified. Positive effects on glycemic control were noted with studies examining telemedicine, with a mean reduction of 0.18% at the end of intervention. Studies with longer duration (>6 months who had recruited patients with a higher baseline HbA1c (≥9% were associated with larger effects. Telemedicine interventions that involve individualized assessments, audit with feedback and skill building were also more effective in improving glycemic control. However, no benefits were observed on blood pressure, lipids, weight, quality of life, and adverse events.Conclusions and Relevance: There is insufficient evidence to support telemedicine use for glycemic
DiSilvestro, Kevin J; Tjoumakaris, Fotios P; Maltenfort, Mitchell G; Spindler, Kurt P; Freedman, Kevin B
The number of systematic reviews published in the orthopaedic literature has increased, and these reviews can help guide clinical decision making. However, the quality of these reviews can affect the reader's ability to use the data to arrive at accurate conclusions and make clinical decisions. To evaluate the methodological and reporting quality of systematic reviews and meta-analyses in the sports medicine literature to determine whether such reviews should be used to guide treatment decisions. The hypothesis was that many systematic reviews in the orthopaedic sports medicine literature may not follow the appropriate reporting guidelines or methodological criteria recommended for systematic reviews. Systematic review. All clinical sports medicine systematic reviews and meta-analyses from 2009 to 2013 published in The American Journal of Sports Medicine (AJSM), The Journal of Bone and Joint Surgery (JBJS), Arthroscopy, Sports Health, and Knee Surgery, Sports Traumatology, Arthroscopy (KSSTA) were reviewed and evaluated for level of evidence according to the guidelines from the Oxford Centre for Evidence-Based Medicine, for reporting quality according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, and for methodological quality according to the Assessment of Multiple Systematic Reviews (AMSTAR) tool. Analysis was performed by year and journal of publication, and the levels of evidence included in the systematic reviews were also analyzed. A total of 200 systematic reviews and meta-analyses were identified over the study period. Of these, 53% included evidence levels 4 and 5 in their analyses, with just 32% including evidence levels 1 and 2 only. There were significant differences in the proportion of articles with high levels of evidence (P Sports Health and KSSTA on the PRISMA and AMSTAR. The average PRISMA score by year varied from 85% to 89%, and the average AMSTAR score varied from 70% to 76%. Systematic reviews
Cooke, B; Ernst, E
Aromatherapy is becoming increasingly popular; however there are few clear indications for its use. To systematically review the literature on aromatherapy in order to discover whether any clinical indication may be recommended for its use, computerised literature searches were performed to retrieve all randomised controlled trials of aromatherapy from the following databases: MEDLINE, EMBASE, British Nursing Index, CISCOM, and AMED. The methodological quality of the trials was assessed using the Jadad score. All trials were evaluated independently by both authors and data were extracted in a pre-defined, standardised fashion. Twelve trials were located: six of them had no independent replication; six related to the relaxing effects of aromatherapy combined with massage. These studies suggest that aromatherapy massage has a mild, transient anxiolytic effect. Based on a critical assessment of the six studies relating to relaxation, the effects of aromatherapy are probably not strong enough for it to be considered for the treatment of anxiety. The hypothesis that it is effective for any other indication is not supported by the findings of rigorous clinical trials. PMID:10962794
Effects of green tea or green tea extract on insulin sensitivity and glycaemic control in populations at risk of type 2 diabetes mellitus: a systematic review and meta-analysis of randomised controlled trials.
Wang, X; Tian, J; Jiang, J; Li, L; Ying, X; Tian, H; Nie, M
Although the regular consumption of green tea or green tea extract has been considered to improve insulin sensitivity, the reported results are inconsistent. Therefore, we conducted a meta-analysis to evaluate the effect of green tea or green tea extract on insulin sensitivity and glycaemic control in populations at risk of type 2 diabetes mellitus (T2DM). Electronic databases, including PUBMED, The Cochrane Library, EMBASE, ISI Web of Knowledge, Chinese Biomedical Literature Database and Chinese Scientific Journals Fulltext Database, were systematically searched to identify randomised controlled trials (RCTs) up to December 2011, supplemented by the Clinicaltrials.gov websites and the reference lists of identified studies. Two reviewers independently selected trials, extracted data, and evaluated the methodological qualities and evidence levels. Seven RCTs involving 510 participants were identified. There was no statistically significant difference between green tea or green tea extract group and placebo group with regard to fasting plasma glucose [standardised mean difference (SMD) 0.04; 95% confidence interval (CI) -0.15 to 0.24], fasting serum insulin (SMD -0.09; 95% CI -0.30 to 0.11), 2-h plasma glucose in the oral glucose tolerance test (OGTT-2 h) (SMD -0.14; 95% CI -0.63 to 0.34), haemoglobin A₁c (SMD 0.10; 95% CI -0.13 to 0.33) and homeostasis model of insulin resistance (HOMA(IR)) index (SMD -0.06; 95% CI -0.35 to 0.23) in participants at risk of T2DM. The consumption of green tea did not decrease the levels of fasting plasma glucose, fasting serum insulin, OGTT-2 h glucose, haemoglobin A₁c and HOMA(IR) in populations at risk of T2DM. Larger, longer-term and high-quality RCTs are needed to further definitely determine the effect of green tea or green tea extract on insulin sensitivity and glycaemic control in populations at risk of T2DM. © 2013 The British Dietetic Association Ltd.
Bennett, Sally; Hoffmann, Tammy; McCluskey, Annie; Coghlan, Nicole; Tooth, Leigh
We sought to identify and describe the number, topics, and publishing trends of systematic reviews relevant to occupational therapy indexed in the OTseeker database. We performed a cross-sectional survey of the systematic reviews contained in OTseeker in December 2011. Of the 1,940 systematic reviews indexed in OTseeker, only 53 (2.7%) were published in occupational therapy journals. The most common diagnostic categories were stroke (n = 195, 10.1%) and affective disorders (n = 204, 10.5%). The most common intervention categories were consumer education (n = 644, 33.2%) and psychosocial techniques (n = 571, 29.4%). Only 390 (20.1%) of the 1,940 systematic reviews specifically involved occupational therapy. Occupational therapists need to search broadly to locate relevant systematic reviews or, alternatively, to use databases such as OTseeker. Clarity about the involvement of occupational therapy in reports of future research will improve the ability to identify occupational therapy research for all stakeholders. Finally, occupational therapy practitioners need to read systematic reviews critically to determine whether review conclusions are justified. Copyright © 2013 by the American Occupational Therapy Association, Inc.
The goal for this workshop is to receive scientific input regarding approaches for different steps within a systematic review, such as evaluating individual studies, synthesizing evidence within a particular discipline, etc.
Steffens, João Paulo; Glaci Reinke, Stella Maria; Angel Muñoz, Miguel; Santos, Fábio André dos; Luiz Pilatti, Gibson
There may be an interaction between periodontal disease and some systemic diseases such as diabetes mellitus. The objective of this review was to verify, by means of a review of clinical trials, if there is a positive association between periodontal disease and the glycemic control of type 2 diabetes mellitus (DM-2) patients. Eleven articles that fi t the study criteria were revised. It was concluded that periodontal disease may influence the metabolic control of DM-2. Additional studies with larger sample sizes and longer follow up are necessary for a better clarification of this issue.
Westgate, Martin J; Lindenmayer, David B
The need for robust evidence to support conservation actions has driven the adoption of systematic approaches to research synthesis in ecology. However, applying systematic review to complex or open questions remains challenging, and this task is becoming more difficult as the quantity of scientific literature increases. We drew on the science of linguistics for guidance as to why the process of identifying and sorting information during systematic review remains so labor intensive, and to provide potential solutions. Several linguistic properties of peer-reviewed corpora-including nonrandom selection of review topics, small-world properties of semantic networks, and spatiotemporal variation in word meaning-greatly increase the effort needed to complete the systematic review process. Conversely, the resolution of these semantic complexities is a common motivation for narrative reviews, but this process is rarely enacted with the rigor applied during linguistic analysis. Therefore, linguistics provides a unifying framework for understanding some key challenges of systematic review and highlights 2 useful directions for future research. First, in cases where semantic complexity generates barriers to synthesis, ecologists should consider drawing on existing methods-such as natural language processing or the construction of research thesauri and ontologies-that provide tools for mapping and resolving that complexity. These tools could help individual researchers classify research material in a more robust manner and provide valuable guidance for future researchers on that topic. Second, a linguistic perspective highlights that scientific writing is a rich resource worthy of detailed study, an observation that can sometimes be lost during the search for data during systematic review or meta-analysis. For example, mapping semantic networks can reveal redundancy and complementarity among scientific concepts, leading to new insights and research questions. Consequently
Systematic review and meta-analysis of randomized clinical trials comparing efficacy and safety outcomes of insulin glargine with NPH insulin, premixed insulin preparations or with insulin detemir in type 2 diabetes mellitus.
Rys, Przemyslaw; Wojciechowski, Piotr; Rogoz-Sitek, Agnieszka; Niesyczyński, Grzegorz; Lis, Joanna; Syta, Albert; Malecki, Maciej T
A variety of basal insulin preparations are used to treat patients with type 2 diabetes mellitus (T2DM). We aimed to summarize scientific evidence on relative efficacy and safety of insulin glargine (IGlar) and other insulins in T2DM. A systematic review was carried out in major medical databases up to December 2012. Relevant studies compared efficacy and safety of IGlar, added to oral drugs (OAD) or/and in combination with bolus insulin, with protamine insulin (NPH) or premixed insulin (MIX) in the same regimen, as well as with insulin detemir (IDet), in T2DM. Target HbA1c level without hypoglycemic events was considered the primary endpoint. Twenty eight RCTs involving 12,669 T2DM patients followed for 12-52 weeks were included in quantitative analysis. IGlar + OAD use was associated with higher probability of reaching target HbA1c level without hypoglycemia as compared to NPH + OAD (RR = 1.32 [1.09, 1.59]) or MIX without OAD (RR = 1.61 [1.22, 2.13]) and similar effect as IDet + OAD (RR = 1.07 [0.87, 1.33]) and MIX + OAD (RR = 1.09 [0.86, 1.38]). IGlar + OAD demonstrated significantly lower risk of symptomatic hypoglycemia as compared to NPH + OAD (RR = 0.89 [0.83, 0.96]), MIX + OAD (RR = 0.75 [0.68, 0.83]) and MIX without OAD(RR = 0.75 [0.68, 0.83]), but not with IDet + OAD (RR = 0.99 [0.90, 1.08]). In basal-bolus regimens, IGlar demonstrated similar proportion of T2DM patients achieving target HbA1c as compared to NPH (RR = 1.14 [0.91, 1.44]) but higher than MIX (RR = 1.26 [1.12, 1.42) or IDet (RR = 1.38 [1.11, 1.72]). The risk of severe hypoglycemia was lower in IGlar than in NPH (RR = 0.77 [0.63, 0.94]), with no differences in comparison with MIX (RR = 0.74 [0.46, 1.20]) and IDet (RR = 1.10 [0.54, 2.25]). IGlar + OAD has comparable safety profile to NPH, with less frequent adverse events leading to treatment discontinuation than MIX + OAD (RR = 0.41 [0.22, 0.76]) and IDet + OAD (RR = 0.40 [0.24, 0.69]). Also severe adverse reactions were less common for IGlar
There is an unrelenting global increase in the incidence and prevalence of diabetes mellitus (DM) with its attendant cardiovascular complications. Macrovascular complications such as peripheral arterial disease (PAD) are major consequences of DM. This review briefly summarizes the broader literature on the burden of ...
Is a Previously or Currently Reduced Testosterone Level in Male Patients with Type 2 Diabetes Mellitus a Risk Factor for the Development of Coronary Artery Disease? A Systematic Review and Meta-analysis.
We aimed to systematically investigate the association between testosterone level and cardiovascular risk in male patients with type 2 diabetes mellitus (T2DM) by comparing male T2DM patients with low testosterone levels to male T2DM patients with normal testosterone levels at baseline in terms of the number of cases of coronary artery disease (CAD). Online databases were carefully searched for studies relating to testosterone, diabetes mellitus, and cardiovascular risk by using the search terms 'testosterone,' 'diabetes mellitus,' and 'coronary artery/cardiovascular disease.' The only endpoint in this analysis was CAD/atherosclerosis/coronary plaque/major adverse coronary event prior to or following testosterone reduction at baseline. The analytical parameters used in this analysis were the risk ratio (RR) with the 95% confidence interval (CI), as obtained using the RevMan 5.3 software. 3467 male patients with T2DM (1079 patients with a low testosterone level versus 2388 patients with a normal testosterone level) were included. The results of this analysis showed that when a random effects model was used, a higher risk of CAD/cardiovascular disease was observed in diabetic patients with a low testosterone level than in those with a normal testosterone level (RR 1.24, 95% CI 0.94-1.63; P = 0.13). However, the difference in risk was not statistically significant. Similarly, with a fixed effects model, a low testosterone level was associated with a higher CAD/cardiovascular risk of disease (RR 1.12, 95% CI 0.98-1.34; P = 0.08); in this case, the difference in risk between the T2DM patients with low and normal testosterone levels approached statistical significance. A previously or currently reduced testosterone level was not found to be statistically significantly associated with a high risk of CAD/cardiovascular disease in male patients with T2DM. However, the difference in risk between the T2DM patients with low and normal testosterone levels was observed
Lima, Ana Luiza; Illing, Tanja; Schliemann, Sibylle; Elsner, Peter
Diabetes mellitus is a widespread endocrine disease with severe impact on health systems worldwide. Increased serum glucose causes damage to a wide range of cell types, including endothelial cells, neurons, and renal cells, but also keratinocytes and fibroblasts. Skin disorders can be found in about one third of all people with diabetes and frequently occur before the diagnosis, thus playing an important role in the initial recognition of underlying disease. Noninfectious as well as infectious diseases have been described as dermatologic manifestations of diabetes mellitus. Moreover, diabetic neuropathy and angiopathy may also affect the skin. Pruritus, necrobiosis lipoidica, scleredema adultorum of Buschke, and granuloma annulare are examples of frequent noninfectious skin diseases. Bacterial and fungal skin infections are more frequent in people with diabetes. Diabetic neuropathy and angiopathy are responsible for diabetic foot syndrome and diabetic dermopathy. Furthermore, antidiabetic therapies may provoke dermatologic adverse events. Treatment with insulin may evoke local reactions like lipohypertrophy, lipoatrophy and both instant and delayed type allergy. Erythema multiforme, leukocytoclastic vasculitis, drug eruptions, and photosensitivity have been described as adverse reactions to oral antidiabetics. The identification of lesions may be crucial for the first diagnosis and for proper therapy of diabetes.
Rodrigo Pinheiro Araldi
Full Text Available Abstract In the last decades, a group of viruses has received great attention due to its relationship with cancer development and its wide distribution throughout the vertebrates: the papillomaviruses. In this article, we aim to review some of the most relevant reports concerning the use of bovines as an experimental model for studies related to papillomaviruses. Moreover, the obtained data contributes to the development of strategies against the clinical consequences of bovine papillomaviruses (BPV that have led to drastic hazards to the herds. To overcome the problem, the vaccines that we have been developing involve recombinant DNA technology, aiming at prophylactic and therapeutic procedures. It is important to point out that these strategies can be used as models for innovative procedures against HPV, as this virus is the main causal agent of cervical cancer, the second most fatal cancer in women.
Araldi, Rodrigo Pinheiro; Assaf, Suely Muro Reis; de Carvalho, Rodrigo Franco; de Carvalho, Márcio Augusto Caldas Rocha; de Souza, Jacqueline Mazzuchelli; Magnelli, Roberta Fiusa; Módolo, Diego Grando; Roperto, Franco Peppino; Stocco, Rita de Cassia; Beçak, Willy
Abstract In the last decades, a group of viruses has received great attention due to its relationship with cancer development and its wide distribution throughout the vertebrates: the papillomaviruses. In this article, we aim to review some of the most relevant reports concerning the use of bovines as an experimental model for studies related to papillomaviruses. Moreover, the obtained data contributes to the development of strategies against the clinical consequences of bovine papillomaviruses (BPV) that have led to drastic hazards to the herds. To overcome the problem, the vaccines that we have been developing involve recombinant DNA technology, aiming at prophylactic and therapeutic procedures. It is important to point out that these strategies can be used as models for innovative procedures against HPV, as this virus is the main causal agent of cervical cancer, the second most fatal cancer in women. PMID:28212457
Homeopathy remains one of the most controversial subjects in therapeutics. This article is an attempt to clarify its effectiveness based on recent systematic reviews. Electronic databases were searched for systematic reviews/meta-analysis on the subject. Seventeen articles fulfilled the inclusion/exclusion criteria. Six of them related to re-analyses of one landmark meta-analysis. Collectively they implied that the overall positive result of this meta-analysis is not supported by a critical analysis of the data. Eleven independent systematic reviews were located. Collectively they failed to provide strong evidence in favour of homeopathy. In particular, there was no condition which responds convincingly better to homeopathic treatment than to placebo or other control interventions. Similarly, there was no homeopathic remedy that was demonstrated to yield clinical effects that are convincingly different from placebo. It is concluded that the best clinical evidence for homeopathy available to date does not warrant positive recommendations for its use in clinical practice. PMID:12492603
Lundh, Andreas; Knijnenburg, Sebastiaan L; Jørgensen, Anders W
BACKGROUND: To ensure evidence-based decision making in pediatric oncology systematic reviews are necessary. The objective of our study was to evaluate the methodological quality of all currently existing systematic reviews in pediatric oncology. METHODS: We identified eligible systematic reviews...... through a systematic search of the literature. Data on clinical and methodological characteristics of the included systematic reviews were extracted. The methodological quality of the included systematic reviews was assessed using the overview quality assessment questionnaire, a validated 10-item quality...... assessment tool. We compared the methodological quality of systematic reviews published in regular journals with that of Cochrane systematic reviews. RESULTS: We included 117 systematic reviews, 99 systematic reviews published in regular journals and 18 Cochrane systematic reviews. The average methodological...
Akilen, Rajadurai; Tsiami, Amalia; Devendra, Devasenan; Robinson, Nicola
Cinnamon seems to be highly bioactive, appearing to mimic the effect of insulin through increased glucose uptake in adipocytes and skeletal muscles. This systematic review and Meta analysis examined the effect of cinnamon on glycaemic control in patients with Type 2 Diabetes mellitus. A systematic literature search was conducted from the earliest possible date through to 01 August 2011. Search terms included free text terms, MeSH and Medline medical index terms such as: "cinnamon", "cinnamomum", "cinnamomum cassia", "cinnamomum zeylanicum", "type 2 diabetes mellitus". Each was crossed with the term "diabetes mellitus". In addition, references of key articles were hand searched. A total of 6 clinical trials met the strict inclusion criteria and considered a total of 435 patients; follow up between 40 days-4 months, doses ranging from 1 g to 6 g per day. Meta-analysis of RCTs showed a significant decrease in mean HbA1c [0.09%; 95% CI was 0.04-0.14] and mean FPG [0.84 mmol/l; 95% CI was 0.66-1.02]. Use of cinnamon showed a beneficial effect on glycaemic control (both HbA1c and FPG) and the short term (cinnamon on glycaemic control looks promising. Copyright © 2012 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.
Jose Antonio Garbino
Full Text Available The authors proposed a systematic review on the current concepts of primary neural leprosy by consulting the following online databases: MEDLINE, Lilacs/SciELO, and Embase. Selected studies were classified based on the degree of recommendation and levels of scientific evidence according to the “Oxford Centre for Evidence-based Medicine”. The following aspects were reviewed: cutaneous clinical and laboratorial investigations, i.e. skin clinical exam, smears, and biopsy, and Mitsuda's reaction; neurological investigation (anamnesis, electromyography and nerve biopsy; serological investigation and molecular testing, i.e. serological testing for the detection of the phenolic glycolipid 1 (PGL-I and the polymerase chain reaction (PCR; and treatment (classification criteria for the definition of specific treatment, steroid treatment, and cure criteria.
L. Chaker (Layal); A. Falla (Abby); S.J. van der Lee (Sven); T. Muka (Taulant); D. Imo (David); L. Jaspers (Loes); V. Colpani (Veronica); S. Mendis (Shanthi); R. Chowdhury (Rajiv); W.M. Bramer (Wichor); R. Pazoki (Raha); O.H. Franco (Oscar)
textabstractNon-communicable diseases (NCDs) have large economic impact at multiple levels. To systematically review the literature investigating the economic impact of NCDs [including coronary heart disease (CHD), stroke, type 2 diabetes mellitus (DM), cancer (lung, colon, cervical and breast),
Bearman, Margaret; Smith, Calvin D.; Carbone, Angela; Slade, Susan; Baik, Chi; Hughes-Warrington, Marnie; Neumann, David L.
Systematic review methodology can be distinguished from narrative reviews of the literature through its emphasis on transparent, structured and comprehensive approaches to searching the literature and its requirement for formal synthesis of research findings. There appears to be relatively little use of the systematic review methodology within the…
Little is known about the barriers, facilitators and interventions that impact on systematic review uptake. The objective of this study was to identify how uptake of systematic reviews can be improved.
Harris, Joshua D; Quatman, Carmen E; Manring, M M; Siston, Robert A; Flanigan, David C
The role of evidence-based medicine in sports medicine and orthopaedic surgery is rapidly growing. Systematic reviews and meta-analyses are also proliferating in the medical literature. To provide the outline necessary for a practitioner to properly understand and/or conduct a systematic review for publication in a sports medicine journal. Review. The steps of a successful systematic review include the following: identification of an unanswered answerable question; explicit definitions of the investigation's participant(s), intervention(s), comparison(s), and outcome(s); utilization of PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines and PROSPERO registration; thorough systematic data extraction; and appropriate grading of the evidence and strength of the recommendations. An outline to understand and conduct a systematic review is provided, and the difference between meta-analyses and systematic reviews is described. The steps necessary to perform a systematic review are fully explained, including the study purpose, search methodology, data extraction, reporting of results, identification of bias, and reporting of the study's main findings. Systematic reviews or meta-analyses critically appraise and formally synthesize the best existing evidence to provide a statement of conclusion that answers specific clinical questions. Readers and reviewers, however, must recognize that the quality and strength of recommendations in a review are only as strong as the quality of studies that it analyzes. Thus, great care must be used in the interpretation of bias and extrapolation of the review's findings to translation to clinical practice. Without advanced education on the topic, the reader may follow the steps discussed herein to perform a systematic review. © 2013 The Author(s).
Full Text Available Anne CM Pelzer,1 Frank MMA van der Heijden,2 Erik den Boer3 1Department of Psychiatry, Reinier van Arkel, ‘s-Hertogenbosch, 2Department of Psychiatry, Vincent van Gogh Institute for Psychiatry, Venlo, 3Department of Psychiatry, GGzE, Eindhoven, the Netherlands Objective: To investigate the evidence-based treatment of catatonia in adults. The secondary aim is to develop a treatment protocol. Materials and methods: A systematic review of published treatment articles (case series, cohort or randomized controlled studies which examined the effects of particular interventions for catatonia and/or catatonic symptoms in adult populations and used valid outcome measures was performed. The articles for this review were selected by searching the electronic databases of the Cochrane Library, MEDLINE, EMBASE and PSYCHINFO. Results: Thirty-one articles met the inclusion criteria. Lorazepam and electroconvulsive therapy (ECT proved to be the most investigated treatment interventions. The response percentages in Western studies varied between 66% and 100% for studies with lorazepam, while in Asian and Indian studies, they were 0% and 100%. For ECT, the response percentages are 59%–100%. There does not seem to be evidence for the use of antipsychotics in catatonic patients without any underlying psychotic disorder. Conclusion: Lorazepam and ECT are effective treatments for which clinical evidence is found in the literature. It is not possible to develop a treatment protocol because the evidence for catatonia management on the basis of the articles reviewed is limited. Stringent treatment studies on catatonia are warranted. Keywords: review, catatonia, therapeutics, electroconvulsive therapy, benzodiazepines, lorazepam, ECT
Nelson, Amanda E; Smith, Michael W; Golightly, Yvonne M; Jordan, Joanne M
Given the conflicting definitions of "generalized osteoarthritis" (GOA) in the literature, we performed a systematic review of GOA definitions, risk factors, and outcomes. We searched the MEDLINE literature with the terms osteoarthritis, generalized, polyarticular, multiple joint, and multi-joint to obtain articles related to GOA, following evidence-based guidelines. Titles and abstracts of 948 articles were reviewed, with full-text review of 108. Data were extracted based on pre-specified criteria for 74 articles plus 24 identified through bibliographic review (n = 98). Twenty-four large cohorts (n ~ 30,000) were represented along with numerous clinical series (n ~ 9000), across 22 countries and 60 years (1952-2012). No less than 15 definitions of GOA were given in 30 studies with a stated GOA definition; at least 6 groups used a summed score of joints or radiographic grades. Prevalence estimates based on these GOA definitions were 1-80%, although most were 5-25%. Increased risk and progression of GOA was associated with age, female sex, and genetic/familial factors. Associations with increased body mass index or bone mineral density were not consistent. A study estimated the heritability of GOA at 42%. Collagen biomarker levels increased with the number of involved joints. Increased OA burden was associated with increased mortality and disability, poorer health, and function. While there remains no standard definition of GOA, this term is commonly used. The impact on health may be greater when OA is in more than one joint. A descriptive term, such as multi-joint or polyarticular OA, designating OA of multiple joints or joint groups is recommended. Copyright © 2014 Elsevier Inc. All rights reserved.
Full Text Available Human body is continuously exposed to different types of agents that results in the production of reactive species called as free radicals (ROS/RNS which by the transfer of their free unpaired electron causes the oxidation of cellular machinery. In order to encounter the deleterious effects of such species, body has got endogenous antioxidant systems or it obtains exogenous antioxidants from diet that neutralizes such species and keeps the homeostasis of body. Any imbalance between the RS and antioxidants leads to produce a condition known as “oxidative stress” that results in the development of pathological condition among which one is diabetes. Most of the studies reveal the inference of oxidative stress in diabetes pathogenesis by the alteration in enzymatic systems, lipid peroxidation, impaired Glutathione metabolism and decreased Vitamin C levels. Lipids, proteins, DNA damage, Glutathione, catalane and superoxide dismutase are various biomarkers of oxidative stress in diabetes mellitus. Oxidative stress induced complications of diabetes may include stroke, neuropathy, retinopathy and nephropathy. The basic aim of this review was to summarize the basics of oxidative stress in diabetes mellitus.
Full Text Available Hemochromatosis is a disorder characterized by iron storage amended. The acquired form of the disease can be caused by iron overload, alcoholism, infection by C virus hepatitis, non-alcoholic hepatitis and chronic liver disease. The hereditary form can be caused by different mutations, being the C282Y and H63D the most frequent, 83% of cases are homozigotous for C282Y and 4% are compound heterozygous (C282Y/H63D. Hemochromatosis is a condition that can affect several organs, including: heart, joints, liver, hypothalamus, pituitary, pancreas and gonads. The aim of this study was to report a case of hemochromatosis and review the literature, with special attention to the association of hemochromatosis and diabetes mellitus. Patient 53 years, male presented to the doctor with arthralgia metacarpophalangeal, ankles, knees, coxofemoral right, and cervical and lumbar, complaints of fatigue and weight loss. Between 3 brothers, one of them had a diagnosis of hereditary hemochromatosis, with PCR demonstrating homozygous for C282Y. Labs: GOT 128 U/L, ALT 231 U/L, alkaline phosphatase 258 U/L, abdominal ultrasound with hepatomegaly and spleen at the upper limit of normal. Liver biopsy demonstrated portal fibrosis extension with hemosiderosis intense. It also made the diagnosis of diabetes mellitus. The research confirmed the same mutation of the changing family: homozygous for C282Y
Kuske, Silke; Schiereck, Tim; Grobosch, Sandra; Paduch, Andrea; Droste, Sigrid; Halbach, Sarah; Icks, Andrea
Information-seeking behaviour is necessary to improve knowledge on diabetes therapy and complications. Combined with other self-management skills and autonomous handling of the disease, it is essential for achieving treatment targets. However, a systematic review addressing this topic is lacking. The aims of this systematic review were to identify and analyse existing knowledge of information-seeking behaviour: (1) types information-seeking behaviour, (2) information sources, (3) the content of searched information, and (4) associated variables that may affect information-seeking behaviour. The systematic review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) requirements. MEDLINE, CINAHL, EMBASE, ScienceDirect, PsycInfo, Cochrane Library, Web of Science, CCMed, ERIC, Journals@OVID, Deutsches Ärzteblatt and Karlsruher virtueller Katalog (KvK) databases were searched. Publications dealing with information-seeking behaviour of people with diabetes mellitus published up to June 2015 were included. A forward citation tracking was performed in September 2016 and June 2017. Additionally, an update of the two main databases (MEDLINE, CINAHL) was conducted, considering studies published up to July 2017. Studies published in languages other than English or German were excluded, as well as letters, short reports, editorials, comments and discussion papers. A study selection and the critical appraisal of the selected studies were performed independently by two reviewers. A third reviewer was consulted if any disagreement was found. Data extraction and content analysis were performed using selected dimensions of Wilson's 'model of information behaviour'. Twenty-six studies were included. Five 'types of information-seeking behaviour' were identified, e.g. passive and active search. The 'Internet' and 'healthcare professionals' were the most frequently reported sources. 'Diet', 'complications', 'exercise' and 'medications and
Full Text Available Nádia Nara Rolim Lima,1 Vânia Barbosa do Nascimento,1 Sionara Melo Figueiredo de Carvalho,1 Luiz Carlos de Abreu,1,3 Modesto Leite Rolim Neto,2 Aline Quental Brasil,2 Francisco Telésforo Celestino Junior,2 Gislene Farias de Oliveira,2 Alberto Olavo Advíncula Reis3 1Programa de Pós-graduação em Ciências da Saúde, Faculdade de Medicina do ABC, Santo André, São Paulo, Brazil; 2Departamento de Medicina. Universidade Federal do Ceará, UFC, Barbalha, Ceará, Brazil; 3Departamento de Saúde Materno Infantil, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, Brazil Abstract: As an important public health issue, childhood depression deserves special attention, considering the serious and lasting consequences of the disease to child development. Taking this into consideration, the present study was based on the following question: what practical contributions to clinicians and researchers does the current literature on childhood depression have to offer? The objective of the present study was to conduct a systematic review of articles regarding childhood depression. To accomplish this purpose, a systematic review of articles on childhood depression, published from January 1, 2010 to November 24, 2012, on MEDLINE and SciELO databases was carried out. Search terms were “depression” (medical subject headings [MeSH], “child” (MeSH, and "childhood depression" (keyword. Of the 180 retrieved studies, 25 met the eligibility criteria. Retrieved studies covered a wide range of aspects regarding childhood depression, such as diagnosis, treatment, prevention and prognosis. Recent scientific literature regarding childhood depression converge to, directly or indirectly, highlight the negative impacts of depressive disorders to the children's quality of life. Unfortunately, the retrieved studies show that childhood depression commonly grows in a background of vulnerability and poverty, where individual and familiar needs
Tabbers, Merit M.; Boluyt, Nicole; Berger, Marjolein Y.; Benninga, Marc A.
OBJECTIVE: To summarize the evidence and assess the reported quality of studies concerning nonpharmacologic treatments for childhood constipation, including fiber, fluid, physical movement, prebiotics, probiotics, behavioral therapy, multidisciplinary treatment, and forms of alternative medicine. METHODS: We systematically searched 3 major electronic databases and reference lists of existing reviews. We included systematic reviews and randomized controlled trials (RCTs) that reported on nonph...
Kontoangelos, K; Papageorgiou, C C; Raptis, A E; Rabavilas, A D; Papadimitriou, G N
Oxytocin (OXT) is a neurohypophysial hormone which is synthesized in the paraventricular and supraoptic nuclei of the hypothalamus. OXT is currently attracting considerable attention because it has been discovered that it regulates various functions of behavior especially in the context of social interactions. OXT is a key component in bone formation, glycemia, male sexuality, cardiac differentiation and pregnancy and thus it is important to be further explored. The authors review various aspects of gestational diabetes, including definition, screening, diagnostic procedures, complications, clinical evaluation, indications of delivery and neonatal aspects. Not only the relation among diabetes mellitus, oxytocin and neurophysiology concerning erectile dysfunction, but also the role of OXT in the activity of arginine and vasopressin is investigated. It is imperative to develop technological and experimental methods that will be able to reveal the oxytocin and its potential.
Diabetes mellitus is a condition that is extremely serious from both clinical and public health standpoints. The traditional healthcare system of India, Ayurveda, offers a balanced and holistic multi-modality approach to treating this disorder. Many Ayurvedic modalities have been subjected to empirical scientific evaluation, but most such research has been done in India, receiving little attention in North America. This paper offers a review of the English language literature related to Ayurveda and diabetes care, encompassing herbs, diet, yoga, and meditation as modalities that are accessible and acceptable to Western clinicians and patients. There is a considerable amount of data from both animal and human trials suggesting efficacy of Ayurvedic interventions in managing diabetes. However, the reported human trials generally fall short of contemporary methodological standards. More research is needed in the area of Ayurvedic treatment of diabetes, assessing both whole practice and individual modalities.
Lang, Lisa A; Teich, Sorin T
Systematic reviews analyze the data of published research in an effort to assemble the scientific evidence to help clinicians apply evidence-based information in decision making. The quality of systematic reviews varies greatly. The purpose of this study was to critically appraise the current systematic review process by evaluating systematic reviews that pertain to zirconia-based single crowns. The following PICO (patients, intervention, comparison, outcome) question was formulated: "In adults, how does the long-term prognosis of zirconia-based single crowns compare with conventional single crowns on natural teeth?" An electronic search was performed in PubMed and the Cochran Library for articles published in English between 1950 and October 2012. Additional manual searches were completed. To be included in the analysis, the study must have been a systematic review, published in an English-speaking peer-reviewed journal, and evaluated zirconia crowns on teeth. Two examiners qualitatively evaluated the publications with an Assessment of Multiple Systematic Reviews checklist and the Oxford Systematic Review Appraisal form. Three systematic reviews were identified that met the search criteria. Two studies met 5 of the 11 Assessment of Multiple Systematic Reviews criteria, whereas the third met only 1 criterion. The same 2 studies met 3 of the 5 Oxford Systematic Review Appraisal criteria and the third met only 2 criteria. Because of the variation in methodologies, systematic reviews should be interpreted cautiously. The Assessment of Multiple Systematic Reviews Checklist and the Oxford Systematic Review Appraisal Sheet are practical tools for appraising and determining the quality of systematic reviews. Copyright © 2014 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.
Udina, Marc; Foulon, Hubert; Valdés, Manuel; Bhattacharyya, Sagnik; Martín-Santos, Rocío
Dhat syndrome is a widely recognized clinical condition often seen on the Indian subcontinent that is characterized by a preoccupation with semen loss in urine and other symptoms such as fatigue or depressed mood. Although it has been considered to be a culture-bound syndrome, it may also be regarded as a distinct manifestation of depression or another medical illness. The purpose of this paper was to carry out a systematic review on Dhat syndrome. A review of the literature published up until February 2012 was conducted using the key words [Dhat syndrome] or [semen-loss anxiety] or [semen-loss syndrome]. We included only original studies. The majority of studies reported patients from the Indian subcontinent. There was a high degree of heterogeneity among the studies. Dhat was a common condition in young people from certain cultures and origins. Depressive and anxiety symptoms were common, including fatigue, sleepiness, and sexual dysfunction. Good clinical engagement, social support, and sexual education were useful in some cases. Given the high rate of comorbid depressive symptoms, antidepressant has been used. In an increasingly globalized world, clinicians must be able to properly diagnose and treat patients from other cultures, who may report symptoms that are influenced by their beliefs, culture, or place of origin. Dhat may be a common manifestation of a depressive or anxiety disorder in certain cultures. Further research is needed to improve our understanding of this condition, to clarify its nosologic status, and to offer appropriate treatment to affected individuals. Copyright © 2013 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.
Doudt, Alexander D; Kehoe, John E; Ignacio, Romeo C; Christman, Matthew S
Abdominoscrotal hydrocele (ASH) is an uncommon condition characterized by a fluid-filled mass with inguinoscrotal and abdominal components. Controversy exists regarding the best management. We conducted a systematic review of the literature with special interest in presentation, management and outcomes. A search was conducted of the MEDLINE/PubMed, Embase, Ovid, Web of Science and Scopus databases. Two authors independently extracted data and assessed the risk of bias in each study. We found 18 case series that met selection criteria, describing 116 patients with 146 hydroceles. Unilateral ASH was found in 59% of cases with almost even distribution between left and right-sided hydroceles. Ipsilateral undescended testicle, testicular dysmorphism, and contralateral pathology (inguinal hernia) often accompanied ASH. Management was always surgical. The most common approaches were inguinal (67.2%), combined laparoscopic + inguinal (11.2%), and scrotal (10.3%). Complications were poorly reported, but were generally minor. There were a decreased number of complications with the scrotal approach because of avoidance of a difficult inguinal dissection. ASH is a rare entity treated most commonly via an inguinal approach. However, consideration should be given to combining with an extraperitoneal or laparoscopic approach given coexisting pathology, or to the scrotal approach for reducing morbidity. Published by Elsevier Inc.
Stanko, Peter; Izakovicova Holla, Lydie
Diabetes mellitus is a metabolic disorder characterized by hyperglycemia. The abnormal glucose metabolism results from defects in insulin production or insulin action, or both. For decades, it was suspected that diabetes contributed to poorer oral health and the increased frequency of periodontitis. More recently it was found that periodontitis could adversely affect glycemic control in diabetics. This review focuses on the bidirectional relationship between diabetes mellitus and periodontitis. A review of the literature on periodontal disease in diabetes using the following key words: periodontitis/periodontal disease and diabetes mellitus, hyperglycemia/glycemic control. There is strong evidence for an association between diabetes mellitus and inflammatory periodontal disease. Diabetes mellitus increases the risk for and severity of periodontitis, and periodontal diseases can aggravate insulin resistance and affect glycemic control. Periodontal treatment improves glycemic control in type 2 diabetics; control of periodontal infection is not only important for oral health, it may also improve overall health.
Kristi W Kelley
Full Text Available Approximately 90% of diabetes cases in pregnant women are considered gestational diabetes mellitus (GDM. It is well known that uncontrolled glucose results in poor pregnancy outcomes in both the mother and fetus. Worldwide there are many guidelines with recommendations for appropriate management strategies for GDM once lifestyle modifications have been instituted and failed to achieve control. The efficacy and particularly the safety of other treatment modalities for GDM has been the source of much debate in recent years. Studies that have demonstrated the safety and efficacy of both glyburide and metformin in the management of patients with GDM will be reviewed. There is a lack of evidence with other oral and injectable non-insulin agents to control blood glucose in GDM. The role of insulin will be discussed, with emphasis on insulin analogs. Ideal patient characteristics for each treatment modality will be reviewed. In addition, recommendations for postpartum screening of patients will be described as well as recommendations for use of agents to manage subsequent type 2 diabetes in patients who are breastfeeding.
Manikas, Konstantinos; Hansen, Klaus Marius
. However, there exists no systematic overview of the research done on software ecosystems from a software engineering perspective. We performed a systematic literature review of software ecosystem research, analyzing 90 papers on the subject taken from a gross collection of 420. Our main conclusions...
Sahajal Dhooria; Ritesh Agarwal
Background & objectives: Amitraz is a member of formamidine family of pesticides. Poisoning from amitraz is underrecognized even in areas where it is widely available. It is frequently misdiagnosed as organophosphate poisoning. This systematic review provides information on the epidemiology, toxicokinetics, mechanisms of toxicity, clinical features, diagnosis and management of amitraz poisoning. Methods: Medline and Embase databases were searched systematically (since inception to January...
Comparing the Clinical Outcomes between Drug Eluting Stents and Bare Metal Stents in Patients with Insulin-Treated Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis of 10 Randomized Controlled Trials.
Bundhun, Pravesh Kumar; Bhurtu, Akash; Soogund, Mohammad Zafooruddin Sani; Long, Man-Yun
Several studies have shown Drug Eluting Stents (DES) to be better compared to Bare Metal Stents (BMS) in patients with type 2 Diabetes Mellitus (T2DM). Since, the adverse clinical outcomes in patients with Insulin-Treated Type 2 Diabetes Mellitus (ITDM) implanted with DES and BMS have not been previously studied, we aim to compare the clinical outcomes in similar patients with cardiovascular diseases, treated with DES and BMS. Randomized Controlled Trials (RCTs) comparing patients treated with DES and BMS were searched from PubMed and EMBASE databases. Outcome data for the patients with ITDM were carefully extracted. Major Adverse Cardiac Events (MACEs), mortality, Target Vessel Revascularization (TVR), Target Lesion Revascularization (TLR), Myocardial Infarction (MI) and Stent Thrombosis (ST) were considered as the clinical endpoints for this analysis. Odds ratios (OR) with 95% confidence intervals (CIs) were calculated and the pooled analyses were performed with RevMan 5.3 software. Ten RCTs consisting of 830 patients with ITDM (477 patients in the DES group and 353 patients in the BMS group) from a total number of 9,141 patients were included in this analysis. During a follow-up period from one month to one year, MACEs were not increased with the use of DES in these patients with ITDM. At 9 months, MACEs were significantly lower in the DES group with OR: 0.40, 95% CI: 0.23-0.72; P = 0.002 with no increase in mortality. TVR and TLR also favored the DES group with OR: 0.44, 95% CI: 0.22-0.88, P = 0.02 and OR: 0.28, 95% CI: 0.14-0.53; P = 0.0001 respectively at 9 months, and OR: 0.46, 95% CI: 0.23-0.94, P = 0.03 and OR: 0.28, 95% CI: 0.14-0.55; P = 0.0003 respectively at one year. Results for MI, and ST were not statistically significant. Compared to BMS, DES were associated with a significantly lower rate of repeated revascularization, without any increase in MACEs or mortality in these patients with ITDM during a follow up period of one year. However, due to the
Comparing the Clinical Outcomes between Drug Eluting Stents and Bare Metal Stents in Patients with Insulin-Treated Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis of 10 Randomized Controlled Trials.
Pravesh Kumar Bundhun
Full Text Available Several studies have shown Drug Eluting Stents (DES to be better compared to Bare Metal Stents (BMS in patients with type 2 Diabetes Mellitus (T2DM. Since, the adverse clinical outcomes in patients with Insulin-Treated Type 2 Diabetes Mellitus (ITDM implanted with DES and BMS have not been previously studied, we aim to compare the clinical outcomes in similar patients with cardiovascular diseases, treated with DES and BMS.Randomized Controlled Trials (RCTs comparing patients treated with DES and BMS were searched from PubMed and EMBASE databases. Outcome data for the patients with ITDM were carefully extracted. Major Adverse Cardiac Events (MACEs, mortality, Target Vessel Revascularization (TVR, Target Lesion Revascularization (TLR, Myocardial Infarction (MI and Stent Thrombosis (ST were considered as the clinical endpoints for this analysis. Odds ratios (OR with 95% confidence intervals (CIs were calculated and the pooled analyses were performed with RevMan 5.3 software.Ten RCTs consisting of 830 patients with ITDM (477 patients in the DES group and 353 patients in the BMS group from a total number of 9,141 patients were included in this analysis. During a follow-up period from one month to one year, MACEs were not increased with the use of DES in these patients with ITDM. At 9 months, MACEs were significantly lower in the DES group with OR: 0.40, 95% CI: 0.23-0.72; P = 0.002 with no increase in mortality. TVR and TLR also favored the DES group with OR: 0.44, 95% CI: 0.22-0.88, P = 0.02 and OR: 0.28, 95% CI: 0.14-0.53; P = 0.0001 respectively at 9 months, and OR: 0.46, 95% CI: 0.23-0.94, P = 0.03 and OR: 0.28, 95% CI: 0.14-0.55; P = 0.0003 respectively at one year. Results for MI, and ST were not statistically significant.Compared to BMS, DES were associated with a significantly lower rate of repeated revascularization, without any increase in MACEs or mortality in these patients with ITDM during a follow up period of one year. However, due to
EPA hosted an event to examine the systematic review process for development and applications of methods for different types of evidence (epidemiology, animal toxicology, and mechanistic). The presentations are also available.
McQuay, H. J; Kalso, Eija; Moore, R. Andrew
"Presents invited papers from the 6th IASP Research Symposium, Systematic Reviews and Meta-Analyses in Pain, held in Spain in September 2006, organized by the International Collaboration on Evidence...
van den Berg, Maartje M.; Benninga, M. A.; Di Lorenzo, C.
OBJECTIVE: A systematic review of the published literature was performed to assess the prevalence, incidence, natural history, and comorbid conditions of functional constipation in children. METHODS: Articles were identified through electronic searches in Medline, Embase, Cochrane Central Library,
Leeflang, Mariska M G; Deeks, Jonathan J; Gatsonis, Constantine
More and more systematic reviews of diagnostic test accuracy studies are being published, but they can be methodologically challenging. In this paper, the authors present some of the recent developments in the methodology for conducting systematic reviews of diagnostic test accuracy studies......-operating characteristic or the bivariate model for the data analysis. Challenges that remain are the poor reporting of original diagnostic test accuracy studies and difficulties with the interpretation of the results of diagnostic test accuracy research....
Thompson, Jenna; Davis, Jacqueline; Mazerolle, Lorraine
The wide variety of readily available electronic media grants anyone the freedom to retrieve published references from almost any area of research around the world. Despite this privilege, keeping up with primary research evidence is almost impossible because of the increase in professional publishing across disciplines. Systematic reviews are a…
Kc, Kamana; Shakya, Sumisti; Zhang, Hua
Fetal macrosomia, defined as a birth weight ≥ 4,000 g, may affect 12% of newborns of normal women and 15-45% of newborns of women with gestational diabetes mellitus (GDM). The increased risk of macrosomia in GDM is mainly due to the increased insulin resistance of the mother. In GDM, a higher amount of blood glucose passes through the placenta into the fetal circulation. As a result, extra glucose in the fetus is stored as body fat causing macrosomia, which is also called 'large for gestational age'. This paper reviews studies that explored the impact of GDM and fetal macrosomia as well as macrosomia-related complications on birth outcomes and offers an evaluation of maternal and fetal health. Fetal macrosomia is a common adverse infant outcome of GDM if unrecognized and untreated in time. For the infant, macrosomia increases the risk of shoulder dystocia, clavicle fractures and brachial plexus injury and increases the rate of admissions to the neonatal intensive care unit. For the mother, the risks associated with macrosomia are cesarean delivery, postpartum hemorrhage and vaginal lacerations. Infants of women with GDM are at an increased risk of becoming overweight or obese at a young age (during adolescence) and are more likely to develop type II diabetes later in life. Besides, the findings of several studies that epigenetic alterations of different genes of the fetus of a GDM mother in utero could result in the transgenerational transmission of GDM and type II diabetes are of concern.
Hasan, Haroon; Muhammed, Taaha; Yu, Jennifer; Taguchi, Kelsi; Samargandi, Osama A; Howard, A Fuchsia; Lo, Andrea C; Olson, Robert; Goddard, Karen
The objective of our study was to evaluate the methodological quality of systematic reviews and meta-analyses in Radiation Oncology. A systematic literature search was conducted for all eligible systematic reviews and meta-analyses in Radiation Oncology from 1966 to 2015. Methodological characteristics were abstracted from all works that satisfied the inclusion criteria and quality was assessed using the critical appraisal tool, AMSTAR. Regression analyses were performed to determine factors associated with a higher score of quality. Following exclusion based on a priori criteria, 410 studies (157 systematic reviews and 253 meta-analyses) satisfied the inclusion criteria. Meta-analyses were found to be of fair to good quality while systematic reviews were found to be of less than fair quality. Factors associated with higher scores of quality in the multivariable analysis were including primary studies consisting of randomized control trials, performing a meta-analysis, and applying a recommended guideline related to establishing a systematic review protocol and/or reporting. Systematic reviews and meta-analyses may introduce a high risk of bias if applied to inform decision-making based on AMSTAR. We recommend that decision-makers in Radiation Oncology scrutinize the methodological quality of systematic reviews and meta-analyses prior to assessing their utility to inform evidence-based medicine and researchers adhere to methodological standards outlined in validated guidelines when embarking on a systematic review. Copyright © 2017 Elsevier Ltd. All rights reserved.
Bundhun, Pravesh Kumar; Pursun, Manish; Teeluck, Abhishek Rishikesh; Long, Man-Yun
Controversies still exist with the use of Everolimus-Eluting Stents (EES) compared to other Drug-Eluting Stents (DES) in patients with Type 2 Diabetes Mellitus (T2DM). Therefore, in order to solve this issue, we aim to compare the 1-year adverse clinical outcomes between EES and non-EE DES with a larger number of patients with T2DM.Medline, EMBASE, PubMed databases, as well as the Cochrane library were searched for randomized controlled trials (RCTs) and observational studies (OS) comparing EES and non-EE DES in patients with T2DM. One-year adverse outcomes were considered as the clinical endpoints in this study. Odd ratios (OR) with 95% confidence interval (CI) were used to express the pooled effect on discontinuous variables and the pooled analyses were performed with RevMan 5.3.Ten studies consisting of a total of 11,981 patients with T2DM (6800 patients in the EES group and 5181 in the non-EE DES group) were included in this meta-analysis. EES were associated with a significantly lower major adverse cardiac events (MACEs) with OR: 0.83, 95% CI: 0.70-0.98, P = 0.03. Revascularization including target vessel revascularization (TVR) and target lesion revascularization (TLR) were also significantly lower in the EES group with OR: 0.62, 95% CI: 0.40-0.94, P = 0.03 and OR: 0.74, 95% CI: 0.57-0.95, P = 0.02, respectively. Also, a significantly lower rate of stent thrombosis with OR: 0.63, 95% CI: 0.46-0.86, P = 0.003 was observed in the EES group. However, a similar mortality rate was reported between the EES and non-EE DES groups.During this 1-year follow-up period, EES were associated with significantly better clinical outcomes compared to non-EE DES in patients suffering from T2DM. However, further research comparing EES with non-EE DES in insulin-treated and noninsulin-treated patients with T2DM are recommended.
Peltopuro, Minna; Ahonen, Timo; Kaartinen, Jukka; Seppälä, Heikki; Närhi, Vesa
The literature related to people with borderline intellectual functioning (BIF) was systematically reviewed in order to summarize the present knowledge. Database searches yielded 1,726 citations, and 49 studies were included in the review. People with BIF face a variety of hardships in life, including neurocognitive, social, and mental health…
Systematic reviews are used to appraise relevant research and synthesize existing evidence. The health sciences field uses them widely to inform studies and evaluate research findings' relevance to public health policy. These reviews follow a rigorous methodology, developed by the international research network, the ...
Cook, Carly N; Possingham, Hugh P; Fuller, Richard A
Systematic reviews comprehensively summarize evidence about the effectiveness of conservation interventions. We investigated the contribution to management decisions made by this growing body of literature. We identified 43 systematic reviews of conservation evidence, 23 of which drew some concrete conclusions relevant to management. Most reviews addressed conservation interventions relevant to policy decisions; only 35% considered practical on-the-ground management interventions. The majority of reviews covered only a small fraction of the geographic and taxonomic breadth they aimed to address (median = 13% of relevant countries and 16% of relevant taxa). The likelihood that reviews contained at least some implications for management tended to increase as geographic coverage increased and to decline as taxonomic breadth increased. These results suggest the breadth of a systematic review requires careful consideration. Reviews identified a mean of 312 relevant primary studies but excluded 88% of these because of deficiencies in design or a failure to meet other inclusion criteria. Reviews summarized on average 284 data sets and 112 years of research activity, yet the likelihood that their results had at least some implications for management did not increase as the amount of primary research summarized increased. In some cases, conclusions were elusive despite the inclusion of hundreds of data sets and years of cumulative research activity. Systematic reviews are an important part of the conservation decision making tool kit, although we believe the benefits of systematic reviews could be significantly enhanced by increasing the number of reviews focused on questions of direct relevance to on-the-ground managers; defining a more focused geographic and taxonomic breadth that better reflects available data; including a broader range of evidence types; and appraising the cost-effectiveness of interventions. © 2013 The Authors. Conservation Biology published by Wiley
Boluyt, Nicole; Tjosvold, Lisa; Lefebvre, Carol; Klassen, Terry P.; Offringa, Martin
OBJECTIVE: To determine the sensitivity and precision of existing search strategies for retrieving child health systematic reviews in MEDLINE using PubMed. DESIGN: Filter (diagnostic) accuracy study. We identified existing search strategies for systematic reviews, combined them with a filter that
Larson, Bradley P; Chung, Kevin C
The usefulness of peer review has been expressed as a method to improve the quality of published work. However, there has been a lack of systematic reviews to date to highlight the essential themes of the peer-review process. We performed a search of the English language literature published prior to October 2011 using PubMed to identify articles regarding peer review. Inclusion and exclusion criteria were developed a priori. Data were extracted and then analyzed for the prevalence of peer-review themes contained within the literature. Of the 941 articles found during our original literature search, 37 were selected for review. The majority were commentary/editorial articles. The themes in our search included the structure and process of the peer-review system, the criteria for papers, ethics, and the different forms of the peer-review process. The criteria for submission will vary, but our systematic review provides a comprehensive overview of what reviewers expect from authors. Our systematic review also highlighted ethical considerations for both authors and reviewers during the peer-review process. Although the topic of peer review is expansive and its process may vary from journal to journal, the understanding of the themes outlined in this paper will help authors recognize how to write a more successful paper. Also, more research must be carried out to establish the efficacy of the different styles of peer review, and it would be presumptuous to draw conclusions until further research is established.
Mayo-Wilson, Evan; Ng, Sueko Matsumura; Chuck, Roy S; Li, Tianjing
Systematic reviews should inform American Academy of Ophthalmology (AAO) Preferred Practice Pattern® (PPP) guidelines. The quality of systematic reviews related to the forthcoming Preferred Practice Pattern® guideline (PPP) Refractive Errors & Refractive Surgery is unknown. We sought to identify reliable systematic reviews to assist the AAO Refractive Errors & Refractive Surgery PPP. Systematic reviews were eligible if they evaluated the effectiveness or safety of interventions included in the 2012 PPP Refractive Errors & Refractive Surgery. To identify potentially eligible systematic reviews, we searched the Cochrane Eyes and Vision United States Satellite database of systematic reviews. Two authors identified eligible reviews and abstracted information about the characteristics and quality of the reviews independently using the Systematic Review Data Repository. We classified systematic reviews as "reliable" when they (1) defined criteria for the selection of studies, (2) conducted comprehensive literature searches for eligible studies, (3) assessed the methodological quality (risk of bias) of the included studies, (4) used appropriate methods for meta-analyses (which we assessed only when meta-analyses were reported), (5) presented conclusions that were supported by the evidence provided in the review. We identified 124 systematic reviews related to refractive error; 39 met our eligibility criteria, of which we classified 11 to be reliable. Systematic reviews classified as unreliable did not define the criteria for selecting studies (5; 13%), did not assess methodological rigor (10; 26%), did not conduct comprehensive searches (17; 44%), or used inappropriate quantitative methods (3; 8%). The 11 reliable reviews were published between 2002 and 2016. They included 0 to 23 studies (median = 9) and analyzed 0 to 4696 participants (median = 666). Seven reliable reviews (64%) assessed surgical interventions. Most systematic reviews of interventions for
Treating a pressure ulcer takes lots of nursing personnel's time and is costly both in terms of human suffering and use of resources. The purpose of this study was to collect and assamble research data about the prevention of pressure ulcers. The study was done as a systematic literature review. With the results, the knowledge and know-how of pressure ulcers' prevention can be increased and updated. The results can be utilised by everyone working with pressure ulcers. The systematic ...
Full Text Available Abstract Background Policy makers and others often require synthesis of knowledge in an area within six months or less. Traditional systematic reviews typically take at least 12 months to conduct. Rapid reviews streamline traditional systematic review methods in order to synthesize evidence within a shortened timeframe. There is great variation in the process of conducting rapid reviews. This review sought to examine methods used for rapid reviews, as well as implications of methodological streamlining in terms of rigour, bias, and results. Methods A comprehensive search strategy--including five electronic databases, grey literature, hand searching of relevant journals, and contacting key informants--was undertaken. All titles and abstracts (n = 1,989 were reviewed independently by two reviewers. Relevance criteria included articles published between 1995 and 2009 about conducting rapid reviews or addressing comparisons of rapid reviews versus traditional reviews. Full articles were retrieved for any titles deemed relevant by either reviewer (n = 70. Data were extracted from all relevant methodological articles (n = 45 and from exemplars of rapid review methods (n = 25. Results Rapid reviews varied from three weeks to six months; various methods for speeding up the process were employed. Some limited searching by years, databases, language, and sources beyond electronic searches. Several employed one reviewer for title and abstract reviewing, full text review, methodological quality assessment, and/or data extraction phases. Within rapid review studies, accelerating the data extraction process may lead to missing some relevant information. Biases may be introduced due to shortened timeframes for literature searching, article retrieval, and appraisal. Conclusions This review examined the continuum between diverse rapid review methods and traditional systematic reviews. It also examines potential implications of streamlined review methods. More of
Khazrai, Y M; Defeudis, G; Pozzilli, P
Type 2 diabetes mellitus is one of the fastest growing diseases; the number of people affected by diabetes will soon reach 552 million worldwide, with associated increases in complications and healthcare expenditure. Lifestyle and medical nutrition therapy are considered the keystones of type 2 diabetes prevention and treatment, but there is no definite consensus on how to treat this disease with these therapies. The American Diabetes Association has made several recommendations regarding the medical nutrition therapy of diabetes; these emphasize the importance of minimizing macrovascular and microvascular complications in people with diabetes. Four types of diets were reviewed for their effects on diabetes: the Mediterranean diet, a low-carbohydrate/high-protein diet, a vegan diet and a vegetarian diet. Each of the four types of diet has been shown to improve metabolic conditions, but the degree of improvement varies from patient to patient. Therefore, it is necessary to evaluate a patient's pathophysiological characteristics in order to determine the diet that will achieve metabolic improvement in each individual. Many dietary regimens are available for patients with type 2 diabetes to choose from, according to personal taste and cultural tradition. It is important to provide a tailor-made diet wherever possible in order to maximize the efficacy of the diet on reducing diabetes symptoms and to encourage patient adherence. Additional randomized studies, both short term (to analyse physiological responses) and long term, could help reduce the multitude of diets currently recommended and focus on a shorter list of useful regimens. Copyright © 2013 John Wiley & Sons, Ltd.
Full Text Available Objective: Polycystic ovarian syndrome (PCOS is a common condition amongst women of reproductive age that can result in increased mortality and morbidity in women due to increased risk of diabetes mellitus and cardiovascular diseases. The aim of this systematic review was to assess the effectiveness of common treatments of PCOS on the predictors of diabetes in non-diabetic PCOS women.Materials and methods: An extensive search was performed on the publications in three medical databases including pubmed, scopus and google scholar from 1995 till 2017. The articles were screened based on their quality and included in this systematic review. A total of 25 articles including cohort, randomised controlled trial, review and meta-analysis were included in the review.Results: This systematic review revealed that the effect of lifestyle modification might be low in PCOS subjects due to high drop-out rate while the benefits of this intervention including weight and fat reduction may not be achieved by medical interventions. Metformin treatment may result in improvements in insulin sensitivity while its weight reduction effect is still not documented in PCOS subjects. Thiazolidendiones might be tolerated by the PCOS subjects and may result in similar effects as metformin but this effect should be documented by further studies.Conclusion: Combination of lifestyle modification with metformin or thiazolidinedions might improve the outcome of the prevention strategies. On the other hand this study revealed a different response to treatments in non-obese compared with obese PCOS subjects.
Spencer, Angela J; Eldredge, Jonathan D
What roles do librarians and information professionals play in conducting systematic reviews? Librarians are increasingly called upon to be involved in systematic reviews, but no study has considered all the roles librarians can perform. This inventory of existing and emerging roles aids in defining librarians' systematic reviews services. For this scoping review, the authors conducted controlled vocabulary and text-word searches in the PubMed; Library, Information Science & Technology Abstracts; and CINAHL databases. We separately searched for articles published in the Journal of the European Association for Health Information and Libraries, Evidence Based Library and Information Practice, the Journal of the Canadian Heath Libraries Association, and Hypothesis. We also text-word searched Medical Library Association annual meeting poster and paper abstracts. We identified 18 different roles filled by librarians and other information professionals in conducting systematic reviews from 310 different articles, book chapters, and presented papers and posters. Some roles were well known such as searching, source selection, and teaching. Other less documented roles included planning, question formulation, and peer review. We summarize these different roles and provide an accompanying bibliography of references for in-depth descriptions of these roles. Librarians play central roles in systematic review teams, including roles that go beyond searching. This scoping review should encourage librarians who are fulfilling roles that are not captured here to document their roles in journal articles and poster and paper presentations.
Wong, Vincent Wing-Ming
Gestational diabetes mellitus (GDM) is a condition that affects the wellbeing of mother and fetus. Women with GDM are at risk of type 2 diabetes mellitus in the future, while fetal exposure to hyperglycaemia in-utero may affect their glycometabolic profile later in life. Appropriate screening and management of this problem is important in ensuring good pregnancy outcomes. In this review, the clinical implications, the various ways to screen and diagnose GDM, and management strategies d...
Abstract Background Hundreds of studies of maternity care interventions have been published, too many for most people involved in providing maternity care to identify and consider when making decisions. It became apparent that systematic reviews of individual studies were required to appraise, summarise and bring together existing studies in a single place. However, decision makers are increasingly faced by a plethora of such reviews and these are likely to be of variable quality and scope, with more than one review of important topics. Systematic reviews (or overviews) of reviews are a logical and appropriate next step, allowing the findings of separate reviews to be compared and contrasted, providing clinical decision makers with the evidence they need. Methods The methods used to identify and appraise published and unpublished reviews systematically, drawing on our experiences and good practice in the conduct and reporting of systematic reviews are described. The process of identifying and appraising all published reviews allows researchers to describe the quality of this evidence base, summarise and compare the review\\'s conclusions and discuss the strength of these conclusions. Results Methodological challenges and possible solutions are described within the context of (i) sources, (ii) study selection, (iii) quality assessment (i.e. the extent of searching undertaken for the reviews, description of study selection and inclusion criteria, comparability of included studies, assessment of publication bias and assessment of heterogeneity), (iv) presentation of results, and (v) implications for practice and research. Conclusion Conducting a systematic review of reviews highlights the usefulness of bringing together a summary of reviews in one place, where there is more than one review on an important topic. The methods described here should help clinicians to review and appraise published reviews systematically, and aid evidence-based clinical decision-making.
Murrah, V A
Oral research concerning diabetes mellitus has revealed a number of clinical implications. These include, among others, the need for more intense management of the diabetic patient with periodontal disease because tissue destruction may be accelerated, the need for rapid control of oral infection in these patients in order to prevent exacerbation of the existing metabolic imbalance, and the desirability of performing a screening for diabetes mellitus on all patients exhibiting asymptomatic parotid enlargement. Despite the explosion of knowledge concerning diabetes mellitus that has occurred since the discovery of insulin, its definitive etiology continues to elude the scientific community and its treatment remains in the realm of clinical management rather than in that of prevention and cure. In the past, research on diabetes has focused on the role of insulin in seeking the fundamental etiology of diabetes and its complications. With the progression of research, it has become apparent that the initiation and progression of the disease probably involve the interplay of a multiplicity of factors. Hereditary and immunologic factors, as suggested earlier, appear to be operated on by environmental factors, subsequently altering the body's metabolic milieu with widespread primary and secondary effects. Fertile areas for future oral research in diabetes mellitus will include, therefore, genetics, immunology, enzymology, and basement membrane pathology. On the cellular and molecular levels, particularly, the oral cavity and associated structures comprise a somewhat under-investigated area in diabetes mellitus research and, thus, hold great promise for increasing our knowledge of this complex disease.
Andersen, C.L.; Hasselbalch, H.C.; Kristensen, T.K.
of the cell has been described and its fascinating biology has only recently been depicted. We here give a review of systemic mastocytosis in regards to cell biology, diagnostic approaches and clinical practice. METHODS: A search was made in PubMed in August 2011 entering the keywords: mastocytosis, (systemic...
Phuong, Linny Kimly; Bonetto, Caterina; Buttery, Jim; Pernus, Yolanda Brauchli; Chandler, Rebecca; Felicetti, Patrizia; Goldenthal, Karen L; Kucuku, Merita; Monaco, Giuseppe; Pahud, Barbara; Shulman, Stanford T; Top, Karina A; Trotta, Francesco; Ulloa-Gutierrez, Rolando; Varricchio, Frederick; de Ferranti, Sarah; Newburger, Jane W; Dahdah, Nagib; Singh, Surjit; Bonhoeffer, Jan; Burgner, David
Kawasaki disease is a complex and potentially serious condition. It has been observed in temporal relation to immunisation. We conducted a systematic literature review using various reference sources to review the available evidence published in the literature. We identified twenty seven publications reporting a temporal association between immunisation and Kawasaki disease. We present a systematic review of data drawn from randomised controlled trials, observational studies, case series and reports, and reviews. Overall there was a lack of standardised case definitions, making data interpretation and comparability challenging. Although a temporal relationship between immunisation and Kawasaki disease is suggested, evidence for an increased risk or a causal association is lacking. Implementation of a standardised Kawasaki disease case definition would increase confidence in the findings and add value to future studies of pre- or post-licensure vaccine safety studies. Copyright © 2016. Published by Elsevier Ltd.
Dreier, Julie Werenberg; Andersen, Anne-Marie Nybo; Berg-Beckhoff, Gabriele
was to systematically review evidence from epidemiologic studies on adverse health outcomes of the offspring in relation to exposure to maternal fever during pregnancy. METHODS: Systematic searches in PubMed, Web of Science, and the Cochrane Library were performed by using Medical Subject Headings, Boolean operators......BACKGROUND AND OBJECTIVE: Fever during pregnancy has been suspected to harm the developing fetus. However, until now, no systematic analysis of the available evidence has been undertaken to assess the impact of maternal fever on health outcomes in the child. The goal of this study......, and truncation, and references of references were reviewed. Cohort and case-control studies addressing health outcomes of prenatal fever exposure in humans were eligible for inclusion. Studies with no direct reference to fever, studies in selected populations (eg, preterm births), and studies published before...
Mònica Bulló; Patricia López-Uriarte; Patricia Casas-Agustench; Nancy Babio; Jordi Salas-Salvadó
Nuts and oxidation: a systematic review In recent years, nuts have received special attention because of their potential role in preventing cardiovascular disease. Because nuts are very rich in total fat that can potentially be oxidized and their skins contain several antioxidants, studies have been conducted to evaluate the potential effect of nut consumption on oxidative stress. This review evaluates the in vitro and in vivo studies conducted in animals or humans to analyze the effect of...
Kamhieh, Y; Fox, H
The role of tranexamic acid in the management of epistaxis remains unclear. There is uncertainty about its safety and about the contraindications for its use. We performed a systematic review of the use of systemic and topical tranexamic acid in epistaxis and a comparative review of its use in other specialties. This review assesses and summarises the existing evidence for the efficacy and safety of tranexamic acid in the management of epistaxis. Systematic review. MEDLINE and EMBASE were searched for 'epistaxis' and equivalent MESH terms, combined with the Boolean operator 'OR' and 'tranexamic acid'. The Cochrane library and society guidelines were reviewed for evidence regarding the use of tranexamic acid in other specialties. All five relevant RCTs were included in the review and were evaluated according to the recommendations of the Cochrane Handbook for Systematic Reviews. Three RCTS pertained to spontaneous epistaxis; of these, one trial found no benefit of oral tranexamic acid in acute epistaxis, one trial found no significant benefit of topical tranexamic acid, but the largest of the trials showed significant benefit of topical tranexamic acid in acute epistaxis management. Two RCTs examined oral tranexamic acid for prophylaxis of recurrent epistaxes in patients with hereditary haemorrhagic telangiectasia; both showed significant reduction in severity and frequency. Tranexamic acid, as a WHO 'essential medicine', is a powerful, readily available tool, the use of which in epistaxis has been limited by uncertainty over its efficacy and its safety profile. This systematic review summarises the existing evidence and extrapolates from the wealth of data for other specialties to address the clinical question - does TXA have a role in epistaxis management? © 2016 John Wiley & Sons Ltd.
Følstad, Asbjørn; Kvale, Knut
Purpose – Customer journeys has become an increasingly important topic in service management and design. The study reviews customer journey terminology and approaches within the research literature prior to 2013, mainly from the fields of design, management, and marketing. Design/methodology/approach - The study was conducted as a systematic literature review. Searches in Google Scholar, Scopus, Web of Knowledge, ACM Digital Library, and ScienceDirect identified 45 papers for analysis. The pa...
French, David P; Cameron, Elaine; Benton, Jack S; Deaton, Christi; Harvie, Michelle
The assessment and communication of disease risk that is personalised to the individual is widespread in healthcare contexts. Despite several systematic reviews of RCTs, it is unclear under what circumstances that personalised risk estimates promotes change in four key health-related behaviours: smoking, physical activity, diet and alcohol consumption. The present research aims to systematically identify, evaluate and synthesise the findings of existing systematic reviews. This systematic review of systematic reviews followed published guidance. A search of four databases and two-stage screening procedure with good reliability identified nine eligible systematic reviews. The nine reviews each included between three and 15 primary studies, containing 36 unique studies. Methods of personalising risk feedback included imaging/visual feedback, genetic testing, and numerical estimation from risk algorithms. The reviews were generally high quality. For a broad range of methods of estimating and communicating risk, the reviews found no evidence that risk information had strong or consistent effects on health-related behaviours. The most promising effects came from interventions using visual or imaging techniques and with smoking cessation and dietary behaviour as outcomes, but with inconsistent results. Few interventions explicitly used theory, few targeted self-efficacy or response efficacy, and a limited range of Behaviour Change Techniques were used. Presenting risk information on its own, even when highly personalised, does not produce strong effects on health-related behaviours or changes which are sustained. Future research in this area should build on the existing knowledge base about increasing the effects of risk communication on behaviour.
Since malnutrition and undernutrition with cassava consumption and cyanide intoxication have been thought to be the major cause of diabetes in tropical countries, WHO Expert Committee on Diabetes suggested, in its report, that the relationship between Malnutrition-Modulated Diabetes Mellitus (MMDM) and high cassava ...
Background: The incidence of diabetes mellitus (DM) is rapidly on the increase worldwide and is gradually becoming a major public health problem for developing nations. Diabetes in all its forms is one of the main cardiovascular risk factors. Cardiovascular complications are a leading cause of death in diabetic patients ...
Azar, Farbod Ebadifard; Azami-Aghdash, Saber; Pournaghi-Azar, Fatemeh; Mazdaki, Alireza; Rezapour, Aziz; Ebrahimi, Parvin; Yousefzadeh, Negar
Due to extensive literature in the field of lung cancer and their heterogeneous results, the aim of this study was to systematically review of systematic reviews studies which reviewed the cost-effectiveness of various lung cancer screening and treatment methods. In this systematic review of systematic reviews study, required data were collected searching the following key words which selected from Mesh: "lung cancer", "lung oncology", "lung Carcinoma", "lung neoplasm", "lung tumors", "cost- effectiveness", "systematic review" and "Meta-analysis". The following databases were searched: PubMed, Cochrane Library electronic databases, Google Scholar, and Scopus. Two reviewers (RA and A-AS) evaluated the articles according to the checklist of "assessment of multiple systematic reviews" (AMSTAR) tool. Overall, information of 110 papers was discussed in eight systematic reviews. Authors focused on cost-effectiveness of lung cancer treatments in five systematic reviews. Targeted therapy options (bevacizumab, Erlotinib and Crizotinib) show an acceptable cost-effectiveness. Results of three studies failed to show cost-effectiveness of screening methods. None of the studies had used the meta-analysis method. The Quality of Health Economic Studies (QHES) tool and Drummond checklist were mostly used in assessing the quality of articles. Most perspective was related to the Payer (64 times) and the lowest was related to Social (11times). Most cases referred to Incremental analysis (82%) and also the lowest point of referral was related to Discounting (in 49% of the cases). The average quality score of included studies was calculated 9.2% from 11. Targeted therapy can be an option for the treatment of lung cancer. Evaluation of the cost-effectiveness of computerized tomographic colonography (CTC) in lung cancer screening is recommended. The perspective of the community should be more taken into consideration in studies of cost-effectiveness. Paying more attention to the topic of
Karthikeyan, I.; Desai, Shrikar R.; Singh, Rika
Background: Short implants are manufactured for use in atrophic regions of the jaws. Although many studies report on short implants as ≤10 mm length with considerable success, the literature regarding survival rate of ≤7 mm is sparse. Purpose: The purpose of this study was to systematically evaluate the publications concerning short dental implants defined as an implant with a length of ≤7 mm placed in the maxilla or in the mandible. Materials and Methods: A Medline and manual search was conducted to identify studies concerning short dental implants of length ≤7 mm published between 1991 and 2011. The articles included in this study report data on implant length ≤7 mm, such as demographic variables, implant type, location in jaws, observation time, prostheses and complications. Results: The 28 included studies represent one randomized controlled trial, 12 prospective studies and 10 retrospective studies. The survival rate of short implant was found to be increased from 80% to 90% gradually, with recent articles showing 100%. Conclusion: When severe atrophy of jaws was encountered, short and wide implants can be placed successfully. PMID:23162320
Roda, G; Narula, N; Pinotti, R
BACKGROUND: Disease extent in ulcerative colitis is one of the major factors determining prognosis over the long-term. Disease extent is dynamic and a proportion of patients presenting with limited disease progress to more extensive forms of disease over time. AIM: To perform a systematic review ...
Robert I. Radics; Ronalds Gonzalez; Edward M. (Ted) Bilek; Stephen S. Kelley
This literature review aims to provide a systematic analysis of studies on the financial aspects of producing torrefied biomass and torrefied pellets. There are substantial differences in the specific technologies, operating conditions, scale of the demonstration, and properties of biomass feedstock. There is a lack of reports that consider the entire supply chain,...
Hoogeveen, Eelke J.; Jansma, Johan; Ren, Yijin
INTRODUCTION: Corticotomy and dental distraction have been proposed as effective and safe methods to shorten orthodontic treatment duration in adolescent and adult patients. A systematic review was performed to evaluate the evidence supporting these claims. METHODS: PubMed, Embase, and Cochrane
We systematically reviewed the available literature and meta-analyzed the data which was specialized in Down syndrome (DS) diagnosis with proteomic techniques. Pubmed, EBSCOhost and ScienceDirect searches for relevant articles published from inception until July 2010 were obtained and ten articles were selected.
Kimer, N; Krag, A; Møller, Søren
BACKGROUND: Rifaximin is recommended for prevention of hepatic encephalopathy (HE). The effects of rifaximin on overt and minimal HE are debated. AIM: To perform a systematic review and meta-analysis of randomised controlled trials (RCTs) on rifaximin for HE. METHODS: We performed electronic...
Staniford, Leanne J.; Breckon, Jeff D.; Copeland, Robert J.
Childhood obesity trends have increased dramatically over the past three decade's. The purpose of this quantitative systematic review is to provide an update of the evidence, illustrating the efficacy of childhood obesity treatment, considering whether treatment fidelity has been measured and/or reported and whether this related to the treatment…
Dhami, S.; Panesar, S. S.; Roberts, G.; Muraro, A.; Worm, M.; Bilo, M. B.; Cardona, V.; Dubois, A. E. J.; DunnGalvin, A.; Eigenmann, P.; Fernandez-Rivas, M.; Halken, S.; Lack, G.; Niggemann, B.; Rueff, F.; Santos, A. F.; Vlieg-Boerstra, B.; Zolkipli, Z. Q.; Sheikh, A.
To establish the effectiveness of interventions for the acute and long-term management of anaphylaxis, seven databases were searched for systematic reviews, randomized controlled trials, quasi-randomized controlled trials, controlled clinical trials, controlled before-after studies and interrupted
Anthony I. Cognato
The systematic history of the southern pine beetle, Dendroctonus frontalis Zimmermann, is reviewed. Morphological, biological, karyological, and molecular data clearly define and diagnose the species limits of D. frontalis. More complete phylogenetic analysis and characterization of population genetic variation will further clarify the evolutionary history of the D....
Vroomen, PCAJ; de Krom, MCTFM; Slofstra, PD; Knottnerus, JA
Most patients with sciatica (often caused by disc herniations) are managed conservatively at first. The natural course seems to be favorable. The additional value of many conservative therapies remains controversial. Because a systematic review of the conservative treatment of sciatica is lacking,
Tumours rarely metastasise to the pancreas. While surgical resection of such metastases is believed to confer a survival benefit, there is limited data to support such management. We present a systematic review of case series of pancreatic metastasectomy and analysis of survival outcomes.
... 10 Energy 4 2010-01-01 2010-01-01 false Systematic review for declassification. 1045.43 Section... Systematic review for declassification. (a) The Secretary shall ensure that RD documents, and the DoD shall... Classification (and with the DoD for FRD) to ensure the systematic review of RD and FRD documents. (c) Review of...
Liu, Lizhou; Skinner, Margot; McDonough, Suzanne; Mabire, Leon; Baxter, George David
Objective. As evidence of the effectiveness of acupuncture for low back pain (LBP) is inconsistent, we aimed to critically appraise the evidence from relevant systematic reviews. Methods. Systematic reviews of randomized controlled trials (RCTs) concerning acupuncture and LBP were searched in seven databases. Internal validity and external validity of systematic reviews were assessed. Systematic reviews were categorized and high quality reviews assigned greater weightings. Conclusions were ge...
Full Text Available Multiple sclerosis (MS is a chronic, inflammatory disease of the central nervous system characterised by immune-mediated demyelination, and is a leading cause of neurological disability worldwide. It has a wide spectrum of clinical presentations which overlap with other neurological conditions many times. Further, the radiological array of findings in MS can also be confused for multiple other conditions, leading to the need to look for the more typical findings, and interpret these in close conjunction with the clinical picture including temporal evolution. This review aims to revisit the MRI findings in MS, including recent innovations in imaging, and to help distinguish MS from its mimics.
Grivas, E; Roudsari, R V; Satterthwaite, J D
The purpose of this study is to review the available literature related to composite inlays. Electronic databases published up to November 2013 were searched. Studies that evaluate composite resin inlays for the restoration of posterior teeth were selected. The studies should compare composite inlays against gold inlays, ceramic inlays and direct composite fillings regarding longevity, aesthetic quality and postoperative sensitivity or comparing the clinical effectiveness of them on premolars versus molars or on 1-2 surface preparations versus multi-surface preparations. Despite the heterogeneity of the available clinical trials composite inlays seem to be an effective method for the restoration of posterior teeth.
Hanschmidt, Franz; Linde, Katja; Hilbert, Anja; Riedel-Heller, Steffi G; Kersting, Anette
Although stigma has been identified as a potential risk factor for the well-being of women who have had abortions, little attention has been paid to the study of abortion-related stigma. A systematic search of the databases Medline, PsycArticles, PsycInfo, PubMed and Web of Science was conducted; the search terms were "(abortion OR pregnancy termination) AND stigma * ." Articles were eligible for inclusion if the main research question addressed experiences of individuals subjected to abortion stigma, public attitudes that stigmatize women who have had abortions or interventions aimed at managing abortion stigma. To provide a comprehensive overview of this issue, any study published by February 2015 was considered. The search was restricted to English- and German-language studies. Seven quantitative and seven qualitative studies were eligible for inclusion. All but two dated from 2009 or later; the earliest was from 1984. Studies were based mainly on U.S. samples; some included participants from Ghana, Great Britain, Mexico, Nigeria, Pakistan, Peru and Zambia. The majority of studies showed that women who have had abortions experience fear of social judgment, self-judgment and a need for secrecy. Secrecy was associated with increased psychological distress and social isolation. Some studies found stigmatizing attitudes in the public. Stigma appeared to be salient in abortion providers' lives. Evidence of interventions to reduce abortion stigma was scarce. Most studies had limitations regarding generalizability and validity. More research, using validated measures, is needed to enhance understanding of abortion stigma and thereby reduce its impact on affected individuals. Copyright © 2016 by the Guttmacher Institute.
Corry, Margarita; While, Alison; Neenan, Kathleen; Smith, Valerie
To evaluate the effectiveness of interventions to support caregivers of people with selected chronic conditions. Informal caregivers provide millions of care hours each week contributing to significant healthcare savings. Despite much research evaluating a range of interventions for caregivers, their impact remains unclear. A systematic review of systematic reviews of interventions to support caregivers of people with selected chronic conditions. The electronic databases of PubMed, CINAHL, British Nursing Index, PsycINFO, Social Science Index (January 1990-May 2014) and The Cochrane Library (Issue 6, June 2014), were searched using Medical Subject Heading and index term combinations of the keywords caregiver, systematic review, intervention and named chronic conditions. Papers were included if they reported a systematic review of interventions for caregivers of people with chronic conditions. The methodological quality of the included reviews was independently assessed by two reviewers using R-AMSTAR. Data were independently extracted by two reviewers using a pre-designed data extraction form. Narrative synthesis of review findings was used to present the results. Eight systematic reviews were included. There was evidence that education and support programme interventions improved caregiver quality of life. Information-giving interventions improved caregiver knowledge for stroke caregivers. Education, support and information-giving interventions warrant further investigation across caregiver groups. A large-scale funded programme for caregiver research is required to ensure that studies are of high quality to inform service development across settings. © 2014 John Wiley & Sons Ltd.
Tschentscher, Marcus; Niederseer, David; Niebauer, Josef
Modern lifestyle, with its lack of everyday physical activity and exercise training, predisposes people to chronic diseases such as diabetes mellitus, obesity, hypertension, and coronary artery diseases. Brisk walking as a simple and safe form of exercise is undisputedly an effective measure to counteract sedentary lifestyle risks even in the most unfit and could lead to a reduction of the prevalence of chronic diseases in all populations. The purpose of this review is to systematically summarize, analyze, and interpret the health benefits of Nordic walking (walking with poles), and to compare it to brisk walking and jogging. A systematic and comprehensive literature search was performed between November 2010 and May 2012. Data were analyzed between April 2011 and May 2012. Sixteen RCTs with a total of 1062 patients and 11 observational studies with 831 patients were identified. The current analysis revealed that with regard to short- and long-term effects on heart rate, oxygen consumption, quality of life, and other measures, Nordic walking is superior to brisk walking without poles and in some endpoints to jogging. Nordic walking exerts beneficial effects on resting heart rate, blood pressure, exercise capacity, maximal oxygen consumption, and quality of life in patients with various diseases and can thus be recommended to a wide range of people as primary and secondary prevention. Copyright © 2013 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
Kakava, Kassiani; Tournis, Symeon; Papadakis, Georgios; Karelas, Ioannis; Stampouloglou, Pavlos; Kassi, Evanthia; Triantafillopoulos, Ioannis; Villiotou, Vasiliki; Karatzas, Theodore
This article reviews epidemiology, risk factors and treatment modalities of postsurgical hypoparathyroidism (PHypo). PHypo occurs after total thyroidectomy due to injury of parathyroid glands and/or their blood supply or after parathyroidectomy. PHypo results in hypocalcemia because parathyroid hormone (PTH) secretion is impaired and cannot mobilize calcium from bone, reabsorb calcium from the distal nephron and stimulate renal 1α-hydroxylase activity. It usually appears in the first days after surgery and it can be symptomatic or asymptomatic. Risk factors are low level of intraoperative PTH and presence of parathyroid gland in the pathological specimen. Patients usually present with paresthesia, cramps or tetany, but the disorder may also manifest acutely with seizures, bronchospasm, laryngospasm or cardiac rhythm disturbances. Standard treatment is vitamin D analogues and calcium supplementation. Copyright © 2016 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.
Morris, Arden M; Regenbogen, Scott E; Hardiman, Karin M; Hendren, Samantha
Diverticulitis is a common disease. Recent changes in understanding its natural history have substantially modified treatment paradigms. To review the etiology and natural history of diverticulitis and recent changes in treatment guidelines. We searched the MEDLINE and Cochrane databases for English-language articles pertaining to diagnosis and management of diverticulitis published between January 1, 2000, and March 31, 2013. Search terms applied to 4 thematic topics: pathophysiology, natural history, medical management, and indications for surgery. We excluded small case series and articles based on data accrued prior to 2000. We hand searched the bibliographies of included studies, yielding a total of 186 articles for full review. We graded the level of evidence and classified recommendations by size of treatment effect, according to the guidelines from the American Heart Association Task Force on Practice Guidelines. Eighty articles met criteria for analysis. The pathophysiology of diverticulitis is associated with altered gut motility, increased luminal pressure, and a disordered colonic microenvironment. Several studies examined histologic commonalities with inflammatory bowel disease and irritable bowel syndrome but were focused on associative rather than causal pathways. The natural history of uncomplicated diverticulitis is often benign. For example, in a cohort study of 2366 of 3165 patients hospitalized for acute diverticulitis and followed up for 8.9 years, only 13.3% of patients had a recurrence and 3.9%, a second recurrence. In contrast to what was previously thought, the risk of septic peritonitis is reduced and not increased with each recurrence. Patient-reported outcomes studies show 20% to 35% of patients managed nonoperatively progress to chronic abdominal pain compared with 5% to 25% of patients treated operatively. Randomized trials and cohort studies have shown that antibiotics and fiber were not as beneficial as previously thought and that
Grace, Karen Trister; Anderson, Jocelyn C.
Reproductive coercion is behavior that interferes with the autonomous decision-making of a woman, with regards to reproductive health. It may take the form of birth control sabotage, pregnancy coercion, or controlling the outcome of a pregnancy. The objectives of this article are to address the questions: 1. What is known about reproductive coercion, its prevalence and correlates? 2. What strategies do women use to preserve their reproductive autonomy when experiencing reproductive coercion? 3. What interventions are effective to decrease reproductive coercion? In this review of 27 research studies, 12 contained findings regarding the general phenomenon of reproductive coercion, and 19 contained findings about at least one component of reproductive coercion. Additionally, 11 studies contained findings related to the intersection of IPV and reproductive coercion, 6 presented data on strategies women use to resist reproductive coercion, and 3 included intervention data. Variation in measurement makes synthesis of prevalence and correlate data challenging. The reviewed literature presents reproductive coercion as a phenomenon that disproportionately affects women experiencing concurrent IPV, women of lower socioeconomic status, single women, and African American and multiracial women. Women who experience reproductive coercion were found to present frequently for certain health services. Most data on reproductive coercion are descriptive; there is need for further research to examine the co-occurrence with related phenomena such as IPV and unintended pregnancy. More research is also needed on the strategies women use to resist reproductive coercion as well as interventions aimed at survivors and perpetrators of reproductive coercion and healthcare providers who encounter them. PMID:27535921
Luís Carlos Machado Júnior
Full Text Available Objective: this study aimed to review the literature regarding late preterm births (34 weeks to 36 weeks and 6 days of gestation in its several aspects. Sources: the MEDLINE, LILACS, and Cochrane Library databases were searched, and the references of the articles retrieved were also used, with no limit of time. Data synthesis: numerous studies showed a recent increase in late preterm births. In all series, late preterm comprised the majority of preterm births. Studies including millions of births showed a strong association between late preterm birth and neonatal mortality. A higher mortality in childhood and among young adults was also observed. Many studies found an association with several neonatal complications, and also with long-term disorders and sequelae: breastfeeding problems, cerebral palsy, asthma in childhood, poor school performance, schizophrenia, and young adult diabetes. Some authors propose strategies to reduce late preterm birth, or to improve neonatal outcome: use of antenatal corticosteroids, changes in some of the guidelines for early delivery in high-risk pregnancies, and changes in neonatal care for this group. Conclusions: numerous studies show greater mortality and morbidity in late preterm infants compared with term infants, in addition to long-term disorders. More recent studies evaluated strategies to improve the outcomes of these neonates. Further studies on these strategies are needed.
Van Camp, L S C; Sabbe, B G C; Oldenburg, J F E
Cognitive insight is the ability to re-evaluate thoughts and beliefs in order to make thoughtful conclusions. It differs from clinical insight, as it focuses on more general metacognitive processes. Therefore, it could be relevant to diverse disorders and non-clinical subjects. There is a growing body of research on cognitive insight in individuals with and without psychosis. This review has summarised the current state of the art regarding this topic. We conclude that while cognitive insight in its current form seems valid for use in individuals with psychosis, it is less so for individuals without psychosis. Additionally, higher cognitive insight not always leads to better psychological functioning. For instance, higher levels of self-reflection are often associated with depressive mood. We therefore recommend the sub-components of cognitive insight to be studied separately. Also, it is unclear what position cognitive insight takes within the spectrum of metacognitive processes and how it relates to other self-related concepts that have been defined previously in literature. Combining future and past research on cognitive insight and its analogue concepts will help in the formation of a uniform definition that fits all subjects discussed here. Copyright © 2017. Published by Elsevier Ltd.
Machado Júnior, Luís Carlos; Passini Júnior, Renato; Rodrigues Machado Rosa, Izilda
this study aimed to review the literature regarding late preterm births (34 weeks to 36 weeks and 6 days of gestation) in its several aspects. the MEDLINE, LILACS, and Cochrane Library databases were searched, and the references of the articles retrieved were also used, with no limit of time. numerous studies showed a recent increase in late preterm births. In all series, late preterm comprised the majority of preterm births. Studies including millions of births showed a strong association between late preterm birth and neonatal mortality. A higher mortality in childhood and among young adults was also observed. Many studies found an association with several neonatal complications, and also with long-term disorders and sequelae: breastfeeding problems, cerebral palsy, asthma in childhood, poor school performance, schizophrenia, and young adult diabetes. Some authors propose strategies to reduce late preterm birth, or to improve neonatal outcome: use of antenatal corticosteroids, changes in some of the guidelines for early delivery in high-risk pregnancies, and changes in neonatal care for this group. numerous studies show greater mortality and morbidity in late preterm infants compared with term infants, in addition to long-term disorders. More recent studies evaluated strategies to improve the outcomes of these neonates. Further studies on these strategies are needed. Copyright © 2014 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.
de Macedo, Geisa Maria Campos; Nunes, Samanta; Barreto, Tania
Skin disorders, usually neglected and frequently underdiagnosed among diabetic patients, are common complications and encounter a broad spectrum of disorders in both type 1 and type 2 diabetes mellitus (DM)?e.g. cutaneous infection, dry skin, pruritus. Skin disorders are highly associated with increased risk of important outcomes, such as skin lesions, ulcerations and diabetic foot, which can lead to major complications and revolve around multifactorial factors besides hyperglycemia and advan...
Background Maternity care providers, particularly midwives, have a window of opportunity to influence pregnant women about positive health choices. This aim of this paper is to identify evidence of effective public health interventions from good quality systematic reviews that could be conducted by midwives. Methods Relevant databases including MEDLINE, Pubmed, EBSCO, CRD, MIDIRS, Web of Science, The Cochrane Library and Econlit were searched to identify systematic reviews in October 2010. Quality assessment of all reviews was conducted. Results Thirty-six good quality systematic reviews were identified which reported on effective interventions. The reviews were conducted on a diverse range of interventions across the reproductive continuum and were categorised under: screening; supplementation; support; education; mental health; birthing environment; clinical care in labour and breast feeding. The scope and strength of the review findings are discussed in relation to current practice. A logic model was developed to provide an overarching framework of midwifery public health roles to inform research policy and practice. Conclusions This review provides a broad scope of high quality systematic review evidence and definitively highlights the challenge of knowledge transfer from research into practice. The review also identified gaps in knowledge around the impact of core midwifery practice on public health outcomes and the value of this contribution. This review provides evidence for researchers and funders as to the gaps in current knowledge and should be used to inform the strategic direction of the role of midwifery in public health in policy and practice. PMID:23134701
Oosterhuis, W. P.; Niessen, R. W.; Bossuyt, P. M.
BACKGROUND: Systematic reviews have gradually replaced single studies as the highest level of documented effectiveness of health care interventions. Systematic reviewing is a new scientific method, concerned with the development and application of methods for identifying relevant literature,
McKenzie-Brown, Ann Marie; Shah, Rinoo V; Sehgal, Nalini; Everett, Clifford R
The sacroiliac joint is an accepted source of low back pain with or without associated lower extremity symptoms. The diagnosis and management of sacroiliac joint pain and the role of interventional techniques have been controversial. To evaluate the clinical usefulness of sacroiliac joint interventions in the diagnosis and management of sacroiliac joint pain. A systematic review using the criteria as outlined by the Agency for Healthcare Research and Quality (AHRQ), Cochrane Review Group Criteria, and QUADAS criteria for diagnostic studies. The databases of EMBASE and MEDLINE (1966 to November 2004), and Cochrane Review were searched. The searches included systematic reviews, narrative reviews, prospective and retrospective studies, and cross-references from articles reviewed. The search strategy included sacroiliac joint pain and dysfunction, sacroiliac joint injections, interventions, and radiofrequency. The results of this systematic evaluation showed that for diagnostic purposes, there is moderate evidence showing the accuracy of comparative, controlled local anesthetic blocks. Prevalence of sacroiliac joint pain was demonstrated to be 10% to 19% by a double block paradigm. The false-positive rate of single, uncontrolled, sacroiliac joint injections was reported as 20%.For therapeutic purposes intraarticular sacroiliac joint injections with steroid and radiofrequency neurotomy were evaluated. Based on this review, there was moderate evidence for short-term and limited evidence for long-term relief with intraarticular sacroiliac joint injections. Evidence for radiofrequency neurotomy in managing sacroiliac joint pain was limited or inconclusive. The evidence for the specificity and validity of diagnostic sacroiliac joint injections was moderate.The evidence for therapeutic intraarticular sacroiliac joint injections was limited to moderate. The evidence for radiofrequency neurotomy in managing chronic sacroiliac joint pain was limited.
Lester, Soraya; Lawrence, Cayleigh; Ward, Catherine L
Many children across the world are exposed to school violence, which undermines their right to education and adversely affects their development. Studies of interventions for school violence suggest that it can be prevented. However, this evidence base is challenging to navigate. We completed a systematic review of interventions to reduce four types of school violence: (a) peer violence; (b) corporal punishment; (c) student-on-teacher violence and (d) teacher-on-student violence. Reviewers independently searched databases and journals. Included studies were published between 2005 and 2015; in English; considered school-based interventions for children and measured violence as an outcome. Many systematic reviews were found, thus we completed a systematic review of systematic reviews. Only systematic reviews on interventions for intimate partner violence (IPV) and peer aggression were found. These reviews were generally of moderate quality. Research on both types of violence was largely completed in North America. Only a handful of programmes demonstrate promise in preventing IPV. Cognitive behavioral, social-emotional and peer mentoring/mediation programmes showed promise in reducing the levels of perpetration of peer aggression. Further research needs to determine the long-term effects of interventions, potential moderators and mediators of program effects, program effects across different contexts and key intervention components.
Full Text Available BACKGROUND: A systematic review may evaluate different aspects of a health care intervention. To accommodate the evaluation of various research questions, the inclusion of more than one study design may be necessary. One aim of this study is to find and describe articles on methodological issues concerning the incorporation of multiple types of study designs in systematic reviews on health care interventions. Another aim is to evaluate methods studies that have assessed whether reported effects differ by study types. METHODS AND FINDINGS: We searched PubMed, the Cochrane Database of Systematic Reviews, and the Cochrane Methodology Register on 31 March 2012 and identified 42 articles that reported on the integration of single or multiple study designs in systematic reviews. We summarized the contents of the articles qualitatively and assessed theoretical and empirical evidence. We found that many examples of reviews incorporating multiple types of studies exist and that every study design can serve a specific purpose. The clinical questions of a systematic review determine the types of design that are necessary or sufficient to provide the best possible answers. In a second independent search, we identified 49 studies, 31 systematic reviews and 18 trials that compared the effect sizes between randomized and nonrandomized controlled trials, which were statistically different in 35%, and not different in 53%. Twelve percent of studies reported both, different and non-different effect sizes. CONCLUSIONS: Different study designs addressing the same question yielded varying results, with differences in about half of all examples. The risk of presenting uncertain results without knowing for sure the direction and magnitude of the effect holds true for both nonrandomized and randomized controlled trials. The integration of multiple study designs in systematic reviews is required if patients should be informed on the many facets of patient relevant
There has recently been interest in applying the techniques of systematic review to bioethics literature. In this paper, I identify the three models of systematic review proposed to date in bioethics: systematic reviews of empirical bioethics research, systematic reviews of normative bioethics literature, and systematic reviews of reasons. I argue that all three types yield information useful to scholarship in bioethics, yet they also face significant challenges particularly in relation to terminology and time. Drawing on my recent experience conducting a systematic review, I suggest that complete comprehensiveness may not always be an appropriate goal of a literature review in bioethics, depending on the research question. In some cases, all the relevant ideas may be captured without capturing all the relevant literature. I conclude that systematic reviews in bioethics have an important role to play alongside the traditional broadbrush approach to reviewing literature in bioethics.
Lindsay, Karen L; Walsh, Colin A; Brennan, Lorraine; McAuliffe, Fionnuala M
To systematically review the literature on the use of probiotics in pregnancy and their impact on maternal outcomes. Online databases were searched in April 2012 using the following terms to identify eligible studies: "probiotics", "pregnancy", "maternal outcomes" and "metabolism". Primary outcomes of selected studies were maternal fasting glucose during pregnancy and rates of gestational diabetes mellitus (GDM). Secondary outcomes were rates of pre-eclampsia, maternal inflammatory markers and lipid profiles and gestational weight gain. Studies whose primary outcomes were bacterial vaginosis, pre-term delivery and infant atopy were excluded. Only English-language articles were included. The limited number of eligible studies and varying outcomes precluded formal meta-analysis of these data. Initially, 189 articles were identified and screened. Seven articles met inclusion criteria and are included in the present review. Results demonstrated that probiotic use in pregnancy could significantly reduce maternal fasting glucose, incidence of GDM and pre-eclampsia rates and levels of C-reactive protein. Probiotics hold potential as a safe therapeutic tool for the prevention of pregnancy complications and adverse outcomes related to maternal metabolism. Further randomised controlled trials are urgently required, particularly among those at high risk of metabolic disorders, such as overweight and obese pregnant women.
Angelo V. Vasiliadis
Full Text Available Background: Stroke is a leading cause of death and acquired disability worldwide. In Europe, strokes account for almost 1.1 million death per year. In particular, countries in Southern Europe constitute populations with a different lifestyle and dietary habits from those in Northern Europe and that may influence stroke incidence, type and risk factors.Aim: The objective of this study was to review and summarise the trends of the incidence of stroke in Southern Europe, as well as,to mention stroke subtypes and recognise the risk factors for stroke.Methods: A systematic review in PubMed was conducted.Results: Therefore, twenty-three articles, representing seven countries, related to incidence, type and risk factors of stroke in this specific geographical area of Europe were identified. The annual stroke incidence varied from approximately 1.41 to 3.73 per 1000 population per year. Currently, in all the countries studied, ischemic stroke was the commonest stroke type in all series. Hypertension remains the main risk factor for both ischemic andhemorrhagic strokes, followed by diabetes mellitus, hyperlipidemia and other factors.Conclusions: A wide range of stroke incidence may be due to the different lifestyle and behavioural factors among countries. Further research that uses the best possible methods to study the incidence, type and risk factors of stroke are urgently needed in Balkan Peninsula.
Alba, Luz Helena; Murillo, Raúl; Castillo, Juan Sebastián
A systematic review on efficacy and safety of smoking cessation counseling was developed. The ADAPTE methodology was used with a search of Clinical Practice Guidelines (CPG) in Medline, EMBASE, CINAHL, LILACS, and Cochrane. DELBI was used to select CPG with score over 60 in methodological rigor and applicability to the Colombian health system. Smoking cessation rates at 6 months were assessed according to counseling provider, model, and format. In total 5 CPG out of 925 references were selected comprising 44 systematic reviews and meta-analyses. Physician brief counseling and trained health professionals' intensive counseling (individual, group, proactive telephone) are effective with abstinence rates between 2.1% and 17.4%. Only practical counseling and motivational interview were found effective intensive interventions. The clinical effect of smoking cessation counseling is low and long term cessation rates uncertain. Cost-effectiveness analyses are recommended for the implementation of counseling in public health programs.
Lavallée, Mathieu; Robillard, Pierre-N.; Mirsalari, Reza
Reviewers performing systematic literature reviews require understanding of the review process and of the knowledge domain. This paper presents an iterative approach for conducting systematic literature reviews that addresses the problems faced by reviewers who are novices in one or both levels of understanding. This approach is derived from…
Dugdill, L; Brettle, A; Hulme, C; McCluskey, S; Long, AF
Purpose – This paper aims to report a synopsis of a recent systematic review of the literature regarding the effectiveness of workplace physical activity interventions, commissioned by the National Institute for Health and Clinical Excellence (NICE). \\ud \\ud Design/methodology/approach – A search for English-language papers published between 1996 and 2007 was conducted using 12 relevant databases and associated grey literature. Search protocols and analysis regarding study quality as recommen...
Forsyth, SR; Malone, RE
INTRODUCTION: Video games are played by a majority of adolescents, yet little is known about whether and how video games are associated with smoking behavior and attitudes. This systematic review examines research on the relationship between video games and smoking. METHODS: We searched MEDLINE, psycINFO, and Web of Science through August 20, 2014. Twenty-four studies met inclusion criteria. Studies were synthesized qualitatively in four domains: the prevalence and incidence of smoking imager...
Iankoulova, Iliana; Daneva, Maia; Rolland, C; Castro, J.; Pastor, O
Many publications have dealt with various types of security requirements in cloud computing but not all types have been explored in sufficient depth. It is also hard to understand which types of requirements have been under-researched and which are most investigated. This paper's goal is to provide a comprehensive and structured overview of cloud computing security requirements and solutions. We carried out a systematic review and identified security requirements from previous publications th...
Batbaatar, Enkhjargal; Dorjdagva, Javkhlanbayar; Luvsannyam, Ariunbat; Savino, Matteo Mario; Amenta, Pietro
A large number of studies have addressed the detection of patient satisfaction determinants, and the results are still inconclusive. Furthermore, it is known that contradicting evidence exists across patient satisfaction studies. This article is the second part of a two-part series of research with a goal to review a current conceptual framework of patient satisfaction for further operationalisation procedures. The aim of this work was to systematically identify and review evidence regarding determinants of patient satisfaction between 1980 and 2014, and to seek the reasons for contradicting results in relationships between determinants and patient satisfaction in the literature to design a further robust measurement system for patient satisfaction. This systematic review followed the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. The search was conducted in PubMed, CINAHL, and Scopus in October 2014. Studies published in full in peer reviewed journals between January 1980 and August 2014 and in the English language were included. We included 109 articles for the synthesis. We found several number of determinants of patient satisfaction investigated in a wide diversity of studies. However, study results were varied due to no globally accepted formulation of patient satisfaction and measurement system. Health care service quality indicators were the most influential determinants of patient satisfaction across the studies. Among them, health providers' interpersonal care quality was the essential determinant of patient satisfaction. Sociodemographic characteristics were the most varied in the review. The strength and directions of associations with patient satisfaction were found inconsistent. Therefore, person-related characteristics should be considered to be the potential determinants and confounders simultaneously. The selected studies were not able to show all potential characteristics which may have had
Elangovan, Satheesh; Avila-Ortiz, Gustavo; Johnson, Georgia K; Karimbux, Nadeem; Allareddy, Veerasathpurush
Systematic reviews represent the highest form of evidence in the current hierarchy of evidence-based dentistry. Critical analysis of published systematic reviews may help to analyze their strengths and weaknesses and to identify areas that need future improvement. The aim of this overview is to determine and compare the quality of systematic reviews published in the field of periodontal regeneration using established checklists, such as the Assessment of Multiple Systematic Reviews (AMSTAR) guidelines. A systematic search was conducted to retrieve reviews on periodontal regeneration in humans. A total of 14 systematic reviews were selected using a set of inclusion and exclusion criteria. Two independent reviewers appraised the quality of the selected reviews using AMSTAR guidelines. Each article was given an AMSTAR total score, based on the number of AMSTAR criteria that were fulfilled. The quality of included reviews was further assessed using a checklist proposed in 2003. Only one of the selected systematic reviews satisfied all the AMSTAR guidelines, whereas two reviews satisfied just two of the 11 items. This study shows that published systematic reviews on periodontal regeneration exhibit significant structural and methodologic variability. Quality assessment using the additional checklist further confirmed the variability in the way systematic reviews were conducted and/or reported. Consideration of guidelines for quality assessment, such as AMSTAR, when designing and conducting systematic reviews may increase the validity and clinical applicability of future reviews.
Full Text Available Introduction. A burgeoning number of systematic reviews considering lurasidone in the treatment of bipolar depression have occurred since its Food and Drug Administration extended approval in 2013. While a paucity of available quantitative evidence still precludes preliminary meta-analysis on the matter, the present quality assessment of systematic review of systematic reviews, nonetheless, aims at highlighting current essential information on the topic. Methods. Both published and unpublished systematic reviews about lurasidone mono- or adjunctive therapy in the treatment of bipolar depression were searched by two independent authors inquiring PubMed/Cochrane/Embase/Scopus from inception until October 2016. Results. Twelve included systematic reviews were of moderate-to-high quality and consistent in covering the handful of RCTs available to date, suggesting the promising efficacy, safety, and tolerability profile of lurasidone. Concordance on the drug profile seems to be corroborated by a steadily increasing number of convergent qualitative reports on the matter. Limitations. Publication, sponsorship, language, citation, and measurement biases. Conclusions. Despite being preliminary in nature, this overview stipulates the effectiveness of lurasidone in the acute treatment of Type I bipolar depression overall. As outlined by most of the reviewed evidence, recommendations for future research should include further controlled trials of extended duration.
Mota, Vitor Gomes; Markman Filho, Brivaldo
Doppler echocardiography (Echo) is a non-invasive method of excellent accuracy to screen portopulmonary hypertension (PPH) and to assess intrapulmonary shunts (IPS) in chronic liver disease (CLD). In the past decade, Echo proved to play a fundamental role in the diagnosis of cirrhotic cardiomyopathy (CCM). To perform a systematic review of relevant articles on the subject 'Echo in CLD'. In November 2011, a systematic review was performed in the PubMed, LILACS and SciELO databases, and the characteristics of the studies selected were reported. The search based on descriptors and free terms obtained 204 articles (179 in Pubmed, 21 in LILACS, and 1 in SciELO). Of those 204 articles, 22 were selected for systematic review. A meta-analysis could not be performed because of the heterogeneity of the articles. Echo should be part of CLD stratification for screening PPH, IPS and CCM, because, most of the time, such complications are diagnosed only when patients are already waiting for a liver transplant.
Cohen, Alison K.; Rai, Manisha; Rehkopf, David H.; Abrams, Barbara
Background Although previous systematic reviews considered the relationship between socioeconomic status and obesity, almost 200 peer-reviewed articles have been published since the last review on that topic, and this paper focuses specifically on education, which has different implications. Methods The authors systematically review the peer-reviewed literature from around the world considering the association between educational attainment and obesity. Databases from public health and medicine, education, psychology, economics, and other social sciences were searched, and articles published in English, French, Portuguese, and Spanish were included. Results This paper includes 289 articles that report on 410 populations in 91 countries. The relationship between educational attainment and obesity was modified by both gender and the country's economic development level: an inverse association was more common in studies of higher-income countries and a positive association was more common in lower-income countries, with stronger social patterning among women. Relatively few studies reported on lower-income countries, controlled for a comprehensive set of potential confounding variables, and/or attempted to assess causality through the use of quasi-experimental designs. Conclusions Future research should address these gaps to understand if the relationship between educational attainment and obesity may be causal, thus supporting education policy as a tool for obesity prevention. PMID:23889851
H. Bueno (Hector); R. Hernáez (Rubén); A.V. Hernández (Adrián)
textabstractIntroduction. In spite of having a high prevalence of diabetes mellitus the prevalence of ischemic heart disease is low in Spain. Methods. A narrative review of the bibliography was performed to search for potential particularities in the epidemiology, pathogenecity, and care of diabetes
Spineli, Loukia M.; Pandis, Nikolaos; Salanti, Georgia
Objectives: The purpose of the study was to provide empirical evidence about the reporting of methodology to address missing outcome data and the acknowledgement of their impact in Cochrane systematic reviews in the mental health field. Methods: Systematic reviews published in the Cochrane Database of Systematic Reviews after January 1, 2009 by…
Hundreds of studies of maternity care interventions have been published, too many for most people involved in providing maternity care to identify and consider when making decisions. It became apparent that systematic reviews of individual studies were required to appraise, summarise and bring together existing studies in a single place. However, decision makers are increasingly faced by a plethora of such reviews and these are likely to be of variable quality and scope, with more than one review of important topics. Systematic reviews (or overviews) of reviews are a logical and appropriate next step, allowing the findings of separate reviews to be compared and contrasted, providing clinical decision makers with the evidence they need.
Ekmektzoglou, Konstantinos A; Zografos, Georgios C
This paper reviews the negative impact of diabetes mellitus or hypothyroidism on wound healing, both in experimental and clinical settings. Since both are metabolic disorders of great clinical importance, special attention is given, not only to their pathophysiology, but also to their biochemical and histological effects on tissue integrity and regeneration. Also, special focus is awarded on wound healing of the gastrointestinal tract, i.e. in intestinal anastomosis, and how these disorders can lead to wound dehiscence. Since diabetes mellitus and hypothyroidism can coexist in clinical settings, more research must be directed on their influence on wound healing, considering them as one clinical entity. PMID:16718759
Lee, Joseph G L; Ylioja, Thomas; Lackey, Mellanye
Research on the health of lesbian, gay, bisexual, and transgender (LGBT) populations can provide important information to address existing health inequalities. Finding existing research in LGBT health can prove challenging due to the plethora of terminology used. We sought to describe existing search strategies and to identify more comprehensive LGBT search terminology. We iteratively created a search string to identify systematic reviews and meta-analyses about LGBT health and implemented it in Embase, PubMed/MEDLINE, and PsycINFO databases on May 28-29, 2015. We hand-searched the journal LGBT Health. Inclusion criteria were: systematic reviews and meta-analyses that addressed LGBT health, used systematic searching, and used independent coders for inclusion. The published search terminology in each record and search strings provided by authors on request were cross-referenced with our original search to identify additional terminology. Our search process identified 19 systematic reviews meeting inclusion criteria. The number of search terms used to identify LGBT-related records ranged from 1 to 31. From the included studies, we identified 46 new search terms related to LGBT health. We removed five search terms as inappropriate and added five search terms used in the field. The resulting search string included 82 terms. There is room to improve the quality of searching and reporting in LGBT health systematic reviews. Future work should attempt to enhance the positive predictive value of LGBT health searches. Our findings can assist LGBT health reviewers in capturing the diversity of LGBT terminology when searching.
Turunen, Elina; Hiilamo, Heikki
In the aftermath of the global financial crisis, millions of households have been left with debts that they are unable to manage. Indebtedness may impair the wellbeing of those affected by it for years to come. This systematic review focuses on the long-term consequences of indebtedness on health. The method used in the paper is a systematic review. First, bibliographic databases were searched for peer-reviewed articles. Second, the references and citations of the included articles were searched for additional articles. The results from our sample of 33 peer-reviewed studies demonstrate serious health effects related to indebtedness. Individuals with unmet loan payments had suicidal ideation and suffered from depression more often than those without such financial problems. Unpaid financial obligations were also related to poorer subjective health and health-related behaviour. Debt counselling and other programmes to mitigate debt-related stress are needed to alleviate the adverse effects of indebtedness on health. The results demonstrate that indebtedness has serious effects on health.
Jasmine B. MacDonald
Full Text Available The present study aims to provide a concise, comprehensive, and systematic review of the quantitative literature relating to the experience of burnout in journalists of various specialties and mediums. The systematic review method adopted is that prescribed by Fink (2010, which contains three main elements: Sampling the literature, screening the literature, and extracting data. Results indicate that journalists most at risk of burnout are females who are younger, with fewer years of journalism experience, working in small circulation newspapers. Editors and reporters seem to experience higher levels of burnout than those in other roles, as do journalists in non-management positions. The thorough and structured process adopted in this review provides the ability to assert with some degree of certainty what areas within the burnout and journalism literature require further consideration. This review emphasises and problematises the large focus on male reporters in newspaper settings, settings that are becoming less significant over time. Studies have tended to focus on reporters, without providing a convincing a priori rationale. What is lacking is consideration of other role groups central to broadcast news, such as camera-operators. A range of methodological and theoretical issues and future areas of research are discussed.
Xu, Tingting; He, Yasheng; Dainelli, Livia; Yu, Kai; Detzel, Patrick; Silva-Zolezzi, Irma; Volger, Sheri; Fang, Hai
Gestational Diabetes Mellitus (GDM) is a type of diabetes which occurs during pregnancy. Women with GDM are at greater risk of complications during pregnancy and delivery, while babies born from mothers with GDM are at greater risk of post-natal complications. Using the most updated diagnosis criteria, the GDM prevalence is estimated at 9.3-25.5% worldwide and 9.3-18.9% in China. Our objective was to identify healthcare interventions aimed at GDM prevention and control in China. A best-evidence synthesis was performed based on a systematic search of literature published between 1997 and October 2015 in PubMed, Web of Science, China National Knowledge Infrastructure (CNKI), and Wan-fang databases using keywords "Gestational Diabetes Mellitus", "GDM", "Intervention" "Medical Intervention" "Early Medical Intervention", "Dietary Intervention", "Exercise Intervention", "Lifestyle Intervention", "Therapy", "Treatment" and "China". Inclusion criteria were studies conducted in China, reporting GDM healthcare interventions, and published in either Chinese or English. Two reviewers independently assessed eligibility and quality of the studies and extracted the data. Treatment efficacy was examined with weighted pooled odds ratio (OR) meta-analyses. The search resulted in 5961 articles (published in 276 different Chinese language journals and 6 English language journals), of which 802 were included in this synthesis. While 39.4% (n = 316) failed to report the GDM diagnostic criteria used, the remaining studies classified GDM with various international (n = 5) or Chinese (n = 7) diagnostic standards. Treatment interventions were categorized into 6 types: dietary (18.6%), exercise (1.6%), medication (20.7%), health education (9.0%), psychological (2.6%) and combination (47.4%). No interventions aimed at GDM prevention were identified. Meta-analyses demonstrated a statistically significant overall benefit of GDM treatment strategies in reducing the odds of maternal and
Beatriz Cardoso Lobato
Full Text Available This integrative review sought to find evidence in the literature regarding the impact of diabetes mellitus upon work. The data collection was performed using the National Library of Medicine; Health Sciences Literature in Latin America and the Caribbean; and the Cumulative Index to Nursing and Allied Health Literature. Seventeen publications were found that met the selection criteria. Evidence was presented in four areas: reduced capacity and productivity at work; chronic complications that worsen the impact of Diabetes mellitus upon work; early retirement and its economic consequences for society; and aspects that enable self-care of the disease at work. Diabetes mellitus has negative implications for the insertion and retention of people in the labor market, worsened by chronic complications, conducive to the development of disabilities and inability to work, as well as early retirement. doi: 10.5216/ree.v16i4.22328.
Full Text Available Orientation: To identify and report on cultural intelligence truths. Research purpose: To explore cultural intelligence truths by means of a systematic review of the cultural intelligence literature. Motivation for the study: Cultural intelligence truths must be systemised if the business and academic communities are to derive optimal value from the diverse knowledge base. Research design, approach and method: The research was qualitative in nature, comprising a systematic literature review. The period covered was from 01 January 2002 to 31 May 2015. The final number of included studies was 76, representing 48 different journals. Cultural intelligence hypotheses were identified and thematically categorised. Validated hypotheses constituted truths (i.e. truth statements. Key findings are both reported and commented on. Main findings: Cultural intelligence hypotheses may be classified into 13 separate themes plus a ‘not categorised’ group. In total, 60% of the hypotheses on cultural intelligence have given rise to truth statements. Accordingly, there remains some divide between theorised cultural intelligence relationships and how these have played out under empirical investigation. Practical managerial/implications: Business professionals will find it easier to consume the cultural intelligence literature, thereby facilitating their understanding of how best to leverage the knowledge in equipping the workforce to function optimally in cross-cultural interfaces. Scholars will be better positioned to tailor the focus and structure of cultural intelligence studies going forward. Contribution: Cultural intelligence truths have been systematically identified, organised and reported on.
Ron, Yulia; Kivity, Shmuel; Ben-Horin, Shomron; Israeli, Eran; Fraser, Gerald M.; Dotan, Iris; Chowers, Yehuda; Confino-Cohen, Ronit; Weiss, Batia
Objective: Administration of infliximab is associated with a well-recognised risk of infusion reactions. Lack of a mechanism-based rationale for their prevention, and absence of adequate and well-controlled studies, has led to the use of diverse empirical administration protocols. The aim of this study is to perform a systematic review of the evidence behind the strategies for preventing infusion reactions to infliximab, and for controlling the reactions once they occur. Methods: We conducted extensive search of electronic databases of MEDLINE [PubMed] for reports that communicate various aspects of infusion reactions to infliximab in IBD patients. Results: We examined full texts of 105 potentially eligible articles. No randomised controlled trials that pre-defined infusion reaction as a primary outcome were found. Three RCTs evaluated infusion reactions as a secondary outcome; another four RCTs included infusion reactions in the safety evaluation analysis; and 62 additional studies focused on various aspects of mechanism/s, risk, primary and secondary preventive measures, and management algorithms. Seven studies were added by a manual search of reference lists of the relevant articles. A total of 76 original studies were included in quantitative analysis of the existing strategies. Conclusions: There is still paucity of systematic and controlled data on the risk, prevention, and management of infusion reactions to infliximab. We present working algorithms based on systematic and extensive review of the available data. More randomised controlled trials are needed in order to investigate the efficacy of the proposed preventive and management algorithms. PMID:26092578
Blaya-Tárraga, J-A; Cervera-Ballester, J; Peñarrocha-Oltra, D; Peñarrocha-Diago, M
The aim of this study was to systematically review the evidence for periapical implant lesion, which makes a patient more susceptible to the periapical lesion, frequency, symptoms, signs (including radiological findings) and possible treatment options. A systematic literature review and analysis of publications included in PubMed, Embase and Cochrane; articles published until March 2016; with a populations, exposures and outcomes (PEO) search strategy was performed, focused on the issue: "In patients with periapical lesion to the implant during the osseointegration, what symptoms, signs, and changes in complementary examination manifested, for according to that stage, be intervened with the appropriate approach?". The set criteria for inclusion were peer-reviewed articles. From a total of 212 papers identified, 36 studies were included in this systematic review, with 15461 implants evaluated and 183 periapical implant lesions. Which 8 papers included more than 5 cases and 28 included equal or less than 5 cases. Analysis of the papers revealed that periapical implant lesion is classified according to evolution stages into acute (non-suppurated and suppurated) and subacute (or suppurated-fistulized). In the acute stage and in the subacute if there is no loss of implant stability, the correct treatment approach is implant periapical surgery. In the subacute stage associated with implant mobility the implant must be removed. Evidence on the subject is very limited, there are few studies with small sample, without homogeneity of criteria for diagnosing the disease and without design of scientific evidence. Currently etiology lacks consensus. The early diagnosis of periapical implant periapical lesions during the osseointegration phase and early treatment, will lead to a higher survival rate of implants treated, hence preventing the need for implant extraction.
Riesenberg, Lee Ann; Leitzsch, Jessica; Little, Brian W
A systematic review of published English-language articles on handoffs is conducted (1987 to June 4, 2008). Forty-six articles describing 24 handoff mnemonics are identified by trained reviewers. The majority (82.6%) have been published in the last 3 years (2006-2008), and SBAR (Situation, Background, Assessment, Recommendation) is the most frequently cited mnemonic (69.6%). Of 7 handoff research articles, only 4 study mnemonics. All 4 of these studies have relatively small sample sizes (10-100) and lack validated instruments. Only 1 study has obtained IRB approval. Scientifically rigorous research studies are needed to assess the effectiveness of handoff mnemonics. These should be published in the peer-reviewed literature using the Standards for QUality Improvement Reporting Excellence (SQUIRE) guidelines.
Sanchis, Joaquin; Gich, Ignasi; Pedersen, Søren
in these outcomes over these 40 years and when partitioned into years 1 to 20 and years 21 to 40. Analyses were conducted in accordance with recommendations from Preferred Reporting Items for Systematic Reviews and Meta-Analyses and Strengthening the Reporting of Observational Studies in Epidemiology. Results Data...... A systematic search for articles reporting direct observation of inhaler technique by trained personnel covered the period from 1975 to 2014. Outcomes were the nature and frequencies of the three most common errors; the percentage of patients demonstrating correct, acceptable, or poor technique; and variations...... were extracted from 144 articles reporting on a total number of 54,354 subjects performing 59,584 observed tests of technique. The most frequent MDI errors were in coordination (45%; 95% CI, 41%-49%), speed and/or depth of inspiration (44%; 40%-47%), and no postinhalation breath-hold (46%; 42...
Juan Sebastián Frías-Ordoñez
Full Text Available Gestational diabetes mellitus (GDM is a state of carbohydrate intolerance that is first recognized during pregnancy. The initial criteria for diagnosis were established more than 50 years ago by O’Sullivan & Mahan, and since then, some modifications have been made. Currently, diagnosis considers two methods: the onestep approach, consisting of an oral glucose tolerance test (OGTT for 2 hours with 75g of glucose, and the two-step approach, which involves an initial screening test with 50g of glucose and OGTT with 100g of glucose if screening is positive. Both diagnostic approaches have been justified by expert consensus; however, an absolute concept about the method to be applied has not been established yet. To select a method, the clinician must take into account various factors. This paper proposes a historical overview and the presentation of the current status of GDM diagnosis.
Bertaso, Angela Gallina; Bertol, Daniela; Duncan, Bruce Bartholow; Foppa, Murilo
Epicardial fat (EF) is a visceral fat deposit, located between the heart and the pericardium, which shares many of the pathophysiological properties of other visceral fat deposits, It also potentially causes local inflammation and likely has direct effects on coronary atherosclerosis. Echocardiography, computed tomography and magnetic resonance imaging have been used to evaluate EF, but variations between methodologies limit the comparability between these modalities. We performed a systematic review of the literature finding associations of EF with metabolic syndrome and coronary artery disease. The summarization of these associations is limited by the heterogeneity of the methods used and the populations studied, where most of the subjects were at high cardiovascular disease risk. EF is also associated with other known factors, such as obesity, diabetes mellitus, age and hypertension, which makes the interpretation of its role as an independent risk marker intricate. Based on these data, we conclude that EF is a visceral fat deposit with potential implications in coronary artery disease. We describe the reference values of EF for the different imaging modalities, even though these have not yet been validated for clinical use. It is still necessary to better define normal reference values and the risk associated with EF to further evaluate its role in cardiovascular and metabolic risk assessment in relation to other criteria currently used
Bertaso, Angela Gallina [Programa de Pós-Graduação em Ciências da Saúde: Cardiologia e Ciências Cardiovasculares - Universidade Federal do Rio Grande do Sul, Porto Alegre (Brazil); Bertol, Daniela [Programa de Pós-Graduação em Epidemiologia - Universidade Federal do Rio Grande do Sul, Porto Alegre (Brazil); Duncan, Bruce Bartholow; Foppa, Murilo, E-mail: email@example.com [Programa de Pós-Graduação em Ciências da Saúde: Cardiologia e Ciências Cardiovasculares - Universidade Federal do Rio Grande do Sul, Porto Alegre (Brazil); Programa de Pós-Graduação em Epidemiologia - Universidade Federal do Rio Grande do Sul, Porto Alegre (Brazil)
Epicardial fat (EF) is a visceral fat deposit, located between the heart and the pericardium, which shares many of the pathophysiological properties of other visceral fat deposits, It also potentially causes local inflammation and likely has direct effects on coronary atherosclerosis. Echocardiography, computed tomography and magnetic resonance imaging have been used to evaluate EF, but variations between methodologies limit the comparability between these modalities. We performed a systematic review of the literature finding associations of EF with metabolic syndrome and coronary artery disease. The summarization of these associations is limited by the heterogeneity of the methods used and the populations studied, where most of the subjects were at high cardiovascular disease risk. EF is also associated with other known factors, such as obesity, diabetes mellitus, age and hypertension, which makes the interpretation of its role as an independent risk marker intricate. Based on these data, we conclude that EF is a visceral fat deposit with potential implications in coronary artery disease. We describe the reference values of EF for the different imaging modalities, even though these have not yet been validated for clinical use. It is still necessary to better define normal reference values and the risk associated with EF to further evaluate its role in cardiovascular and metabolic risk assessment in relation to other criteria currently used.
Issa, Isabela I.; Pigosso, Daniela Cristina Antelmi; McAloone, Tim C.
structured approach to support EPIs selection is still lacking. This paper presents the efforts made in order to identify, classify and systematize the existing EPIs based on the systematic literature review. From the review, 261 EPIs were identified, classified, and then systematized in a digital database...
Muñoz-Ortego, Juan; Solans-Domènech, Maite; Carrion, Carme
Acupuncture is a medical procedure with a very wide range of indications according to the WHO. However the indications require robust scientific evidence to support them. We have conducted a systematic review (2010-2015) in order to define in which pathologies acupuncture can be an effective strategy, STRICTA criteria that aim to set up acupuncture clinical trials standard criteria were defined in 2010. Only systematic reviews and meta-analyses of good or very good methodological quality according to SIGN criteria were selected. Its main objective was to evaluate the effectiveness of acupuncture in the management of any disease. Most of the final 31 selected reviews focus on chronic pain-related diseases, mainly in the disciplines of Neurology, Orthopaedics and Rheumatology. Current evidence supports the use of acupuncture in the treatment of headaches, migraines, back pain, cervical pain and osteoarthritis. The remaining pathologies still require further good quality studies. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.
Schjerning, Ole; Rosenzweig, Mary; Pottegård, Anton; Damkier, Per; Nielsen, Jimmi
Several case reports and epidemiological studies have raised concern about the abuse potential of pregabalin, the use of which has increased substantially over the last decade. Pregabalin is, in some cases, used for recreational purposes and it has incurred attention among drug abusers for causing euphoric and dissociative effects when taken in doses exceeding normal therapeutic dosages or used by alternative routes of administration, such as nasal insufflation or venous injection. The magnitude of the abuse potential and the mechanism behind it are not fully known. The aim of this study was to present a systematic review of the data concerning the abuse potential of pregabalin. We performed a systematic literature search and reviewed the preclinical, clinical and epidemiological data on the abuse potential of pregabalin. We included preclinical (n = 17), clinical (n = 19) and epidemiological (n = 13) studies addressing the abuse potential of pregabalin. We also reviewed case reports (n = 9) concerning abuse of pregabalin. The preclinical studies indicated that pregabalin possesses modulatory effects on the GABA and glutamate systems, leaving room for an abuse potential. Further, clinical studies reported euphoria as a frequent side effect in patients treated with pregabalin. The majority of case reports concerning abuse of pregabalin involved patients with a history of substance abuse and, similarly, epidemiological studies found evidence of abuse, especially among opiate abusers. Overall, the available literature suggests an important clinical abuse potential of pregabalin and prescribers should pay attention to signs of abuse, especially in patients with a history of substance abuse.
Dasteh Goli N.*BSc
Full Text Available Abstract Aims: Intellectual disability is a condition characterised by the inability of a person to undertake normal psychological activities. The purpose of this study was to systematically review the intellectual disability in children and discuss the implications of different environmental and genetic factors, which describe particular categories of intellectual disable cases. Information & Methods: This systematic review was performed in 2014 by searching the existing literature in PubMed database in the scope of “intellectual disability in children”. 38 articles written from 1987 to 2014 were selected and surveyed for review. Findings: The prevalence of ID in the general population is estimated to be approximately 1%. ID disorder is multi-causal, encompassing all factors that interfere with brain development and functioning. Causes usually are classified according to the time of the insult, as prenatal, perinatal, and postnatal or acquired. Some causes, such as environmental toxins or endocrine disorders, may act at multiple times. Others, such as genetic disorders, have different manifestations during postnatal development. The outcome for ID is variable and depends upon the aetiology, associated conditions, and environmental and social factors. The goals of management of ID are to strengthen areas of reduced function, minimize extensive deterioration in mental cognitive and adaptability, and lastly, to promote optimum or normal functioning of the individuals in their community. Conclusion: Prominent features of ID include significant failures in both intellectual functioning and adaptive behaviour, which comprises daily social and practical life skills, commencing earlier in life.
Vondráčková, Petra; Gabrhelík, Roman
Background and aims Out of a large number of studies on Internet addiction, only a few have been published on the prevention of Internet addiction. The aim of this study is provide a systematic review of scientific articles regarding the prevention of Internet addiction and to identify the relevant topics published in this area of interest. Methods The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were adopted. The EBSCO, ProQuest Central, and PubMed databases were searched for texts published in English and Spanish between January 1995 and April 2016. A total of 179 original texts were obtained. After de-duplication and topic-relevance review, 108 texts were systematically classified and subjected to descriptive analysis and subsequent content analysis. Results The results of the content analysis yielded the following thematic areas: (a) target groups, (b) the improvement of specific skills, (c) program characteristics, and (d) environmental interventions. Discussion and conclusion Literature on the prevention of Internet addiction is scarce. There is an urgent need to introduce and implement new interventions for different at-risk populations, conduct well-designed research, and publish data on the effectiveness of these interventions. Developing prevention interventions should primarily target children and adolescents at risk of Internet addiction but also parents, teachers, peers, and others who are part of the formative environment of children and adolescents at risk of Internet addiction. Newly designed interventions focused on Internet addiction should be rigorously evaluated and the results published.
Prostate cancer is a common malignant tumor of the elderly, which accounts for a significant proportion of total morbidity but very low of mortality. In Croatia, it is the second most common cancer in men. Currently, there are many doubts concerning screening, early detection and treatment of prostate cancer. Therefore, this article brings results of Cochrane systematic reviews (SRs) on the topic of prostate cancer published in the last eight years. In June 2016, Cochrane database of systematic reviews was searched using the following keywords: Systematic Reviews, and Prostate Cancer (Malignancy, Neoplasm). Inclusion criterion was publication date of the Cochrane SR or its update in the last eight years. The abstracts were initially screened and those that matched the topic were included in further analysis. Then full texts of all SRs involved were obtained. SRs were classified into four topics: prevention, screening, treatment and psychosocial aspects. Our search retrieved a total of 19 Cochrane SRs on the topic of prostate cancer. Excluded were four articles that did not match the specific topic, and the remaining 15 full texts were obtained. One of these was on screening, two on prevention, the majority, i.e. eleven were on treatment, and one on the psychosocial aspects related to prostate cancer. Based on the results of the Cochrane SRs on prostate cancer, instead of mass/population screening, the individualized/opportunistic screening approach should be applied in men aged 55-69, always providing full information to the patient and taking into account the potential benefits and harms of this procedure.
O'Mara-Eves, Alison; Thomas, James; McNaught, John; Miwa, Makoto; Ananiadou, Sophia
The large and growing number of published studies, and their increasing rate of publication, makes the task of identifying relevant studies in an unbiased way for inclusion in systematic reviews both complex and time consuming. Text mining has been offered as a potential solution: through automating some of the screening process, reviewer time can be saved. The evidence base around the use of text mining for screening has not yet been pulled together systematically; this systematic review fills that research gap. Focusing mainly on non-technical issues, the review aims to increase awareness of the potential of these technologies and promote further collaborative research between the computer science and systematic review communities. Five research questions led our review: what is the state of the evidence base; how has workload reduction been evaluated; what are the purposes of semi-automation and how effective are they; how have key contextual problems of applying text mining to the systematic review field been addressed; and what challenges to implementation have emerged? We answered these questions using standard systematic review methods: systematic and exhaustive searching, quality-assured data extraction and a narrative synthesis to synthesise findings. The evidence base is active and diverse; there is almost no replication between studies or collaboration between research teams and, whilst it is difficult to establish any overall conclusions about best approaches, it is clear that efficiencies and reductions in workload are potentially achievable. On the whole, most suggested that a saving in workload of between 30% and 70% might be possible, though sometimes the saving in workload is accompanied by the loss of 5% of relevant studies (i.e. a 95% recall). Using text mining to prioritise the order in which items are screened should be considered safe and ready for use in 'live' reviews. The use of text mining as a 'second screener' may also be used cautiously
Bjørn, Maya Xania; Perdawood, Sharaf Karim
of the dissection. We aimed to evaluate the literature on TaTME. METHODS: We performed a systematic search of the literature in the PubMed and Embase databases. Both authors assessed the studies. All publications on TaTME were included with the exception of review articles. RESULTS: A total of 29 studies (336...... patients) were included. Only low-quality evidence is available, and the literature consists of case reports and case series. Studies represent the initial experience of surgeons/centres. No precise indication for TaTME is yet specified other than the presence of mid and low rectal tumours, although...
Millington, A J F; Gaunt, A C; Phillips, J S
To determine if there is evidence that post-tonsillectomy dietary advice affects post-operative morbidity. A systematic review was conducted of Embase, Medline, the Cumulative Index to Nursing and Allied Health Literature and PsycInfo, to November 2014. Seventeen articles were included; their heterogeneous nature prevented meta-analysis. Of these, all three small, randomised studies showed no statistical difference in morbidity between restricted and non-restricted diets. Most post-tonsillectomy dietary advice is based on historical anecdotes and not rigorous scientific testing. The existing small-scale, randomised studies show no statistical difference in morbidity between non-restricted and restricted diets.
Yu, Guang; Yu, Man-li; Wang, Jia-feng; Gao, Cong-rong; Chen, Zhong-jin
Wolfram syndrome is a rare hereditary disease characterized by diabetes mellitus and optic atrophy. The outcome of this disease is always poor. WFS1 gene mutation is the main cause of this disease. A patient with diabetes mellitus, diabetes insipidus, renal tract disorder, psychiatric abnormality, and cataract was diagnosed with Wolfram syndrome. Mutations in open reading frame (ORF) of WFS1 gene was analyzed by sequencing. Mutations in WFS1 gene was also summarized by a systematic review in Pubmed and Chinese biological and medical database. Sequencing of WFS1 gene in this patient showed a new mutation, 1962G>A, and two other non-sense mutations, 2433A>G and 2565G>A. Systematic review included 219 patients in total and identified 172 WFS1 gene mutations, most of which were located in Exon 8. These mutations in WFS1 gene might be useful in prenatal diagnosis of Wolfram syndrome.
Hasani-Ranjbar, Shirin; Jouyandeh, Zahra; Abdollahi, Mohammad
Obesity is the most prevalent health problem affecting all age groups, and leads to many complications in the form of chronic heart disease, diabetes mellitus Type 2 and stroke. A systematic review about safety and efficacy of herbal medicines in the management of obesity in human was carried out by searching bibliographic data bases such as, PubMed, Scopus, Google Scholar, Web of Science, and IranMedex, for studies reported between 30th December 2008 to 23rd April 2012 on human or animals, i...
N.E. Lankhorst (Nienke); S.M. Bierma-Zeinstra (Sita); M. van Middelkoop (Marienke)
markdownabstractABSTRACT This review systematically summarises factors associated with patellofemoral pain syndrome (PFPS). A systematic literature search was conducted. Studies including ≥20 patients with PFPS that examined ≥1 possible factor associated with PFPS were included. A
Hjelm, Katarina; Mufunda, Esther; Nambozi, Grace; Kemp, Joan
Diabetes constitutes a global public health problem. Today about 135 million people are affected and it is estimated that the number in 2025 will be 300 million. By reviewing existing literature the aim is to raise awareness among nurses, nurse educators and nursing students of the global epidemic of diabetes mellitus, its multiple underlying causes, especially social ones, and how to fight it. A further aim is to discuss the implications for future curriculum content in nurse education programmes. The main underlying causes of the disease are genetic and environmental factors, such as urbanization and industrialization, as well as increased longevity and changes in lifestyle from a traditional healthy and active life to a modern, sedentary, stressful life and over-consumption of energy-dense foods. This process, labelled 'coca-colonization', is evident all over the world, although more so in developing countries. The prevalence of diabetes mellitus varies among populations due to differences in genetic susceptibility and social risk factors such as change in diet, obesity, physical inactivity and, possibly, factors relating to intrauterine development. Migrants are especially affected. Diabetes mellitus needs to be treated by a holistic approach through dietary adjustment, exercise, medication (if needed), education and self-care measures. Type 2 diabetes mellitus is a preventable disease. The main implication for nurses and nursing curricula is to change the focus from the individual with diabetes mellitus and management to prevent deterioration of health (secondary prevention), to population-based community-intervention programmes. These need to focus on health promoting activities to raise awareness among healthy people of the risk factors for diabetes mellitus. Nurses all over the world have an important role in fighting the diabetic pandemic by health promotion aimed to keep people healthy as long as possible.
Results: The original search yielded 239 articles, of which 52 articles described human cases. After following the inclusion and exclusion criteria, 32 studies describing 310 cases (151 females, 175 children of human poisoning with amitraz were included in this systematic review. The most commonly reported clinical features of amitraz poisoning were altered sensorium, miosis, hyperglycaemia, bradycardia, vomiting, respiratory failure, hypotension and hypothermia. Amitraz poisoning carried a good prognosis with only six reported deaths (case fatality rate, 1.9%. Nearly 20 and 11.9 per cent of the patients required mechanical ventilation and inotropic support, respectively. The role of decontamination methods, namely, gastric lavage and activated charcoal was unclear. Interpretation & conclusions: Our review shows that amitraz is an important agent for accidental or suicidal poisoning in both adults and children. It has a good prognosis with supportive management.
Full Text Available Purpose. The present study aimed to examine the current methods employed to assess anticipation in soccer players as well as to elicit the main findings of recent studies. Methods. The study was carried out in systematic review form and its sample comprised nine scientific papers published in academic journals. Only the studies involving soccer players (professionals and amateurs, except goalkeepers were included in this review. Results and conclusions. We observed that most of the studies employed video footage obtained from soccer matches, which are occluded at a given point for study participants to quickly and precisely elicit the positions of opponents, teammates and the ball as well as anticipate actions (dribbling, shooting, passing from surrounding players (teammates and opponents. In addition, the studies compared the performance of players from both high and low competitive levels in anticipation tasks.
The NRC Systematic Evaluation Program is currently making an assessment of the seismic design safety of 11 older nuclear power plant facilities. The general review philosophy and review criteria relative to seismic input, structural response, and equipment functionability are presented, including the rationale for the development of these guidelines considering the significant evolution of seismic design criteria since these plants were originally licensed. Technical approaches thought more realistic in light of current knowledge are utilized. Initial findings for plants designed to early seismic design procedures suggest that with minor exceptions, these plants possess adequate seismic design margins when evaluated against the intent of current criteria. However, seismic qualification of electrical equipment has been identified as a subject which requires more in-depth evaluation
Choong, Miew Keen; Galgani, Filippo; Dunn, Adam G; Tsafnat, Guy
Snowballing involves recursively pursuing relevant references cited in the retrieved literature and adding them to the search results. Snowballing is an alternative approach to discover additional evidence that was not retrieved through conventional search. Snowballing's effectiveness makes it best practice in systematic reviews despite being time-consuming and tedious. Our goal was to evaluate an automatic method for citation snowballing's capacity to identify and retrieve the full text and/or abstracts of cited articles. Using 20 review articles that contained 949 citations to journal or conference articles, we manually searched Microsoft Academic Search (MAS) and identified 78.0% (740/949) of the cited articles that were present in the database. We compared the performance of the automatic citation snowballing method against the results of this manual search, measuring precision, recall, and F1 score. The automatic method was able to correctly identify 633 (as proportion of included citations: recall=66.7%, F1 score=79.3%; as proportion of citations in MAS: recall=85.5%, F1 score=91.2%) of citations with high precision (97.7%), and retrieved the full text or abstract for 490 (recall=82.9%, precision=92.1%, F1 score=87.3%) of the 633 correctly retrieved citations. The proposed method for automatic citation snowballing is accurate and is capable of obtaining the full texts or abstracts for a substantial proportion of the scholarly citations in review articles. By automating the process of citation snowballing, it may be possible to reduce the time and effort of common evidence surveillance tasks such as keeping trial registries up to date and conducting systematic reviews.
Diabetes mellitus has become a modern global epidemic, with steadily increasing prevalence rates related to lifestyle such that 27% of individuals aged 65 years or older have diabetes mellitus, 95% of whom have type 2. This article reviews the effects of diabetes mellitus on the neuromuscular system. Diabetes mellitus leads to diverse forms of peripheral neuropathy as the major neuromuscular complication. Both focal and diffuse types of neuropathy can develop, with the most common form being diabetic sensorimotor polyneuropathy. Small fibers are damaged early in the development of diabetic sensorimotor polyneuropathy and are not assessed by nerve conduction studies. Small fiber damage occurs even in the prediabetes stage. No disease-modifying therapy for diabetic sensorimotor polyneuropathy is available at this time, but this complication can be limited in patients who have type 1 diabetes mellitus with strict glycemic control; the same outcome is not clearly observed in patients who have type 2 diabetes mellitus. Recently, the evidence base for symptomatic treatments of painful diabetic sensorimotor polyneuropathy underwent systematic review. Effective evidence-based treatments include some anticonvulsants (eg, pregabalin, gabapentin), antidepressants (eg, amitriptyline, duloxetine), opioids (eg, morphine sulfate, oxycodone), capsaicin cream, and transcutaneous electrical nerve stimulation. This article reviews the increasing prevalence of diabetes mellitus and diabetic sensorimotor polyneuropathy and discusses recent consensus opinion on the objective confirmation needed for the diagnosis in the clinical research setting. The evidence from clinical trials shows that intensive glycemic control reduces prevalence of diabetic sensorimotor polyneuropathy in patients with type 1 diabetes mellitus, but variable outcomes are observed in patients with type 2 diabetes mellitus. Finally, despite the lack of disease-modifying treatment, effective evidence-based therapy can
Aouad, Phillip; Hay, Phillipa; Soh, Nerissa; Touyz, Stephen
This systematic review is an evaluation of the empirical literature relating to the disordered eating behaviour Chew and Spit (CHSP). Current theories postulate that CHSP is a symptom exhibited by individuals with recurrent binge eating and Bulimia Nervosa. The review aimed to identify and critically assess studies that have examined the distribution of CHSP behaviour, its relationship to eating disorders, its physical and psychosocial consequences and treatment. A systematic database search with broad inclusion criteria, dated to January 2016 was conducted. Data were extracted by two authors and papers appraised for quality using a modified Downs and Black Quality Index. Nine studies met the inclusion criteria. All were of clinical samples and majority (n = 7) were of low quality. The pathological action of chewing food but not swallowing was reported more often in those with restrictive type eating disorders, such as Anorexia Nervosa, than binge eating type disorders. CHSP also was reported to be an indicator of overall severity of an eating disorder and to appear more often in younger individuals. No studies of treatment were found. Conclusions were limited due to the low quality and small numbers of studies based on clinical samples only. Further research is needed to address gaps in knowledge regarding the physiological, psychological, social, socioeconomic impact and treatment for those engaging in CHSP.
Brooke, Joanne; Ojo, Omorogieva
The aim of this systematic review is to evaluate the role of enteral nutrition in dementia. The prevalence of dementia is predicted to rise worldwide partly due to an aging population. People with dementia may experience both cognitive and physical complications that impact on their nutritional intake. Malnutrition and weight loss in dementia correlates with cognitive decline and the progress of the disease. An intervention for long term eating difficulties is the provision of enteral nutrition through a Percutaneous Endoscopic Gastrostomy tube to improve both nutritional parameters and quality of life. Enteral nutrition in dementia has traditionally been discouraged, although further understanding of physical, nutritional and quality of life outcomes are required. The following electronic databases were searched: EBSCO Host, MEDLINE, PubMed, Cochrane Database of Systematic Reviews and Google Scholar for publications from 1st January 2008 and up to and including 1st January 2014. Inclusion criteria included the following outcomes: mortality, aspiration pneumonia, pressure sores, nutritional parameters and quality of life. Each study included separate analysis for patients with a diagnosis of dementia and/or neurological disease. Retrospective and prospective observational studies were included. No differences in mortality were found for patients with dementia, without dementia or other neurological disorders. Risk factors for poor survival included decreased or decreasing serum albumin levels, increasing age or over 80 years and male gender. Evidence regarding pneumonia was limited, although did not impact on mortality. No studies explored pressure sores or quality of life. PMID:25854831
Full Text Available The aim of this systematic review is to evaluate the role of enteral nutrition in dementia. The prevalence of dementia is predicted to rise worldwide partly due to an aging population. People with dementia may experience both cognitive and physical complications that impact on their nutritional intake. Malnutrition and weight loss in dementia correlates with cognitive decline and the progress of the disease. An intervention for long term eating difficulties is the provision of enteral nutrition through a Percutaneous Endoscopic Gastrostomy tube to improve both nutritional parameters and quality of life. Enteral nutrition in dementia has traditionally been discouraged, although further understanding of physical, nutritional and quality of life outcomes are required. The following electronic databases were searched: EBSCO Host, MEDLINE, PubMed, Cochrane Database of Systematic Reviews and Google Scholar for publications from 1st January 2008 and up to and including 1st January 2014. Inclusion criteria included the following outcomes: mortality, aspiration pneumonia, pressure sores, nutritional parameters and quality of life. Each study included separate analysis for patients with a diagnosis of dementia and/or neurological disease. Retrospective and prospective observational studies were included. No differences in mortality were found for patients with dementia, without dementia or other neurological disorders. Risk factors for poor survival included decreased or decreasing serum albumin levels, increasing age or over 80 years and male gender. Evidence regarding pneumonia was limited, although did not impact on mortality. No studies explored pressure sores or quality of life.
Jaberidoost, Mona; Nikfar, Shekoufeh; Abdollahiasl, Akbar; Dinarvand, Rassoul
Supply of medicine as a strategic product in any health system is a top priority. Pharmaceutical companies, a major player of the drug supply chain, are subject to many risks. These risks disrupt the supply of medicine in many ways such as their quantity and quality and their delivery to the right place and customers and at the right time. Therefore risk identification in the supply process of pharmaceutical companies and mitigate them is highly recommended. In this study it is attempted to investigate pharmaceutical supply chain risks with perspective of manufacturing companies. Scopus, PubMed, Web of Science bibliographic databases and Google scholar scientific search engines were searched for pharmaceutical supply chain risk management studies with 6 different groups of keywords. All results found by keywords were reviewed and none-relevant articles were excluded by outcome of interests and researcher boundaries of study within 4 steps and through a systematic method. Nine articles were included in the systematic review and totally 50 main risks based on study outcome of interest extracted which classified in 7 categories. Most of reported risks were related to supply and supplier issues. Organization and strategy issues, financial, logistic, political, market and regulatory issues were in next level of importance. It was shown that the majority of risks in pharmaceutical supply chain were internal risks due to processes, people and functions mismanagement which could be managed by suitable mitigation strategies.
Joseph G L Lee
Full Text Available Research on the health of lesbian, gay, bisexual, and transgender (LGBT populations can provide important information to address existing health inequalities. Finding existing research in LGBT health can prove challenging due to the plethora of terminology used. We sought to describe existing search strategies and to identify more comprehensive LGBT search terminology. We iteratively created a search string to identify systematic reviews and meta-analyses about LGBT health and implemented it in Embase, PubMed/MEDLINE, and PsycINFO databases on May 28-29, 2015. We hand-searched the journal LGBT Health. Inclusion criteria were: systematic reviews and meta-analyses that addressed LGBT health, used systematic searching, and used independent coders for inclusion. The published search terminology in each record and search strings provided by authors on request were cross-referenced with our original search to identify additional terminology. Our search process identified 19 systematic reviews meeting inclusion criteria. The number of search terms used to identify LGBT-related records ranged from 1 to 31. From the included studies, we identified 46 new search terms related to LGBT health. We removed five search terms as inappropriate and added five search terms used in the field. The resulting search string included 82 terms. There is room to improve the quality of searching and reporting in LGBT health systematic reviews. Future work should attempt to enhance the positive predictive value of LGBT health searches. Our findings can assist LGBT health reviewers in capturing the diversity of LGBT terminology when searching.
Systematic reviews with meta-analysis represent the gold standard for conducting reliable and transparent reviews of the literature. The purpose of this article is threefold: (a) to address why and when it is worthwhile to conduct a systematic review with meta-analysis, covering advantages of this
Hong, Catherine H L; Hu, Shijia; Haverman, Thijs; Stokman, Monique; Napeñas, Joel J; Braber, Jacolien Bos-den; Gerber, Erich; Geuke, Margot; Vardas, Emmanouil; Waltimo, Tuomas; Jensen, Siri Beier; Saunders, Deborah P
INTRODUCTION: This systematic review aims to update on the prevalence of odontogenic-related infections and the efficacy of dental strategies in preventing dental-related complications in cancer patients since the 2010 systematic review. REVIEW METHOD: A literature search was conducted in the
Hong, C.H.L.; Hu, S.; Haverman, T.M.; Stokman, M.; Napeñas, J.J.; Bos-den Braber, J.; Gerber, E.; Geuke, M.; Vardas, E.; Waltimo, T.; Jensen, S.B.; Saunders, D.P.
Introduction: This systematic review aims to update on the prevalence of odontogenic-related infections and the efficacy of dental strategies in preventing dental-related complications in cancer patients since the 2010 systematic review. Review method: A literature search was conducted in the
Full Text Available Taru Tervo,1 Anna Nordström2 1Department of Surgical and Perioperative Sciences, Sports Medicine, Floorball Research and Development Center, Umeå School of Sport Sciences, 2Department of Surgical and Perioperative Sciences, Sports Medicine, Umeå School of Sport Sciences, Umeå University, Umeå, Sweden Background: The purpose of this study was to comprehensively review the scientific research on floorball at the competitive and recreational levels according to field of study. Methods: Full articles containing original data on floorball that had been published in English in peer-reviewed journals were considered for inclusion. Results: Of 75 articles screened, 19 were included in this systematic review. One article each was identified in the fields of sports management and sports psychology, and the remaining 17 articles were in the field of sports medicine. Injury epidemiology in floorball players was the most thoroughly examined topic of research. To date, no research has been performed on the incidence of floorball-related injury, or any aspect of the sport, in children and adolescents. Conclusion: Collaborative research among sports science disciplines is needed to identify strategies to reduce the incidence of injury and enhance the performance of licensed floorball players. Despite the increasing popularity of floorball in recent years, surprisingly little research has examined this sport. Keywords: floorball, unihockey, review
Mishra, Sunil Kumar; Chowdhary, Ramesh; Chrcanovic, Bruno Ramos; Brånemark, Per-Ingvar
Replacement of lost teeth has significant functional and psychosocial effects. The capability of osseointegrated dental implants to transmit a certain amount of sensibility is still unclear. The phenomenon of developing a certain amount of tactile sensibility through osseointegrated dental implants is called osseoperception. The aim of this article is to evaluate the available literature to find osseoperception associated with dental implants. To identify suitable literature, an electronic search was performed using Medline and PubMed database. Articles published in English and articles whose abstract is available in English were included. The articles included in the review were based on osseoperception, tactile sensation, and neurophysiological mechanoreceptors in relation to dental implants. Articles on peri-implantitis and infection-related sensitivity were not included. Review articles without the original data were excluded, although references to potentially pertinent articles were noted for further follow-up. The phenomenon of osseoperception remains a matter of debate, so the search strategy mainly focused on articles on osseoperception and tactile sensibility of dental implants. This review presents the histological, neurophysiological, and psychophysical evidence of osseoperception and also the role of mechanoreceptors in osseoperception. The literature on osseoperception in dental implants is very scarce. The initial literature search resulted in 90 articles, of which 81 articles that fulfilled the inclusion criteria were included in this systematic review. Patients restored with implant-supported prostheses reported improved tactile and motor function when compared with patients wearing complete dentures. © 2016 by the American College of Prosthodontists.
Full Text Available Cutaneous pseudolymphoma (CPL is a reactive polyclonal T- or B-cell lymphoproliferative process. CPL may appear as localized or disseminated skin lesions. While most cases of CPL are idiopathic, they may also occur as a response to, for example, contact dermatitis, arthropod reactions, and bacterial infections. CPL can be classified based on its clinical features, but all variants have similar histopathological patterns of either predominantly B-cell infiltrates, T-cell infiltrates, or mixed T/B-cell infiltrates. The prognosis of CPL is good, but the underlying disease process should be taken into account. If an antigenic stimulus is identified, it should be removed. In patients with idiopathic CPL, a close follow-up control strategy should be adopted. The aim of this systematic review is to summarize all reported treatments for CPL. The review was based on articles from the PubMed database, using the query “skin pseudolymphoma treatment”, English and German, about “human” subjects, and published between 1990 and 2015 documenting adequate treatment and/or aetiology. Mainly individual case reports and small case series were found. Treatment options include topical and intralesional agents, systemic agents, and physical modalities. The final part of the review proposes a treatment algorithm for CPL according to each aetiology, based on the literature of the last 25 years. Future research should focus on randomized controlled trials and studies on long-term outcomes, which were not identified in the current review.
Full Text Available The present article aims to review the available literature on match analysis in adult male Volleyball. Specific key words "performance analysis", "match analysis", "game analysis", "notational analysis", "tactical analysis", "technical analysis", "outcome" and "skills" were used to search relevant databases (PubMed, Web of Science, SportDiscus, Academic Search Complete and the International Journal of Performance Analysis in Sport. The research was conducted according to PRISMA (Preferred Reporting Items for Systematic reviews and Meta analyses guidelines. Of 3407 studies initially identified, only 34 were fully reviewed, and their outcome measures extracted and analyzed. Studies that fit all inclusion criteria were organized into two levels of analysis, according to their research design (comparative or predictive and depending on the type of variables analyzed (skills and their relationship with success, play position and match phase. Results show that from a methodological point of view, comparative studies where currently complemented with some predictive studies. This predictive approach emerged with the aim to identify the relationship between variables, considering their possible interactions and consequently its effect on team performance, contributing to a better understanding of Volleyball game performance through match analysis. Taking into account the limitations of the reviewed studies, future research should provide comprehensive operational definitions for the studied variables, using more recent samples, and consider integrating the player positions and match phase contexts into the analysis of Volleyball.
Mesmar, Bayan; Poola-Kella, Silpa; Malek, Rana
This paper reviews the physiologic mechanisms responsible for glucose intolerance and diabetes mellitus in patients with pheochromocytoma. Google Scholar and PubMed were searched using the following key words: "diabetes," "pheochromocytoma," "adrenoreceptors," and "hyperglycemia." All the articles that were retrieved and reviewed were in the English language. Glucose intolerance and diabetes mellitus, resulting from high circulating levels of catecholamines, are mainly the product of compromised insulin secretion from the β-cells in the pancreas, decreased glucose uptake in the peripheral tissues, and increased insulin resistance. As pheochromocytomas mainly present with cardiovascular and autonomic hyperfunctioning, it is important to understand the metabolic disorders associated with this rare disease. Hyperglycemia is an associated metabolic abnormality which can drastically improve after tumor resection, and significant downscaling of anti-hyperglycemic therapy is often required. GLUT4 = glucose transporter type 4 HbA1c = hemoglobin A1c IL = interleukin OGTT = oral glucose tolerance test.
Full Text Available Abstract Background The use of telemedicine is growing, but its efficacy for achieving comparable or improved clinical outcomes has not been established in many medical specialties. The objective of this systematic review was to evaluate the efficacy of telemedicine interventions for health outcomes in two classes of application: home-based and office/hospital-based. Methods Data sources for the study included deports of studies from the MEDLINE, EMBASE, CINAHL, and HealthSTAR databases; searching of bibliographies of review and other articles; and consultation of printed resources as well as investigators in the field. We included studies that were relevant to at least one of the two classes of telemedicine and addressed the assessment of efficacy for clinical outcomes with data of reported results. We excluded studies where the service did not historically require face-to-face encounters (e.g., radiology or pathology diagnosis. All included articles were abstracted and graded for quality and direction of the evidence. Results A total of 25 articles met inclusion criteria and were assessed. The strongest evidence for the efficacy of telemedicine in clinical outcomes comes from home-based telemedicine in the areas of chronic disease management, hypertension, and AIDS. The value of home glucose monitoring in diabetes mellitus is conflicting. There is also reasonable evidence that telemedicine is comparable to face-to-face care in emergency medicine and is beneficial in surgical and neonatal intensive care units as well as patient transfer in neurosurgery. Conclusions Despite the widespread use of telemedicine in virtually all major areas of health care, evidence concerning the benefits of its use exists in only a small number of them. Further randomized controlled trials must be done to determine where its use is most effective.
Fourman, Matthew M; Saber, Alan A
Obesity is a nationwide epidemic, and the only evidence-based, durable treatment of this disease is bariatric surgery. This field has evolved drastically during the past decade. One of the latest advances has been the increased use of robotics within this field. The goal of our study was to perform a systematic review of the recent data to determine the safety and efficacy of robotic bariatric surgery. The setting was the University Hospitals Case Medical Center (Cleveland, OH). A PubMed search was performed for robotic bariatric surgery from 2005 to 2011. The inclusion criteria were English language, original research, human, and bariatric surgical procedures. Perioperative data were then collected from each study and recorded. A total of 18 studies were included in our review. The results of our systematic review showed that bariatric surgery, when performed with the use of robotics, had similar or lower complication rates compared with traditional laparoscopy. Two studies showed shorter operative times using the robot for Roux-en-Y gastric bypass, but 4 studies showed longer operative times in the robotic arm. In addition, the learning curve appears to be shorter when robotic gastric bypass is compared with the traditional laparoscopic approach. Most investigators agreed that robotic laparoscopic surgery provides superior imaging and freedom of movement compared with traditional laparoscopy. The application of robotics appears to be a safe option within the realm of bariatric surgery. Prospective randomized trials comparing robotic and laparoscopic outcomes are needed to further define the role of robotics within the field of bariatric surgery. Longer follow-up times would also help elucidate any long-term outcomes differences with the use of robotics versus traditional laparoscopy. Copyright © 2012 American Society for Metabolic and Bariatric Surgery. All rights reserved.
Marchiano, Emily; Chin, Oliver Y; Fang, Christina H; Park, Richard Chan; Baredes, Soly; Eloy, Jean Anderson
Adenoid cystic carcinoma is a malignant minor salivary gland tumor that represents laryngeal tumors. The submucosal location of laryngeal adenoid cystic carcinoma (LACC) results in delayed presentation. Here, we present the first systematic review of reported cases of LACC to determine trends in presentation, diagnostic and treatment modalities, and patient outcome. PubMed, Web of Science, MEDLINE, and EMBASE databases. A search of the above databases was done to identify articles reporting cases of LACC. The variables included in the analysis were patient demographics, presenting symptoms, tumor location, imaging, treatment, follow-up time, recurrence, and outcome. A total of 50 articles and 120 cases were included in the review. The most common presenting symptom was dyspnea (48.8%), followed by hoarseness (43.9%). LACC arose most frequently from the subglottis (56.7%). At presentation, 14.6% (13 of 89) of patients had regional disease. The average follow-up time was 54.0 months. At follow-up, distant metastasis was reported in 30 cases (33.3%). Surgery alone (43.3%) and surgery with radiotherapy (43.3%) were used most frequently and resulted in 57.1% and 55.3% of patients alive with no evidence disease at follow-up, respectively. LACC was most often located in the subglottis. Patients commonly presented with dyspnea and hoarseness. In this systematic review, surgery with radiotherapy and surgery alone were the most commonly employed treatment modalities, and both resulted in slightly more than 50% of patients alive with no evidence of disease at follow-up. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2015.
Mohammad Fareed; Nasir Salam; Abdullah T Khoja; Mahmoud Abdulrahman Mahmoud; Maqusood Ahamed
Aims: Role of life style related risk factors is very important in the pathogenesis and progression of Type 2 Diabetes Mellitus. The aim of this article is to review the disease burden of Type 2 diabetes mellitus (T2DM) among the population of Saudi Arabia due to unhealthy life style. Methods: In this review, the information was collected from published literatures related to risk factors like unhealthy dietary pattern and sedentary life style leading to T2DM. Additionally, some e...
Horton, William B; Subauste, Jose S
Type 1 diabetes mellitus (T1DM) results from a highly specific immune-mediated destruction of pancreatic β cells, resulting in chronic hyperglycemia. For many years, one of the mainstays of therapy for patients with T1DM has been exercise balanced with appropriate medications and medical nutrition. Compared to healthy peers, athletes with T1DM experience nearly all the same health-related benefits from exercise. Despite these benefits, effective management of the T1DM athlete is a constant challenge due to various concerns such as the increased risk of hypoglycemia. This review seeks to summarize the available literature and aid clinicians in clinical decision-making for this patient population. PubMed searches were conducted for "type 1 diabetes mellitus AND athlete" along with "type 1 diabetes mellitus AND exercise" from database inception through November 2015. All articles identified by this search were reviewed if the article text was available in English and related to management of athletes with type 1 diabetes mellitus. Subsequent reference searches of retrieved articles yielded additional literature included in this review. The majority of current literature available exists as recommendations, review articles, or proposed societal guidelines, with less prospective or higher-order treatment studies available. The available literature is presented objectively with an attempt to describe clinically relevant trends and findings in the management of athletes living with T1DM. Managing T1DM in the context of exercise or athletic competition is a challenging but important skill for athletes living with this disease. A proper understanding of the hormonal milieu during exercise, special nutritional needs, glycemic control, necessary insulin dosing adjustments, and prevention/management strategies for exercise-related complications can lead to successful care plans for these patients. Individualized management strategies should be created with close cooperation
Ekmektzoglou, Konstantinos A; Zografos, Georgios C
This paper reviews the negative impact of diabetes mellitus or hypothyroidism on wound healing, both in experimental and clinical settings. Since both are metabolic disorders of great clinical importance, special attention is given, not only to their pathophysiology, but also to their biochemical and histological effects on tissue integrity and regeneration. Also, special focus is awarded on wound healing of the gastrointestinal tract, i.e. in intestinal anastomosis, and how these disorders c...
Costa, L; Cunha, JP; Amado, D; Abegão Pinto, L; Ferreira, J
ABSTRACT Glaucoma is a multifactorial condition under serious influence of many risk factors. The role of diabetes mellitus (DM) in glaucoma etiology or progression remains inconclusive. Although, the diabetic patients have different healing mechanism comparing to the general population and it has a possible-negative role on surgical outcomes. This review article attempts to analyze the association of both diseases, glaucoma and DM, before and after the surgery. The epidemiological studies, b...
Harries, A. D.; Satyanarayana, S.; Kumar, A. M. V.; Nagaraja, S. B.; Isaakidis, P.; Malhotra, S.; Achanta, S.; Naik, B.; Wilson, N.; Zachariah, R.; Lönnroth, K.; Kapur, A.
The global burden of diabetes mellitus (DM) is immense, with numbers expected to rise to over 550 million by 2030. Countries in Asia, such as India and China, will bear the brunt of this unfolding epidemic. Persons with DM have a significantly increased risk of developing active tuberculosis (TB) that is two to three times higher than in persons without DM. This article reviews the epidemiology and interactions of these two diseases, discusses how the World Health Organization and Internation...
COOK, CARLY N; POSSINGHAM, HUGH P; FULLER, RICHARD A
Systematic reviews comprehensively summarize evidence about the effectiveness of conservation interventions. We investigated the contribution to management decisions made by this growing body of literature. We identified 43 systematic reviews of conservation evidence, 23 of which drew some concrete conclusions relevant to management. Most reviews addressed conservation interventions relevant to policy decisions; only 35% considered practical on-the-ground management interventions. The majority of reviews covered only a small fraction of the geographic and taxonomic breadth they aimed to address (median = 13% of relevant countries and 16% of relevant taxa). The likelihood that reviews contained at least some implications for management tended to increase as geographic coverage increased and to decline as taxonomic breadth increased. These results suggest the breadth of a systematic review requires careful consideration. Reviews identified a mean of 312 relevant primary studies but excluded 88% of these because of deficiencies in design or a failure to meet other inclusion criteria. Reviews summarized on average 284 data sets and 112 years of research activity, yet the likelihood that their results had at least some implications for management did not increase as the amount of primary research summarized increased. In some cases, conclusions were elusive despite the inclusion of hundreds of data sets and years of cumulative research activity. Systematic reviews are an important part of the conservation decision making tool kit, although we believe the benefits of systematic reviews could be significantly enhanced by increasing the number of reviews focused on questions of direct relevance to on-the-ground managers; defining a more focused geographic and taxonomic breadth that better reflects available data; including a broader range of evidence types; and appraising the cost-effectiveness of interventions. Contribuciones de las Revisiones Sistemáticas a las
Forsyth, Susan R; Malone, Ruth E
Video games are played by a majority of adolescents, yet little is known about whether and how video games are associated with smoking behavior and attitudes. This systematic review examines research on the relationship between video games and smoking. We searched MEDLINE, psycINFO, and Web of Science through August 20, 2014. Twenty-four studies met inclusion criteria. Studies were synthesized qualitatively in four domains: the prevalence and incidence of smoking imagery in video games (n = 6), video game playing and smoking behavior (n = 11), video game addiction and tobacco addiction (n = 5) and genre-specific game playing and smoking behavior (n = 3). Tobacco content was present in a subset of video games. The literature is inconclusive as to whether exposure to video games as a single construct is associated with smoking behavior. Four of five studies found an association between video game addiction and smoking. For genre-specific game playing, studies suggest that the type of game played affected association with smoking behavior. Research on how playing video games influences adolescents' perceptions of smoking and smoking behaviors is still in its nascence. Further research is needed to understand how adolescents respond to viewing and manipulating tobacco imagery, and whether engaging in game smoking translates into changes in real-world attitudes or behavior. Smoking imagery in video games may contribute to normalizing adolescent smoking. A large body of research has shown that smoking imagery in a variety of media types contributes to adolescent smoking uptake and the normalization of smoking behavior, and almost 90% of adolescents play video games, yet there has never been a published systematic review of the literature on this important topic. This is the first systematic review to examine the research on tobacco and video games.We found that tobacco imagery is indeed present in video games, the relationship between video game playing and smoking
Miret Alomar, E; Trilla Herrera, E; Lorente Garcia, D; Regis Placido, L; López Del Campo, R; Cuadras Solé, M; Pont Castellana, T; Moreso Mateos, F; Serón Micas, D; Morote Robles, J
Kidney transplantation from donors with expanded criteria has increased the pool of kidneys at the cost of a higher risk of short and long-term graft dysfunction. The main issue lies in determining which kidneys will offer acceptable function and survival compared with the risk represented by surgery and subsequent immunosuppression. The objective of our article is to review the current evidence on the tools for predicting the functionality of kidney transplantation from cadaveric donors with expanded criteria and determining the validity for their use in standard practice. We conducted a systematic literature review according to the PRISM criteria, through Medline (http://www.ncbi.nlm.nih.gov) and using the keywords (in isolation or in conjunction) "cadaveric renal transplantation; kidney graft function appraisal, graft function predictors". We selected prospective and retrospective series and review articles. A total of 375 articles were analysed, 39 of which were ultimately selected for review. The predictors of functionality include the following: The donor risk indices; the calculation of the renal functional weight or the assessment of the nephronic mass; the measurement of vascular resistances during perfusion in hypothermia; the measurement of the donor's biomarkers in urine and in the perfusion liquid; the measurement of functional and reperfusion parameters in normothermia; and the measurement of morphological parameters (microscopic and macroscopic) of the target organ. In this article, we present an explanatory summary of each of these parameters, as well as their most recent evidence on this issue. None of the reviewed parameters in isolation could reliably predict renal function and graft survival. There is a significant void in terms of the macroscopic assessment of kidney transplantation. We need to continue developing predictors of renal functionality to accurately define the distribution of each currently available donor kidney. Copyright © 2017
Tervo, Taru; Nordström, Anna
Background The purpose of this study was to comprehensively review the scientific research on floorball at the competitive and recreational levels according to field of study. Methods Full articles containing original data on floorball that had been published in English in peer-reviewed journals were considered for inclusion. Results Of 75 articles screened, 19 were included in this systematic review. One article each was identified in the fields of sports management and sports psychology, and the remaining 17 articles were in the field of sports medicine. Injury epidemiology in floorball players was the most thoroughly examined topic of research. To date, no research has been performed on the incidence of floorball-related injury, or any aspect of the sport, in children and adolescents. Conclusion Collaborative research among sports science disciplines is needed to identify strategies to reduce the incidence of injury and enhance the performance of licensed floorball players. Despite the increasing popularity of floorball in recent years, surprisingly little research has examined this sport. PMID:25349484
Villani, Daniela; Carissoli, Claudia; Triberti, Stefano; Marchetti, Antonella; Gilli, Gabriella; Riva, Giuseppe
Emotion regulation (ER) supports multiple individual functions and promotes mental health and wellbeing. Among the tools that may be used to help people in managing their affective states, videogames are reaching attention and are showing positive effects. Yet, little is known about their effectiveness. This study aims to assess the amount and quality of studies investigating the effects and modalities of the use of videogames for ER. A systematic literature search according to PRISMA guidelines was performed. Subsequently, according to expert advice other few studies have been added. Twenty-three studies met the inclusion criteria and were included in the review; they can be categorized into three groups, namely (1) cross-sectional and qualitative studies, (2) experimental studies investigating the effects of videogame experience on ER and (3) ER intervention with serious games. Discussion of the reviewed studies highlights that frequent gaming with commercial games offers more opportunities for ER improvement (related to gameplay and enjoyment of fictional properties) than limited-time experiences, such as those supported by bespoke serious games. This research area is still in its infancy and findings need to be interpreted with caution; furthermore, future reviews are encouraged to include clinical populations. Videogames offer several opportunities for ER and a challenge for educational and psychological interventions.
Chua, Horng Ruey; Schneider, Antoine; Bellomo, Rinaldo
This study was designed to examine the efficacy and risk of bicarbonate administration in the emergent treatment of severe acidemia in diabetic ketoacidosis (DKA). PUBMED database was used to identify potentially relevant articles in the pediatric and adult DKA populations. DKA intervention studies on bicarbonate administration versus no bicarbonate in the emergent therapy, acid-base studies, studies on risk association with cerebral edema, and related case reports, were selected for review. Two reviewers independently conducted data extraction and assessed the citation relevance for inclusion. From 508 potentially relevant articles, 44 were included in the systematic review, including three adult randomized controlled trials (RCT) on bicarbonate administration versus no bicarbonate in DKA. We observed a marked heterogeneity in pH threshold, concentration, amount, and timing for bicarbonate administration in various studies. Two RCTs demonstrated transient improvement in metabolic acidosis with bicarbonate treatment within the initial 2 hours. There was no evidence of improved glycemic control or clinical efficacy. There was retrospective evidence of increased risk for cerebral edema and prolonged hospitalization in children who received bicarbonate, and weak evidence of transient paradoxical worsening of ketosis, and increased need for potassium supplementation. No studies involved patients with an initial pH pediatric population, in view of possible clinical harm and lack of sustained benefits.
Objective This study was designed to examine the efficacy and risk of bicarbonate administration in the emergent treatment of severe acidemia in diabetic ketoacidosis (DKA). Methods PUBMED database was used to identify potentially relevant articles in the pediatric and adult DKA populations. DKA intervention studies on bicarbonate administration versus no bicarbonate in the emergent therapy, acid-base studies, studies on risk association with cerebral edema, and related case reports, were selected for review. Two reviewers independently conducted data extraction and assessed the citation relevance for inclusion. Results From 508 potentially relevant articles, 44 were included in the systematic review, including three adult randomized controlled trials (RCT) on bicarbonate administration versus no bicarbonate in DKA. We observed a marked heterogeneity in pH threshold, concentration, amount, and timing for bicarbonate administration in various studies. Two RCTs demonstrated transient improvement in metabolic acidosis with bicarbonate treatment within the initial 2 hours. There was no evidence of improved glycemic control or clinical efficacy. There was retrospective evidence of increased risk for cerebral edema and prolonged hospitalization in children who received bicarbonate, and weak evidence of transient paradoxical worsening of ketosis, and increased need for potassium supplementation. No studies involved patients with an initial pH < 6.85. Conclusions The evidence to date does not justify the administration of bicarbonate for the emergent treatment of DKA, especially in the pediatric population, in view of possible clinical harm and lack of sustained benefits. PMID:21906367
Abtahi, Mohammad-Ali; Abtahi, Seyed-Hossein; Fazel, Farhad; Roomizadeh, Peyman; Etemadifar, Masoud; Jenab, Keivan; Akbari, Mojtaba
Background and purpose Topiramate (TPM) is a sulfa-derivative monosaccharide that is used mainly for treating epilepsy and preventing migraine. Within the gamut of side effects attributable to this drug, ophthalmologic manifestations are of crucial importance. In this study, for the first time, the aim was to provide a systematic literature review regarding this issue. Methods For the time period 1996–2011, a PubMed search was made for the studies concerning the adverse/beneficial effects of TPM on vision. Overall, 404 citations out of a total of 2756 TPM-related studies were examined for relevance. Results A total of 74 relevant studies were reviewed, 65 of which comprise small observational studies describing the ophthalmic side effects of TPM in 84 patients. Of these patients, 66 were affected by ciliochoroidal effusion syndrome as the cardinal ocular side effect of TPM (17 cases of myopic shift and 49 cases of angle closure glaucoma). A comprehensive statistical analysis is provided on these 66 subjects. Other rare side effects of TPM on the vision were also reviewed, including massive choroidal effusion, ocular inflammatory reactions, visual field defects, probable effects on retina, cornea, and sclera, and neuroophthalmologic complications. In addition, a framework is provided to classify these results. Discussion Due to the expanding spectrum of indications for the administration of TPM, neurologists and psychiatrists should be aware of its diverse ocular side effects. In conclusion, ocular complications following this drug should be taken seriously and be subjected to ophthalmic counseling. PMID:22275816
Full Text Available The objectives of this study were to characterize and clarify the relationships between the various cognitive domains affected in COPD patients and the disease itself, as well as to determine the prevalence of impairment in the various cognitive domains in such patients. To that end, we performed a systematic review using the following databases: PubMed, Scopus, and ScienceDirect. We included articles that provided information on cognitive impairment in COPD patients. The review of the findings of the articles showed a significant relationship between COPD and cognitive impairment. The most widely studied cognitive domains are memory and attention. Verbal memory and learning constitute the second most commonly impaired cognitive domain in patients with COPD. The prevalence of impairment in visuospatial memory and intermediate visual memory is 26.9% and 19.2%, respectively. We found that cognitive impairment is associated with the profile of COPD severity and its comorbidities. The articles reviewed demonstrated that there is considerable impairment of the cognitive domains memory and attention in patients with COPD. Future studies should address impairments in different cognitive domains according to the disease stage in patients with COPD.
van der Valk, J P M; Dubois, A E J; Gerth van Wijk, R; Wichers, H J; de Jong, N W
Recent studies on cashew nut allergy suggest that the prevalence of cashew nut allergy is increasing. Cashew nut consumption by allergic patients can cause severe reactions, including anaphylaxis. This review summarizes current knowledge on cashew nut allergy to facilitate timely clinical recognition and to promote awareness of this emerging food allergy amongst clinicians. The goal of this study is to present a systematic review focused on the clinical aspects of allergy to cashew nut including the characteristics of cashew nut, the prevalence, allergenic components, cross-reactivity, diagnosis and management of cashew nut allergy. The literature search yielded 255 articles of which 40 met our selection criteria and were considered to be relevant for this review. The 40 articles included one prospective study, six retrospective studies and seven case reports. The remaining 26 papers were not directly related to cashew nut allergy. The literature suggests that the prevalence of cashew nut allergy is increasing, although the level of evidence for this is low. A minimal amount of cashew nut allergen may cause a severe allergic reaction, suggesting high potency comparable with other tree nuts and peanuts. Cashew allergy is clearly an underestimated important healthcare problem, especially in children. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Evans, W Douglas; Blitstein, Jonathan; Hersey, James C; Renaud, Jeanette; Yaroch, Amy L
Brands build relationships between consumers and products, services, or lifestyles by providing beneficial exchanges and adding value to their objects. Brands can be measured through associations that consumers hold for products and services. Public health brands are the associations that individuals hold for health behaviors, or lifestyles that embody multiple health behaviors. We systematically reviewed the literature on public health brands; developed a methodology for describing branded health messages and campaigns; and examined specific branding strategies across a range of topic areas, campaigns, and global settings. We searched the literature for published studies on public health branding available through all relevant, major online publication databases. Public health branding was operationalized as any manuscripts in the health, social science, and business literature on branding or brands in health promotion marketing. We developed formalized decision rules and applied them in identifying articles for review. We initially identified 154 articles and reviewed a final set of 37, 10 from Africa, Australia, and Europe. Branded health campaigns spanned most of the major domains of public health and numerous communication strategies and evaluation methodologies. Most studies provided clear information on planning, development, and evaluation of the branding effort, while some provided minimal information. Branded health messages typically are theory based, and there is a body of evidence on their behavior change effectiveness, especially in nutrition, tobacco control, and HIV/AIDS. More rigorous research is needed, however, on how branded health messages impact specific populations and behaviors.
Sareen, Jitender; Stein, Murray B; Thoresen, Siri; Belik, Shay-Lee; Zamorski, Mark; Asmundson, Gordon Jg
To systematically review the literature on the association between deployment to a peacekeeping mission and distress, mental disorders, and suicide. Peer-reviewed English publications were found through key word searches in MEDLINE, PsycINFO, Scopus, and Embase, and by contacting authors in the field. Sixty-eight articles were included in this review. Some studies have found higher levels of postdeployment distress and posttraumatic stress disorder (PTSD) symptoms. Most studies have not shown an increased risk of suicide in former peacekeepers. Correlates of distress and PTSD symptoms included level of exposure to traumatic events during deployment, number of deployments, predeployment personality traits or disorder, and postdeployment stressors. Perceived meaningfulness of the mission, postdeployment social supports, and positive perception of homecoming were associated with lower likelihood of distress. Most peacekeepers do not develop high levels of distress or symptoms of PTSD. As postdeployment distress is consistently shown to be associated with high levels of exposure to combat during deployment, targeted interventions for peacekeepers who have been exposed to high levels of combat should be considered.
Valiente-Gómez, Alicia; Moreno-Alcázar, Ana; Treen, Devi; Cedrón, Carlos; Colom, Francesc; Pérez, Víctor; Amann, Benedikt L.
Background: Eye Movement Desensitization and Reprocessing (EMDR) is a psychotherapeutic approach that has demonstrated efficacy in the treatment of Post-traumatic Stress Disorder (PTSD) through several randomized controlled trials (RCT). Solid evidence shows that traumatic events can contribute to the onset of severe mental disorders and can worsen their prognosis. The aim of this systematic review is to summarize the most important findings from RCT conducted in the treatment of comorbid traumatic events in psychosis, bipolar disorder, unipolar depression, anxiety disorders, substance use disorders, and chronic back pain. Methods: Using PubMed, ScienceDirect, and Scopus, we conducted a systematic literature search of RCT studies published up to December 2016 that used EMDR therapy in the mentioned psychiatric conditions. Results: RCT are still scarce in these comorbid conditions but the available evidence suggests that EMDR therapy improves trauma-associated symptoms and has a minor effect on the primary disorders by reaching partial symptomatic improvement. Conclusions: EMDR therapy could be a useful psychotherapy to treat trauma-associated symptoms in patients with comorbid psychiatric disorders. Preliminary evidence also suggests that EMDR therapy might be useful to improve psychotic or affective symptoms and could be an add-on treatment in chronic pain conditions. PMID:29018388
Full Text Available Background: Eye Movement Desensitization and Reprocessing (EMDR is a psychotherapeutic approach that has demonstrated efficacy in the treatment of Post-traumatic Stress Disorder (PTSD through several randomized controlled trials (RCT. Solid evidence shows that traumatic events can contribute to the onset of severe mental disorders and can worsen their prognosis. The aim of this systematic review is to summarize the most important findings from RCT conducted in the treatment of comorbid traumatic events in psychosis, bipolar disorder, unipolar depression, anxiety disorders, substance use disorders, and chronic back pain.Methods: Using PubMed, ScienceDirect, and Scopus, we conducted a systematic literature search of RCT studies published up to December 2016 that used EMDR therapy in the mentioned psychiatric conditions.Results: RCT are still scarce in these comorbid conditions but the available evidence suggests that EMDR therapy improves trauma-associated symptoms and has a minor effect on the primary disorders by reaching partial symptomatic improvement.Conclusions: EMDR therapy could be a useful psychotherapy to treat trauma-associated symptoms in patients with comorbid psychiatric disorders. Preliminary evidence also suggests that EMDR therapy might be useful to improve psychotic or affective symptoms and could be an add-on treatment in chronic pain conditions.
Eichenberg, Christiane; Schott, Markus
In the evolving digital age, media applications are increasingly playing a greater role in the field of psychotherapy. While the Internet is already in the phase of being established when it comes to the care of mental disorders, experimentation is going on with other modern media such as serious games. A serious game is a game in which education and behavior change is the goal, alongside with entertainment. The objective of the present article was to provide a first empirical overview of serious games applied to psychotherapy and psychosomatic rehabilitation. Therefore, a systematic literature search, including the terms "serious game" or "computer game" and "psychotherapy" or "rehabilitation" or "intervention" or "mental disorders" in the databases Medline and PsycINFO, was performed. Subsequently, an Internet search was conducted to identify studies not published in journals. Publications not providing empirical data about effectiveness were excluded. On the basis of this systematic literature review, the results of N = 15 studies met inclusion criteria. They utilized primarily cognitive behavioral techniques and can be useful for treating a range of mental disorders. Serious games are effective both as a stand-alone intervention or part of psychotherapy and appeal to patients independent of age and sex. Included serious games proved to be an effective therapeutic component. Nonetheless, findings are not conclusive and more research is needed to further investigate the effectiveness of serious games for psychotherapeutic purposes.
Nichols, Andrew W
Probiotic bacteria are defined as live food ingredients that are beneficial to the health of the host. Probiotics occur naturally in fermented food products such as yogurt, kefir, sauerkraut, cabbage kimchee, and soybean-based miso and natto. Numerous health benefits have been attributed to probiotics, including effects on gastrointestinal tract function and diseases, immune function, hyperlipidemia, hypertension, and allergic conditions. A systematic review of the medical literature failed to identify any studies that directly investigated the potential ergogenic effects of probiotics on athletic performance. Two published articles suggest that probiotics may enhance the immune responses of fatigued athletes. In summary, although scientific evidence for an ergogenic effect of probiotics is lacking, probiotics may provide athletes with secondary health benefits that could positively affect athletic performance through enhanced recovery from fatigue, improved immune function, and maintenance of healthy gastrointestinal tract function.
Spurrier, Michael; Blaszczynski, Alexander
Perception of the consequences of risk affects motivation and behaviour. In gambling, distorted expectations and preferences towards outcomes are associated with significant social and clinical harms. A systematic review was conducted to examine the relationship between gambling risk perception and behaviour. Sixteen studies met inclusion criteria. Studies provided evidence that disordered gamblers hold both more optimistic overall perceptions of risk, and a mixture of more positive and more negative specific outcome expectations. Preliminary evidence suggests a range of contextual and individual differences moderate risk perception affecting decision-making. Disordered gamblers appear to sustain motivation to gamble, despite more negative expectations and experiences, via cognitive processes that result in preferential emphasis on positive over negative outcomes. Given potential differences in the perception of risk between various categories of gamblers, clinicians should take into account how gamblers in treatment view gambling as a risky behaviour. Improving the accuracy of such perceptions may reduce the propensity for risk-taking behaviours.
Full Text Available Granuloma faciale is an uncommon benign chronic dermatosis characterized by reddish-brown to violaceous asymptomatic plaques appearing predominantly on the face. The pathogenesis of granuloma faciale remains unclear, and it is frequently unresponsive to therapy. This systematic review aims to summarize all recent publications on the management of granuloma faciale. The publications are mainly individual case reports, small case series and a few retrospective studies. Treatment options included topical, intralesional and systemic corticosteroids, topical pimecrolimus and tacrolimus, topical and systemic dapsone, systemic hydroxychloroquine, clofazimine, and tumour necrosis factor-alpha inhibitors. More invasive therapies using lasers as well as cryosurgery and surgery were also reported. Topical glucocorticosteroids and tacrolimus remain treatments of first choice, possibly supplemented by topical dapsone.
Lawrence, Ryan E; Oquendo, Maria A; Stanley, Barbara
Although religion is reported to be protective against suicide, the empirical evidence is inconsistent. Research is complicated by the fact that there are many dimensions to religion (affiliation, participation, doctrine) and suicide (ideation, attempt, completion). We systematically reviewed the literature on religion and suicide over the last 10 years (89 articles) with a goal of identifying what specific dimensions of religion are associated with specific aspects of suicide. We found that religious affiliation does not necessarily protect against suicidal ideation, but does protect against suicide attempts. Whether religious affiliation protects against suicide attempts may depend on the culture-specific implications of affiliating with a particular religion, since minority religious groups can feel socially isolated. After adjusting for social support measures, religious service attendance is not especially protective against suicidal ideation, but does protect against suicide attempts, and possibly protects against suicide. Future qualitative studies might further clarify these associations.
Feng, Yuan; Zhou, Jihing; Jiang, Ying
Resveratrol, a phytochemical known for its anti- oxidative properties has been explored worldwide for anticancer potential. We performed this systematic review and meta-analysis in order to register the efficacy of resveratrol against lung carcinogenesis. We searched PubMed for preclinical studies reporting efficacy of resveratrol alone or in combination with drugs like curcumin, cisplatin etc. against lung carcinogenesis. The primary outcome of eligible studies included change in overall tumor incidence as well as tumor size. In all of the above studies involving either animal models or in vitro cancer cell experiments a statistically significant reduction in tumor incidence emerged as compared with the control groups, yielding a relative risk reduction of 0.64 (p=0.002). This meta- analysis confirmed the potential of resveratrol against lung carcinogenesis. It can be concluded that resveratrol holds a good potential for future use as a highly efficient therapeutic agent to deal with deadly lung carcinogenesis.
Soole, Rebecca; Kõlves, Kairi; De Leo, Diego
The objective of this study was to provide a review of studies on suicide in children aged 14 years and younger. Articles were identified through a systematic search of Scopus, MEDLINE, and PsychINFO. Key words were "children, suicide, psychological autopsy, and case-study." Additional articles were identified through manual search of reference lists and discussion with colleagues. Fifteen published articles were identified, 8 psychological autopsy studies (PA), and 7 retrospective case-study series. Suicide incidence and gender asymmetry increases with age. Hanging is the most frequent method. Lower rates of psychopathology are evident among child suicides compared to adolescents. Previous suicide attempts were an important risk factor. Children were less likely to consume alcohol prior to suicide. Parent-child conflicts were the most common precipitant.
Solera, Javier; Solís García Del Pozo, Julián
Pulmonary involvement is a rare, focal complication of human brucellosis. The aim of this review is to describe clinical and radiologic features, treatment administered and clinical course of these patients. Areas covered: We conducted a systematic search of scientific reports of brucellosis with pulmonary involvement published from January 1985 to July 2016. Four main patterns of disease were observed: pneumonia, pleural effusion, nodules and interstitial pattern. Cough and fever were the most common symptoms. Brucella spp. culture was obtained from blood (50%) or pleural fluid. Treatment is based on the same antibiotics and combinations of antibiotics as for patients with acute no complicated brucellosis. The most frequent antimicrobial combination was doxycycline and rifampin for six weeks. The clinical course was favorable in most reports, and mortality was remarkably low (Brucellosis from other pulmonary infections, such as tuberculosis, sometimes posed an added diagnostic challenge.
Lauren J Stockman
Full Text Available BACKGROUND: The SARS outbreak of 2002-2003 presented clinicians with a new, life-threatening disease for which they had no experience in treating and no research on the effectiveness of treatment options. The World Health Organization (WHO expert panel on SARS treatment requested a systematic review and comprehensive summary of treatments used for SARS-infected patients in order to guide future treatment and identify priorities for research. METHODS AND FINDINGS: In response to the WHO request we conducted a systematic review of the published literature on ribavirin, corticosteroids, lopinavir and ritonavir (LPV/r, type I interferon (IFN, intravenous immunoglobulin (IVIG, and SARS convalescent plasma from both in vitro studies and in SARS patients. We also searched for clinical trial evidence of treatment for acute respiratory distress syndrome. Sources of data were the literature databases MEDLINE, EMBASE, BIOSIS, and the Cochrane Central Register of Controlled Trials (CENTRAL up to February 2005. Data from publications were extracted and evidence within studies was classified using predefined criteria. In total, 54 SARS treatment studies, 15 in vitro studies, and three acute respiratory distress syndrome studies met our inclusion criteria. Within in vitro studies, ribavirin, lopinavir, and type I IFN showed inhibition of SARS-CoV in tissue culture. In SARS-infected patient reports on ribavirin, 26 studies were classified as inconclusive, and four showed possible harm. Seven studies of convalescent plasma or IVIG, three of IFN type I, and two of LPV/r were inconclusive. In 29 studies of steroid use, 25 were inconclusive and four were classified as causing possible harm. CONCLUSIONS: Despite an extensive literature reporting on SARS treatments, it was not possible to determine whether treatments benefited patients during the SARS outbreak. Some may have been harmful. Clinical trials should be designed to validate a standard protocol for dosage
Bamba, Ravinder; Malhotra, Gautam; Bueno, Reuben A; Thayer, Wesley P; Shack, R Bruce
Ring avulsion injuries can range from soft tissue injury to complete amputation. Grading systems have been developed to guide treatment, but there is controversy with high-grade injuries. Traditionally, advanced ring injuries have been treated with completion amputation, but there is evidence that severe ring injuries can be salvaged. The purpose of this systematic review was to pool the current published data on ring injuries. A systematic review of the English literature published from 1980 to 2015 in PubMed and MEDLINE databases was conducted to identify patients who underwent treatment for ring avulsion injuries. Twenty studies of ring avulsion injuries met the inclusion criteria. There were a total of 572 patients reported with ring avulsion injuries. The Urbaniak class breakdown was class I (54 patients), class II (204 patients), and class III (314 patients). The average total arc of motion (TAM) for patients with a class I injury was 201.25 (n = 40). The average 2-point discrimination was 5.6 (n = 10). The average TAM for patients with a class II injury undergoing microsurgical revascularization was 187.0 (n = 114), and the average 2-point discrimination was 8.3 (n = 40). The average TAM for patients with a class III injury undergoing microsurgical revascularization was 168.2 (n = 170), and the average 2-point discrimination was 10.5 (n = 97). Ring avulsion injuries are commonly classified with the Urbaniak class system. Outcomes are superior for class I and II injuries, and there are select class III injuries that can be treated with replantation. Shared decision making with patients is imperative to determine whether replantation is appropriate.
Full Text Available Abstract Background In contemporary medical research, randomised controlled trials are seen as the gold standard for establishing treatment effects where it is ethical and practical to conduct them. In palliative care such trials are often impractical, unethical, or extremely difficult, with multiple methodological problems. We review the utility of Cochrane reviews in informing palliative care practice. Methods Published reviews in palliative care registered with the Cochrane Pain, Palliative and Supportive Care Group as of December 2007 were obtained from the Cochrane Database of Systematic Reviews, issue 1, 2008. We reviewed the quality and quantity of primary studies available for each review, assessed the quality of the review process, and judged the strength of the evidence presented. There was no prior intention to perform any statistical analyses. Results 25 published systematic reviews were identified. Numbers of included trials ranged from none to 54. Within each review, included trials were heterogeneous with respect to patients, interventions, and outcomes, and the number of patients contributing to any single analysis was generally much lower than the total included in the review. A variety of tools were used to assess trial quality; seven reviews did not use this information to exclude low quality studies, weight analyses, or perform sensitivity analysis for effect of low quality. Authors indicated that there were frequently major problems with the primary studies, individually or in aggregate. Our judgment was that the reviewing process was generally good in these reviews, and that conclusions were limited by the number, size, quality and validity of the primary studies. We judged the evidence about 23 of the 25 interventions to be weak. Two reviews had stronger evidence, but with limitations due to methodological heterogeneity or definition of outcomes. No review provided strong evidence of no effect. Conclusion Cochrane reviews
Nelson, Amanda E.; Smith, Michael W.; Golightly, Yvonne M.; Jordan, Joanne M.
Objectives Given the conflicting definitions of “generalized osteoarthritis” (GOA) in the literature, we performed a systematic review of GOA definitions, risk factors, and outcomes. Methods We searched the Medline literature with terms: osteoarthritis, generalized, polyarticular, multiple joint, and multi-joint, to obtain articles related to GOA, following evidence-based guidelines. Titles and abstracts of 948 articles were reviewed, with full text review of 108. Data were extracted based on pre-specified criteria for 74 articles plus 24 identified through bibliographic review (total=98). Results Twenty-four large cohorts (n~30,000) were represented along with numerous clinical series (n~9000), across 22 countries and 60 years (1952–2012). No less than 15 definitions of GOA were given in 30 studies with a stated GOA definition; at least 6 groups used a summed score of joints or radiographic grades. Prevalence estimates based on these GOA definitions were 1–80%, although most were 5–25%. Increased risk and progression of GOA was associated with age, female sex, and genetic/familial factors. Associations with increased body mass index or bone mineral density were not consistent. One study estimated the heritability of GOA at 42%. Collagen biomarker levels increased with number of involved joints. Increased OA burden was associated with increased mortality and disability, poorer health and function. Conclusion While there remains no standard definition of GOA, this term is commonly used. The impact on health may be greater when OA is in more than one joint. A descriptive term, such as multi-joint or polyarticular OA, designating OA of multiple joints or joint groups, is recommended. PMID:24461078
O'Dwyer, Tom; O'Shea, Finbar; Wilson, Fiona
Physical activity (PA) is associated with numerous health-related benefits among adults with chronic diseases and the general population. As the benefits are dose-dependent, this review aims to establish the PA levels of adults with spondyloarthritis and to compare these to the general population. Electronic databases (Cochrane Central Register of Controlled Trials, EMBASE, MEDLINE/PubMed, PEDro, AMED, CINAHL) were systematically searched from inception to May 2014 using medical subject headings and keywords. This was supplemented by searching conference abstracts and hand-searching reference lists of included studies. Eligible studies were randomized controlled trials and observational studies of adults with SpA in which free-living PA or energy expenditure levels were measured. Subjects less than 18 years or with juvenile-onset SpA were excluded. Outcomes included objective and self-report measurements. Two reviewers independently screened studies for inclusion and assessed methodological quality using the Cochrane risk of bias tool and the RTI item bank. From the 2,431 records reviewed, nine studies involving 2,972 participants were included. This review focused on qualitative synthesis. Meta-analyses were not undertaken due to differences in study design, measurement tools, and participant characteristics. This heterogeneity, coupled with the risk of bias inherent in the included observational studies, limits the generalizability of findings. Objective measurements suggest PA levels may be lower among adults with spondyloarthritis than in healthy population controls. Self-reported PA and self-reported rates of adherence to PA recommendations varied largely across studies; higher disease activity was associated with lower self-reported PA levels. Physical activity levels may be lower in adults with axial spondyloarthritis, with higher disease activity associated with lower PA levels.
Bonilha, Heather Shaw; Focht, Kendrea L; Martin-Harris, Bonnie
Laryngeal endoscopy with stroboscopy (LES) remains the clinical gold standard for assessing vocal fold function. LES is used to evaluate the efficacy of voice treatments in research studies and clinical practice. LES as a voice treatment outcome tool is only as good as the clinician interpreting the recordings. Research using LES as a treatment outcome measure should be evaluated based on rater methodology and reliability. The purpose of this literature review was to evaluate the rater-related methodology from studies that use stroboscopic findings as voice treatment outcome measures. Systematic literature review. Computerized journal databases were searched for relevant articles using terms: stroboscopy and treatment. Eligible articles were categorized and evaluated for the use of rater-related methodology, reporting of number of raters, types of raters, blinding, and rater reliability. Of the 738 articles reviewed, 80 articles met inclusion criteria. More than one-third of the studies included in the review did not report the number of raters who participated in the study. Eleven studies reported results of rater reliability analysis with only two studies reporting good inter- and intrarater reliability. The comparability and use of results from treatment studies that use LES are limited by a lack of rigor in rater methodology and variable, mostly poor, inter- and intrarater reliability. To improve our ability to evaluate and use the findings from voice treatment studies that use LES features as outcome measures, greater consistency of reporting rater methodology characteristics across studies and improved rater reliability is needed. Copyright © 2015 The Voice Foundation. Published by Elsevier Inc. All rights reserved.
Physical activity (PA) is associated with numerous health-related benefits among adults with chronic diseases and the general population. As the benefits are dose-dependent, this review aims to establish the PA levels of adults with spondyloarthritis and to compare these to the general population. Electronic databases (Cochrane Central Register of Controlled Trials, EMBASE, MEDLINE\\/PubMed, PEDro, AMED, CINAHL) were systematically searched from inception to May 2014 using medical subject headings and keywords. This was supplemented by searching conference abstracts and hand-searching reference lists of included studies. Eligible studies were randomized controlled trials and observational studies of adults with SpA in which free-living PA or energy expenditure levels were measured. Subjects less than 18 years or with juvenile-onset SpA were excluded. Outcomes included objective and self-report measurements. Two reviewers independently screened studies for inclusion and assessed methodological quality using the Cochrane risk of bias tool and the RTI item bank. From the 2,431 records reviewed, nine studies involving 2,972 participants were included. This review focused on qualitative synthesis. Meta-analyses were not undertaken due to differences in study design, measurement tools, and participant characteristics. This heterogeneity, coupled with the risk of bias inherent in the included observational studies, limits the generalizability of findings. Objective measurements suggest PA levels may be lower among adults with spondyloarthritis than in healthy population controls. Self-reported PA and self-reported rates of adherence to PA recommendations varied largely across studies; higher disease activity was associated with lower self-reported PA levels. Physical activity levels may be lower in adults with axial spondyloarthritis, with higher disease activity associated with lower PA levels.
Linde, K.; ter Riet, G.; Hondras, M.; Vickers, A.; Saller, R.; Melchart, D.
OBJECTIVE: To provide a comprehensive collection and a summary of systematic reviews of clinical trials on herbal medicines. METHODS: Potentially relevant reviews were searched through the register of the Cochrane Complementary Medicine Field, the Cochrane Library, Medline, and bibliographies of
O'Callaghan, Clare; Bonde, Lars Ole; Rickson, Daphne
This paper describes the kinds of literature reviews found in music therapy writings and offers ideas for authors preparing literature reviews related to their clinical practice and research. It includes a description of systematic review and lists samples of literature reviews and systematic...... reviews conducted in music therapy....
Chimen, M; Kennedy, A; Nirantharakumar, K; Pang, T T; Andrews, R; Narendran, P
Physical activity improves well-being and reduces the risk of heart disease, cancer and type 2 diabetes mellitus in the general population. In individuals with established type 2 diabetes, physical activity improves glucose and lipid levels, reduces weight and improves insulin resistance. In type 1 diabetes mellitus, however, the benefits of physical activity are less clear. There is poor evidence for a beneficial effect of physical activity on glycaemic control and microvascular complications, and significant risk of harm through hypoglycaemia. Here we review the literature relating to physical activity and health in type 1 diabetes. We examine its effect on a number of outcomes, including glycaemic control, lipids, blood pressure, diabetic complications, well-being and overall mortality. We conclude that whilst there is sufficient evidence to recommend physical activity in the management of type 1 diabetes, it is still unclear as to what form, duration and intensity should be recommended and whether there is benefit for many of the outcomes examined.
Vincent Wing-Ming Wong
Full Text Available Gestational diabetes mellitus (GDM is a condition that affects the wellbeing of mother and fetus. Women with GDM are at risk of type 2 diabetes mellitus in the future, while fetal exposure to hyperglycaemia in-utero may affect their glycometabolic profile later in life. Appropriate screening and management of this problem is important in ensuring good pregnancy outcomes. In this review, the clinical implications, the various ways to screen and diagnose GDM, and management strategies during pregnancy will be discussed. For years, insulin is the mainstay of treatment if medical nutrition therapy fails to maintain adequate glycaemic control, but use of other oral pharmacotherapy may gain greater acceptance in the future. Following delivery, ongoing follow-up of these women is worthwhile as early intervention through lifestyle or pharmacotherapy may prevent the development of diabetes.
Thys, Erik; Sabbe, Bernard; De Hert, Marc
The possible link between creativity and psychopathology has been a long-time focus of research up to the present day. However, the research results in this field are heterogeneous and contradictory. Links between creativity and specific psychiatric disorders have been confirmed and refuted in different studies. This disparity is partly explained by the methodological challenges peculiar to this field. In this systematic review of the literature from 1950, research articles in the field of creativity and psychopathology are presented, focusing on the methodology and results of the collected studies. This review confirms the methodological problems and the heterogeneity of the study designs and results. The assessment of psychopathology, but more so of creativity, remains a fundamental challenge. On the whole, study results cautiously confirm an association between creativity and both bipolar disorder and schizotypy. The research on creativity and psychopathology is hampered by serious methodological problems. Study results are to be interpreted with caution and future research needs more methodological rigor. © 2014 S. Karger AG, Basel.
Stepan, L; Shaw, C-K L; Oue, S
Temporomandibular disorder poses a diagnostic challenge to otolaryngologists as orofacial pain, headache and otology symptoms are very common in temporomandibular disorder, and mimic a number of otolaryngological conditions. Missed diagnosis of temporomandibular disorder can lead to unnecessary investigation and treatment, resulting in further patient suffering. To review the current literature and propose management pathways for otolaryngologists to correctly differentiate temporomandibular disorder from other otolaryngological conditions, and to initiate effective treatment for temporomandibular disorder in collaboration with other health professionals. A systematic review using PubMed and Medline databases was conducted, and data on temporomandibular disorder in conjunction with otolaryngological symptoms were collected for analysis. Of 4155 potential studies, 33 were retrieved for detailed evaluation and 12 met the study criteria. There are questionnaires, examination techniques and radiological investigations presented in the literature to assist with distinguishing between otolaryngological causes of symptoms and temporomandibular disorder. Simple treatment can be initiated by the otolaryngologist. Initial temporomandibular disorder treatment steps can be undertaken by the otolaryngologist, with consideration of referral to dentists, oral and maxillofacial surgeons, or physiotherapists if simple pharmacological treatment or temporomandibular disorder exercise fails.
Rachel M Lee
Full Text Available Toxocariasis is an important neglected tropical disease that can manifest as visceral or ocular larva migrans, or covert toxocariasis. All three forms pose a public health problem and cause significant morbidity in areas of high prevalence. To determine the burden of toxocariasis in North America, we conducted a systematic review of the literature following PRISMA guidelines. We found 18 articles with original prevalence, incidence, or case data for toxocariasis. Prevalence estimates ranged from 0.6% in a Canadian Inuit community to 30.8% in Mexican children with asthma. Commonly cited risk factors included: African-American race, poverty, male sex, and pet ownership or environmental contamination by animal feces. Increased prevalence of Toxocara spp. infection was linked in a group of case control studies conducted in Mexico to several high risk groups including waste pickers, asthmatic children, and inpatient psychiatry patients. Further research is needed to determine the true current burden of toxocariasis in North America; however the prevalence estimates gathered in this review suggest that the burden of disease is significant.
Lim, Michelle H; Gleeson, John F M; Alvarez-Jimenez, Mario; Penn, David L
The aim of the review is to understand the relationships between loneliness and related psychological and social factors in individuals with psychosis. Loneliness is poorly understood in people with psychosis. Given the myriad of social challenges facing individuals with psychosis, these findings can inform psychosocial interventions that specifically target loneliness in this vulnerable group. We adhered to the PRISMA guidelines and systematically reviewed empirical studies that measured loneliness either as a main outcome or as an associated variable in individuals with psychosis. A total of ten studies examining loneliness in people diagnosed with a psychotic disorder were examined. Heterogeneity in the assessment of loneliness was found, and there were contradictory findings on the relationship between loneliness and psychotic symptomatology. In individuals with psychosis, loneliness may be influenced by psychological and social factors such as increased depression, psychosis, and anxiety, poor social support, poor quality of life, more severe internalised stigma and perceived discrimination, and low self-esteem. The relationship between loneliness and psychosis remains poorly understood due to a lack of rigorous studies. Although having strong social relationships is crucial to facilitate recovery from serious mental illness, psychosocial interventions that specifically target loneliness in individuals with psychosis are lacking and sorely needed. Interventions targeting loneliness in those with psychosis will also need to account for additional barriers associated with psychosis (e.g., social skill deficits, impoverished social networks, and negative symptoms).
Stallman, Helen M; Kohler, Mark; White, Jason
Medications that trigger sleepwalking may inadvertently put the patient at risk of injury to themselves and/or others, and contribute to poor treatment adherence. The aim of this study was to systematically review the literature to identify drugs that may increase the risk of sleepwalking. A search of CINAHL, EMBASE, PsycINFO, PubMed, and ScienceDirect was conducted with the keywords 'sleepwalking' OR 'somnambulism'. Of the original 83 sourced papers, 62 met the inclusion criteria and were subsequently included for review. Twenty-nine drugs, primarily in four classes-benzodiazepine receptor agonists and other gamma aminobutyric acid (GABA) modulators, antidepressants and other serotonergic agents, antipsychotics, and β-blockers-were identified as possible triggers for sleepwalking. The strongest evidence for medication-induced sleepwalking was for zolpidem and sodium oxybate. All other associations were based on case reports. This research highlights the importance of considering sleepwalking in risk profiles in clinical trials, particularly for drugs that enhance GABA activity at the GABA A receptor, enhance serotonergic activity, or block the activity of noradrenaline at β receptors. The results also have implications for prescribers to consider sleepwalking as a potential adverse effect and ensure that: 1) the patient is educated about a safe sleep environment; 2) they are encouraged to report the onset or exacerbation of sleepwalking, and 3) alternative treatments are considered if sleepwalking occurs. Copyright © 2017 Elsevier Ltd. All rights reserved.
Alderman, Katarzyna; Turner, Lyle R; Tong, Shilu
Floods are the most common type of disaster globally, responsible for almost 53,000 deaths in the last decade alone (23:1 low- versus high-income countries). This review assessed recent epidemiological evidence on the impacts of floods on human health. Published articles (2004-2011) on the quantitative relationship between floods and health were systematically reviewed. 35 relevant epidemiological studies were identified. Health outcomes were categorized into short- and long-term and were found to depend on the flood characteristics and people's vulnerability. It was found that long-term health effects are currently not well understood. Mortality rates were found to increase by up to 50% in the first year post-flood. After floods, it was found there is an increased risk of disease outbreaks such as hepatitis E, gastrointestinal disease and leptospirosis, particularly in areas with poor hygiene and displaced populations. Psychological distress in survivors (prevalence 8.6% to 53% two years post-flood) can also exacerbate their physical illness. There is a need for effective policies to reduce and prevent flood-related morbidity and mortality. Such steps are contingent upon the improved understanding of potential health impacts of floods. Global trends in urbanization, burden of disease, malnutrition and maternal and child health must be better reflected in flood preparedness and mitigation programs. Crown Copyright © 2012. Published by Elsevier Ltd. All rights reserved.
Yang, Lin; Sahlqvist, Shannon; McMinn, Alison; Griffin, Simon J; Ogilvie, David
To determine what interventions are effective in promoting cycling, the size of the effects of interventions, and evidence of any associated benefits on overall physical activity or anthropometric measures. Systematic review. Published and unpublished reports in any language identified by searching 13 electronic databases, websites, reference lists, and existing systematic reviews, and papers identified by experts in the field. Review methods Controlled "before and after" experimental or observational studies of the effect of any type of intervention on cycling behaviour measured at either individual or population level. Twenty five studies (of which two were randomised controlled trials) from seven countries were included. Six studies examined interventions aimed specifically at promoting cycling, of which four (an intensive individual intervention in obese women, high quality improvements to a cycle route network, and two multifaceted cycle promotion initiatives at town or city level) were found to be associated with increases in cycling. Those studies that evaluated interventions at population level reported net increases of up to 3.4 percentage points in the population prevalence of cycling or the proportion of trips made by bicycle. Sixteen studies assessing individualised marketing of "environmentally friendly" modes of transport to interested households reported modest but consistent net effects equating to an average of eight additional cycling trips per person per year in the local population. Other interventions that targeted travel behaviour in general were not associated with a clear increase in cycling. Only two studies assessed effects of interventions on physical activity; one reported a positive shift in the population distribution of overall physical activity during the intervention. Community-wide promotional activities and improving infrastructure for cycling have the potential to increase cycling by modest amounts, but further controlled
Delaney, Aogán; Tamás, Peter A.; Crane, Todd A.; Chesterman, Sabrina
There is increasing interest in using systematic review to synthesize evidence on the social and environmental effects of and adaptations to climate change. Use of systematic review for evidence in this field is complicated by the heterogeneity of methods used and by uneven reporting. In order to
... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Systematic review guidelines. 1312.10 Section 1312.10 Administrative Personnel OFFICE OF MANAGEMENT AND BUDGET OMB DIRECTIVES CLASSIFICATION... Declassification of National Security Information § 1312.10 Systematic review guidelines. The EOP Security Officer...
Saan, M.C.; Boeije, H.R.; Sattoe, J.N.T.; Bal, M.I.; Missler, M.A.; van Wesel, F.
Objectives The use of stakeholders in systematic reviews is increasingly valued, but their influence on the systematicity of the review is often unclear. The aim of this study was to describe some of the processes of involvement of stakeholders and to demonstrate a Tool for Recording and Accounting
Cohen, Jérémie F.; Korevaar, Daniël A.; Wang, Junfeng; Spijker, René; Bossuyt, Patrick M.
Chinese biomedical databases contain a large number of publications available to systematic reviewers, but it is unclear whether they are used for synthesizing the available evidence. We report a case of two systematic reviews on the accuracy of anti-cyclic citrullinated peptide for diagnosing
Saan, M.C.; Boeije, H.R.; Sattoe, J.N.; Bal, M.I.; Missler, M.; Wesel, F. van
Objectives: The use of stakeholders in systematic reviews is increasingly valued, but their influence on the systematicity of the review is often unclear. The aim of this study was to describe some of the processes of involvement of stakeholders and to demonstrate a Tool for Recording and Accounting
MSc M.I. Bal; Dr. J.N.T. Sattoe; M.A. Missler; F. van Wesel; H.R. Boeije; M.C. Saan
OBJECTIVES: The use of stakeholders in systematic reviews is increasingly valued, but their influence on the systematicity of the review is often unclear. The aim of this study was to describe some of the processes of involvement of stakeholders and to demonstrate a Tool for Recording and Accounting
Townsend, Whitney A; Anderson, Patricia F; Ginier, Emily C; MacEachern, Mark P; Saylor, Kate M; Shipman, Barbara L; Smith, Judith E
The project identified a set of core competencies for librarians who are involved in systematic reviews. A team of seven informationists with broad systematic review experience examined existing systematic review standards, conducted a literature search, and used their own expertise to identify core competencies and skills that are necessary to undertake various roles in systematic review projects. The team identified a total of six competencies for librarian involvement in systematic reviews: "Systematic review foundations," "Process management and communication," "Research methodology," "Comprehensive searching," "Data management," and "Reporting." Within each competency are the associated skills and knowledge pieces (indicators). Competence can be measured using an adaptation of Miller's Pyramid for Clinical Assessment, either through self-assessment or identification of formal assessment instruments. The Systematic Review Competencies Framework provides a standards-based, flexible way for librarians and organizations to identify areas of competence and areas in need of development to build capacity for systematic review integration. The framework can be used to identify or develop appropriate assessment tools and to target skill development opportunities.
Roerdink, R L; Dietvorst, M; van der Zwaard, B; van der Worp, H; Zwerver, J
BACKGROUND: Extracorporeal shockwave therapy (ESWT) seems to be an effective treatment for plantar fasciitis (PF) and is assumed to be safe. No systematic reviews have been published that specifically studied the complications and side effects of ESWT in treating PF. Aim of this systematic review is
Jansen, Sofie; Bhangu, Jaspreet; de Rooij, Sophia; Daams, Joost; Kenny, Rose Anne; van der Velde, Nathalie
Objective: Cardiovascular disorders are recognized as risk factors for falls in older adults. The aim of this systematic review was to identify cardiovascular disorders that are associated with falls, thus providing angles for optimization of fall-preventive care. Design: Systematic review. Data
Saan, Marieke; Boeije, H.R.; Sattoe, Jane; Bal, Marjolijn; Missler, M.A.; van Wesel, Floryt
Objectives The use of stakeholders in systematic reviews is increasingly valued, but their influence on the systematicity of the review is often unclear. The aim of this study was to describe some of the processes of involvement of stakeholders and to demonstrate a Tool for Recording and Accounting
Vassar, Matt; Atakpo, Paul; Kash, Melissa J
Manual searches are supplemental approaches to database searches to identify additional primary studies for systematic reviews. The authors argue that these manual approaches, in particular hand-searching and perusing reference lists, are often considered the same yet lead to different outcomes. We conducted a PubMed search for systematic reviews in the top 10 dermatology journals (January 2006-January 2016). After screening, the final sample comprised 292 reviews. Statements related to manual searches were extracted from each review and categorized by the primary and secondary authors. Each statement was categorized as either "Search of Reference List," "Hand Search," "Both," or "Unclear." Of the 292 systematic reviews included in our sample, 143 reviews (48.97%) did not report a hand-search or scan of reference lists. One-hundred thirty-six reviews (46.58%) reported searches of reference lists, while 4 reviews (1.37%) reported systematic hand-searches. Three reviews (1.03%) reported use of both hand-searches and scanning reference lists. Six reviews (2.05%) were classified as unclear due to vague wording. Authors of systematic reviews published in dermatology journals in our study sample scanned reference lists more frequently than they conducted hand-searches, possibly contributing to biased search outcomes. We encourage systematic reviewers to routinely practice hand-searching in order to minimize bias.
Jenssen, C; Pietsch, C; Gottschalk, U; Barreiros, A P; Teufel, A; Cui, X W; Dietrich, C F
In patients with diabetes mellitus, abdominal ultrasonography is the appropriate diagnostic technique to detect and to follow-up secondary and accompanying diseases of the liver, the kidneys, the pancreas, the gastrointestinal tract and of abdominal vessels. Moreover, pancreatic and hepatic diseases may be realized which are of etiological importance for diabetes mellitus. Based on a systematic survey of the published literature, this review in 3 parts will describe the value of abdominal ultrasonography in patients with diabetes mellitus. Part 1 deals with the diagnostic relevance and particular findings of ultrasonographic methods in hepatic manifestations and complications of diabetes mellitus. © Georg Thieme Verlag KG Stuttgart · New York.
Fernandes, Silke; Jit, Mark; Bozzani, Fiammetta; Griffiths, Ulla K; Scott, J Anthony G; Burchett, Helen E D
SYSVAC is an online bibliographic database of systematic reviews and systematic review protocols on vaccines and immunisation compiled by the London School of Hygiene & Tropical Medicine and hosted by the World Health Organization (WHO) through their National Immunization Technical Advisory Groups (NITAG) resource centre (www.nitag-resource.org). Here the development of the database and a bibliometric review of its content is presented, describing trends in the publication of policy-relevant systematic reviews on vaccines and immunisation from 2008 to 2016. Searches were conducted in seven scientific databases according to a standardized search protocol, initially in 2014 with the most recent update in January 2017. Abstracts and titles were screened according to specific inclusion criteria. All included publications were coded into relevant categories based on a standardized protocol and subsequently analysed to look at trends in time, topic, area of focus, population and geographic location. After screening for inclusion criteria, 1285 systematic reviews were included in the database. While in 2008 there were only 34 systematic reviews on a vaccine-related topic, this increased to 322 in 2016. The most frequent pathogens/diseases studied were influenza, human papillomavirus and pneumococcus. There were several areas of duplication and overlap. As more systematic reviews are published it becomes increasingly time-consuming for decision-makers to identify relevant information among the ever-increasing volume available. The risk of duplication also increases, particularly given the current lack of coordination of systematic reviews on vaccine-related questions, both in terms of their commissioning and their execution. The SYSVAC database offers an accessible catalogue of vaccine-relevant systematic reviews with, where possible access or a link to the full-text. SYSVAC provides a freely searchable platform to identify existing vaccine-policy-relevant systematic
Maria Regina Torloni
Full Text Available BACKGROUND: Rising cesarean section (CS rates are a major public health concern and cause worldwide debates. To propose and implement effective measures to reduce or increase CS rates where necessary requires an appropriate classification. Despite several existing CS classifications, there has not yet been a systematic review of these. This study aimed to 1 identify the main CS classifications used worldwide, 2 analyze advantages and deficiencies of each system. METHODS AND FINDINGS: Three electronic databases were searched for classifications published 1968-2008. Two reviewers independently assessed classifications using a form created based on items rated as important by international experts. Seven domains (ease, clarity, mutually exclusive categories, totally inclusive classification, prospective identification of categories, reproducibility, implementability were assessed and graded. Classifications were tested in 12 hypothetical clinical case-scenarios. From a total of 2948 citations, 60 were selected for full-text evaluation and 27 classifications identified. Indications classifications present important limitations and their overall score ranged from 2-9 (maximum grade =14. Degree of urgency classifications also had several drawbacks (overall scores 6-9. Woman-based classifications performed best (scores 5-14. Other types of classifications require data not routinely collected and may not be relevant in all settings (scores 3-8. CONCLUSIONS: This review and critical appraisal of CS classifications is a methodologically sound contribution to establish the basis for the appropriate monitoring and rational use of CS. Results suggest that women-based classifications in general, and Robson's classification, in particular, would be in the best position to fulfill current international and local needs and that efforts to develop an internationally applicable CS classification would be most appropriately placed in building upon this
Torloni, Maria Regina; Betran, Ana Pilar; Souza, Joao Paulo; Widmer, Mariana; Allen, Tomas; Gulmezoglu, Metin; Merialdi, Mario
Rising cesarean section (CS) rates are a major public health concern and cause worldwide debates. To propose and implement effective measures to reduce or increase CS rates where necessary requires an appropriate classification. Despite several existing CS classifications, there has not yet been a systematic review of these. This study aimed to 1) identify the main CS classifications used worldwide, 2) analyze advantages and deficiencies of each system. Three electronic databases were searched for classifications published 1968-2008. Two reviewers independently assessed classifications using a form created based on items rated as important by international experts. Seven domains (ease, clarity, mutually exclusive categories, totally inclusive classification, prospective identification of categories, reproducibility, implementability) were assessed and graded. Classifications were tested in 12 hypothetical clinical case-scenarios. From a total of 2948 citations, 60 were selected for full-text evaluation and 27 classifications identified. Indications classifications present important limitations and their overall score ranged from 2-9 (maximum grade =14). Degree of urgency classifications also had several drawbacks (overall scores 6-9). Woman-based classifications performed best (scores 5-14). Other types of classifications require data not routinely collected and may not be relevant in all settings (scores 3-8). This review and critical appraisal of CS classifications is a methodologically sound contribution to establish the basis for the appropriate monitoring and rational use of CS. Results suggest that women-based classifications in general, and Robson's classification, in particular, would be in the best position to fulfill current international and local needs and that efforts to develop an internationally applicable CS classification would be most appropriately placed in building upon this classification. The use of a single CS classification will facilitate
Baussano, Iacopo; Williams, Brian G; Nunn, Paul; Beggiato, Marta; Fedeli, Ugo; Scano, Fabio
Transmission of tuberculosis (TB) in prisons has been reported worldwide to be much higher than that reported for the corresponding general population. A systematic review has been performed to assess the risk of incident latent tuberculosis infection (LTBI) and TB disease in prisons, as compared to the incidence in the corresponding local general population, and to estimate the fraction of TB in the general population attributable (PAF%) to transmission within prisons. Primary peer-reviewed studies have been searched to assess the incidence of LTBI and/or TB within prisons published until June 2010; both inmates and prison staff were considered. Studies, which were independently screened by two reviewers, were eligible for inclusion if they reported the incidence of LTBI and TB disease in prisons. Available data were collected from 23 studies out of 582 potentially relevant unique citations. Five studies from the US and one from Brazil were available to assess the incidence of LTBI in prisons, while 19 studies were available to assess the incidence of TB. The median estimated annual incidence rate ratio (IRR) for LTBI and TB were 26.4 (interquartile range [IQR]: 13.0-61.8) and 23.0 (IQR: 11.7-36.1), respectively. The median estimated fraction (PAF%) of tuberculosis in the general population attributable to the exposure in prisons for TB was 8.5% (IQR: 1.9%-17.9%) and 6.3% (IQR: 2.7%-17.2%) in high- and middle/low-income countries, respectively. The very high IRR and the substantial population attributable fraction show that much better TB control in prisons could potentially protect prisoners and staff from within-prison spread of TB and would significantly reduce the national burden of TB. Future studies should measure the impact of the conditions in prisons on TB transmission and assess the population attributable risk of prison-to-community spread. Please see later in the article for the Editors' Summary.
Morris, Joanne H; James, Rebecca E; Davey, Rachel; Waddington, Gordon
Complex and chronic disease is placing significant pressure on hospital outpatient departments. Novel ways of delivering care have been developed recently and are often described as 'triage' services. This paper reviews the literature pertaining to definitions and descriptions of orthopaedic/musculoskeletal triage processes, in order to provide information on 'best practice' to assist health care facilities. A comprehensive open-ended search was conducted using electronic databases to identify studies describing models of triage clinics for patients with a musculoskeletal/orthopaedic complaint, who have been referred to hospital outpatient clinics for a surgical consultation. Studies were critically appraised using the McMaster quality appraisal tool and ranked using the National Health and Medical Research Council hierarchy of evidence. A thematic analysis of the definitions, processes and procedures of triage described within the literature was undertaken. 1930 studies were identified and 45 were included in the review (including diagnostic and evaluative research). The hierarchy of evidence ranged from I to IV; however, the majority were at low levels of evidence and scored poorly on the critical appraisal tool. Three broad themes of triage were identified: presence of a referral, configuration of the triage (who, how and where) and the aim of triage. However, there were significant inconsistencies across these themes. This systematic review highlighted the need for standardization of the definition of triage, the procedures of assessment and management and measures of outcome used in orthopaedic/musculoskeletal triage to ensure best-practice processes, procedures and outcomes for triage clinics. © 2014 The Authors. Journal of Evaluation in Clinical Practice published by John Wiley & Sons, Ltd.
O'Dwyer, Tom; O'Shea, Finbar; Wilson, Fiona
To evaluate the effects of therapeutic exercise on pain, stiffness, quality of life, physical function, disease activity, health-related fitness and cardiovascular risk factors in adults with spondyloarthritis (SpA). Electronic databases (Cochrane Central Register of Controlled Trials, EMBASE, MEDLINE/PubMed, PEDro, AMED, CINAHL) were systematically searched from inception to October 2013 using medical subject headings and keywords. This was supplemented by searching conference abstracts and a hand search of reference lists of included studies. Randomised and quasi-randomised studies of adults with SpA in which at least one of the comparison groups received an exercise intervention were included. Outcomes of interest were pain, stiffness, quality of life, physical function and disease activity. Secondary outcomes were health-related fitness and cardiovascular risk factors. Two reviewers independently screened studies for inclusion. Methodological quality was assessed by two reviewers using the Cochrane risk of bias tool and the PEDro scale. Twenty-four studies, involving 1,498 participants, were included. Meta-analyses were not undertaken due to clinical heterogeneity, and this review focuses on qualitative synthesis. Moderate evidence supports exercise interventions in improving physical function, disease activity and chest expansion compared to controls; there is low-level evidence of improved pain, stiffness, spinal mobility and cardiorespiratory function. Supervised group exercise yields better outcomes than unsupervised home exercise. The addition of aerobic components to flexibility programmes improves cardiorespiratory outcomes, but not cardiovascular risk factors. The most effective exercise protocol remains unclear. Current evidence suggests that therapeutic exercises are beneficial for adults with ankylosing spondylitis; effects on other SpA subtypes are unknown.
Wells, Cherie; Kolt, Gregory S; Bialocerkowski, Andrea
To describe Pilates exercise according to peer-reviewed literature, and compare definitions used in papers with healthy participants and those with low back pain. A systematic review of literature was conducted. A search for "pilates" within the maximal date ranges of the Cochrane Library, Medline, Cumulative Index to Nursing and Allied Health Literature, Physiotherapy Evidence Database, ProQuest: Nursing and Allied Health Source, Proquest: Medical and Health Complete, Scopus, Sport Discus, and Web of Science, was undertaken. To be included, papers needed to describe Pilates exercise, and be published in English within an academic, peer-reviewed journal. There were no restrictions on the methodological design or quality of papers. Content analysis was used to record qualitative definitions of Pilates. Frequencies were calculated for mention of content categories, equipment, and traditional Pilates principles. Frequencies were then compared statistically in papers with healthy participants and those with low back pain. 119 papers fulfilled inclusion criteria. Findings suggest that Pilates is a mind-body exercise that focuses on strength, core stability, flexibility, muscle control, posture and breathing. Exercises can be mat-based or involve use of specialised equipment. Posture was discussed statistically significantly more often in papers with participants with low back pain compared to papers with healthy participants. Traditional Pilates principles of centering, concentration, control, precision, flow, and breathing were discussed on average in 23% of papers. Apart from breathing, these principles were not mentioned in papers with low back pain participants. There is a general consensus in the literature of the definition of Pilates exercise. A greater emphasis may be placed on posture in people with low back pain, whilst traditional principles, apart from breathing, may be less relevant. Copyright © 2012 Elsevier Ltd. All rights reserved.
Morris, Joanne H; James, Rebecca E; Davey, Rachel; Waddington, Gordon
Rationale, aims and objectives Complex and chronic disease is placing significant pressure on hospital outpatient departments. Novel ways of delivering care have been developed recently and are often described as ‘triage’ services. This paper reviews the literature pertaining to definitions and descriptions of orthopaedic/musculoskeletal triage processes, in order to provide information on ‘best practice’ to assist health care facilities. Method A comprehensive open-ended search was conducted using electronic databases to identify studies describing models of triage clinics for patients with a musculoskeletal/orthopaedic complaint, who have been referred to hospital outpatient clinics for a surgical consultation. Studies were critically appraised using the McMaster quality appraisal tool and ranked using the National Health and Medical Research Council hierarchy of evidence. A thematic analysis of the definitions, processes and procedures of triage described within the literature was undertaken. Results 1930 studies were identified and 45 were included in the review (including diagnostic and evaluative research). The hierarchy of evidence ranged from I to IV; however, the majority were at low levels of evidence and scored poorly on the critical appraisal tool. Three broad themes of triage were identified: presence of a referral, configuration of the triage (who, how and where) and the aim of triage. However, there were significant inconsistencies across these themes. Conclusions This systematic review highlighted the need for standardization of the definition of triage, the procedures of assessment and management and measures of outcome used in orthopaedic/musculoskeletal triage to ensure best-practice processes, procedures and outcomes for triage clinics. PMID:25410703
Bender, R.; Bunce, C.; Clarke, M.
OBJECTIVE: The objective of this paper is to describe the problem of multiple comparisons in systematic reviews and to provide some guidelines on how to deal with it in practice. STUDY DESIGN AND SETTING: We describe common reasons for multiplicity in systematic reviews, and present some examples....... We provide guidance on how to deal with multiplicity when it is unavoidable. RESULTS: We identified six common reasons for multiplicity in systematic reviews: multiple outcomes, multiple groups, multiple time points, multiple effect measures, subgroup analyses, and multiple looks at accumulating data....... The existing methods to deal with multiplicity in single trials can not always be applied in systematic reviews. CONCLUSION: There is no simple and completely satisfactory solution to the problem of multiple comparisons in systematic reviews. More research is required to develop multiple comparison procedures...
Saldanha, Ian J; Wilson, Lisa M; Bennett, Wendy L; Nicholson, Wanda K; Robinson, Karen A
To ensure appropriate allocation of research funds, we need methods for identifying high-priority research needs. We developed and pilot tested a process to identify needs for primary clinical research using a systematic review in gestational diabetes mellitus. We conducted eight steps: abstract research gaps from a systematic review using the Population, Intervention, Comparison, Outcomes, and Settings (PICOS) framework; solicit feedback from the review authors; translate gaps into researchable questions using the PICOS framework; solicit feedback from multidisciplinary stakeholders at our institution; establish consensus among multidisciplinary external stakeholders on the importance of the research questions using the Delphi method; prioritize outcomes; develop conceptual models to highlight research needs; and evaluate the process. We identified 19 research questions. During the Delphi method, external stakeholders established consensus for 16 of these 19 questions (15 with "high" and 1 with "medium" clinical benefit/importance). We pilot tested an eight-step process to identify clinically important research needs. Before wider application of this process, it should be tested using systematic reviews of other diseases. Further evaluation should include assessment of the usefulness of the research needs generated using this process for primary researchers and funders. Copyright © 2013 Elsevier Inc. All rights reserved.
Melo, Matias Carvalho Aguiar; Daher, Elizabeth De Francesco; Albuquerque, Saulo Giovanni Castor; de Bruin, Veralice Meireles Sales
Sedentary lifestyle is frequent in psychiatric disorders, however the directions of this association and benefits of physical activity are unclear. This is a systematic review about exercise in patients with bipolar disorder. We performed a systematic literature search of studies published in English (1995 Jan to 2016 Jan) in PubMed, and Cochrane Library combining the medical terms 'physical activity' or 'sedentary' or 'physical exercise' with 'bipolar disorder' or 'mania' or 'bipolar depression'. Thirty-one studies were selected and included 15,587 patients with bipolar disorder. Sedentary lifestyle varied from 40% to 64.9%. Physical activity was associated with less depressive symptoms, better quality of life and increased functioning. Some evidence indicates a relationship between vigorous exercises and mania. Three prospective cohorts were reported; and no prospective randomized controlled trial was identified. Three studies focused on biomarkers in bipolar patients; and one reported the relationship between exercise and sleep in this group. Two assessed physical exercise in adolescents. (1) Differences between studies preventing a unified analysis; (2) most studies were cross-sectional; (3) motivation for exercising is a selection bias in most studies; (4) no intervention study assessing only physical exercise; (5) lack of studies comparing exercise across mood states. Generally, exercise was associated with improved health measures including depressive symptoms, functioning and quality of life. Evidence was insufficient to establish a cause-effect relationship between mood and physical exercise. Future research including randomized trials is needed to clarify the role of physical activity in bipolar patients. Copyright © 2016 Elsevier B.V. All rights reserved.
Hoogeveen, Eelke J; Jansma, Johan; Ren, Yijin
Corticotomy and dental distraction have been proposed as effective and safe methods to shorten orthodontic treatment duration in adolescent and adult patients. A systematic review was performed to evaluate the evidence supporting these claims. PubMed, Embase, and Cochrane databases were searched until April 2013 for randomized controlled trials, controlled clinical trials, and case series with 5 or more subjects that focused on velocity of tooth movement, reduction of treatment duration, or complications with various surgical protocols. There were no language restrictions during the search phase. Publications were systematically assessed for eligibility, and 2 observers graded the methodologic quality of the included studies with a predefined scoring system. Eighteen articles met the inclusion criteria. Seven studies were clinical trials, with small investigated groups. Only studies of moderate and low values of evidence were found. Surgically facilitated treatment was indicated for various clinical problems. All publications reported temporarily accelerated tooth movement after surgery. No deleterious effects on the periodontium, no vitality loss, and no severe root resorption were found in any studies. However, the level of evidence to support these findings is limited owing to shortcomings in research methodologies and small treated groups. No research concerning long-term stability could be included. Evidence based on the currently available studies of low-to-moderate quality showed that surgically facilitated orthodontics seems to be safe for the oral tissues and is characterized by a temporary phase of accelerated tooth movement. This can effectively shorten the duration of orthodontic treatment. However, to date, no prospective studies have compared overall treatment time and treatment outcome with those of a control group. Well-conducted, prospective research is still needed to draw valid conclusions. Copyright © 2014 American Association of Orthodontists
Yi, J; Xiao, J; Li, H; Li, Y; Li, X; Zhao, Z
This study was aimed to summarise published systematic reviews (SRs) that assess the effects of adjunctive interventions on the acceleration of orthodontic tooth movement (OTM). Electronic and manual searches were performed up to August 2016. Systematic reviews investigating the impact of adjunctive techniques on the promotion of OTM were included. The methodological quality of the included reviews was evaluated using the A Measurement Tool to Assess Systematic Reviews (AMSTAR) scale. The quality of evidence for each intervention was assessed using GRADE. The Jadad decision algorithm was used to select a study to provide body evidence from discordant reviews on the same intervention. A total of 11 SRs were included in this study. AMSTAR scores ranged from 4 to 10 of 11. The quality of evidence ranged from very low to low. The short-term (1-3 months) effects of low-level laser therapy (LLLT, 5 and 8 J cm -2 ) and corticotomy were supported by low-quality evidence. The evidence regarding the efficacy of photobiomodulation, pulsed electromagnetic field, interseptal bone reduction, two vibrational devices (Tooth Masseuse and Orthoaccel) and electrical current was of very low quality. Relaxin injections and extracorporeal shock waves were reported to have no impact on OTM according to low- and very low-quality evidence, respectively. Based on currently available information, we conclude that low-quality evidence indicates that LLLT (5 and 8 J cm -2 ) and corticotomy are effective to promote OTM in the short term. Future high-quality trials are required to determine the optimal protocols, as well as the long-term effects of LLLT and corticotomy, before warranting recommendations for orthodontics clinics. © 2017 John Wiley & Sons Ltd.
Lau, Francis; Kuziemsky, Craig; Price, Morgan; Gardner, Jesse
The purpose of this review is to consolidate existing evidence from published systematic reviews on health information system (HIS) evaluation studies to inform HIS practice and research. Fifty reviews published during 1994-2008 were selected for meta-level synthesis. These reviews covered five areas: medication management, preventive care, health conditions, data quality, and care process/outcome. After reconciliation for duplicates, 1276 HIS studies were arrived at as the non-overlapping corpus. On the basis of a subset of 287 controlled HIS studies, there is some evidence for improved quality of care, but in varying degrees across topic areas. For instance, 31/43 (72%) controlled HIS studies had positive results using preventive care reminders, mostly through guideline adherence such as immunization and health screening. Key factors that influence HIS success included having in-house systems, developers as users, integrated decision support and benchmark practices, and addressing such contextual issues as provider knowledge and perception, incentives, and legislation/policy.
Background Systematic reviews provide clinical practice recommendations that are based on evaluation of primary evidence. When systematic reviews with the same aims have different conclusions, it is difficult to ascertain which review reported the most credible and robust findings. Methods This study examined five systematic reviews that have investigated the effectiveness of Pilates exercise in people with chronic low back pain. A four-stage process was used to interpret findings of the reviews. This process included comparison of research questions, included primary studies, and the level and quality of evidence of systematic reviews. Two independent reviewers assessed the level of evidence and the methodological quality of systematic reviews, using the National Health and Medical Research Council hierarchy of evidence, and the Revised Assessment of Multiple Systematic Reviews respectively. Any disagreements were resolved by a third researcher. Results A high level of consensus was achieved between the reviewers. Conflicting findings were reported by the five systematic reviews regarding the effectiveness of Pilates in reducing pain and disability in people with chronic low back pain. Authors of the systematic reviews included primary studies that did not match their questions in relation to treatment or population characteristics. A total of ten primary studies were identified across five systematic reviews. Only two of the primary studies were included in all of the reviews due to different inclusion criteria relating to publication date and status, definition of Pilates, and methodological quality. The level of evidence of reviews was low due to the methodological design of the primary studies. The methodological quality of reviews varied. Those which conducted a meta-analysis obtained higher scores. Conclusion There is inconclusive evidence that Pilates is effective in reducing pain and disability in people with chronic low back pain. This is due to the small
Full Text Available Abstract Background Systematic reviews provide clinical practice recommendations that are based on evaluation of primary evidence. When systematic reviews with the same aims have different conclusions, it is difficult to ascertain which review reported the most credible and robust findings. Methods This study examined five systematic reviews that have investigated the effectiveness of Pilates exercise in people with chronic low back pain. A four-stage process was used to interpret findings of the reviews. This process included comparison of research questions, included primary studies, and the level and quality of evidence of systematic reviews. Two independent reviewers assessed the level of evidence and the methodological quality of systematic reviews, using the National Health and Medical Research Council hierarchy of evidence, and the Revised Assessment of Multiple Systematic Reviews respectively. Any disagreements were resolved by a third researcher. Results A high level of consensus was achieved between the reviewers. Conflicting findings were reported by the five systematic reviews regarding the effectiveness of Pilates in reducing pain and disability in people with chronic low back pain. Authors of the systematic reviews included primary studies that did not match their questions in relation to treatment or population characteristics. A total of ten primary studies were identified across five systematic reviews. Only two of the primary studies were included in all of the reviews due to different inclusion criteria relating to publication date and status, definition of Pilates, and methodological quality. The level of evidence of reviews was low due to the methodological design of the primary studies. The methodological quality of reviews varied. Those which conducted a meta-analysis obtained higher scores. Conclusion There is inconclusive evidence that Pilates is effective in reducing pain and disability in people with chronic low back
Bragaru, Mihail; Dekker, Rienk; Geertzen, Jan H B; Dijkstra, Pieter U
Amputation of a limb may have a negative impact on the psychological and physical well-being, mobility and social life of individuals with limb amputations. Participation in sports and/or regular physical activity has a positive effect on the above mentioned areas in able-bodied individuals. Data concerning participation in sports or regular physical activity together with its benefits and risks for individuals with limb amputations are scarce. No systematic review exists that addresses a wide range of outcomes such as biomechanics, cardiopulmonary function, psychology, sport participation and sport injuries. Therefore, the aim of this article is to systematically review the literature about individuals with limb amputations and sport participation. MEDLINE (PubMed), EMBASE, CINAHL® and SportDiscus® were searched without time or language restrictions using free text words and MeSH terms. The last search date was 31 March 2010. Books, internet sites and references of included papers were checked for papers relevant to the topic under review. Papers were included if the research topic concerned sports and a minimum of ten individuals with limb amputations were part of the study population. Papers were excluded if they included individuals with amputations of body parts other than upper or lower limbs or more distal than the wrist or ankle, or if they consisted of case reports, narrative reviews, books, notes or letters to the editor. Title, abstract and full-text assessments were performed by two independent observers following a list of preset criteria. Of the 3689 papers originally identified, 47 were included in the review. Most of the included studies were older than 10 years and had cross-sectional designs. Study participants were generally younger and often had more traumatic amputations than the general population of individuals with limb amputations. Heterogeneity in population characteristics, intervention types and main outcomes made data pooling
Xiong, Xingjiang; Wang, Pengqian; Li, Xiaoke; Zhang, Yuqing
The purpose of this review was to evaluate the efficacy and safety of qigong for hypertension.A systematic literature search was performed in 7 databases from their respective inceptions until April 2014, including the Cochrane Library, EMBASE, PubMed, Chinese Scientific Journal Database, Chinese Biomedical Literature Database, Wanfang database, and Chinese National Knowledge Infrastructure. Randomized controlled trials of qigong as either monotherapy or adjunctive therapy with antihypertensive drugs versus no intervention, exercise, or antihypertensive drugs for hypertension were identified. The risk of bias was assessed using the tool described in Cochrane Handbook for Systematic Review of Interventions, version 5.1.0.Twenty trials containing 2349 hypertensive patients were included in the meta-analysis. The risk of bias was generally high. Compared with no intervention, qigong significantly reduced systolic blood pressure (SBP) (weighted mean difference [WMD] = -17.40 mm Hg, 95% confidence interval [CI] -21.06 to -13.74, P Qigong was inferior to exercise in decreasing SBP (WMD = 6.51 mm Hg, 95% CI 2.81 to 10.21, P = 0.0006), but no significant difference between the effects of qigong and exercise on DBP (WMD = 0.67 mm Hg, 95% CI -1.39 to 2.73, P = 0.52) was identified. Compared with antihypertensive drugs, qigong produced a clinically meaningful but not statistically significant reduction in SBP (WMD = -7.91 mm Hg, 95% CI -16.81 to 1.00, P = 0.08), but appeared to be more effective in lowering DBP (WMD = -6.08 mm Hg, 95% CI -9.58 to -2.58, P = 0.0007). Qigong plus antihypertensive drugs significantly lowered both SBP (WMD = -11.99 mm Hg, 95% CI -15.59 to -8.39, P qigong is an effective therapy for hypertension. However, more rigorously designed randomized controlled trials with long-term follow-up focusing on hard clinical outcomes are required to confirm the results.
Strzelczyk, Adam; Reese, Jens Peter; Dodel, Richard; Hamer, Hajo M
The objective of this review was to overview published cost-of-illness (COI) studies of epilepsy and their methodological approaches. Epilepsy imposes a substantial burden on individuals and society as a whole. The mean prevalence of epilepsy is estimated at 0.52% in Europe, 0.68% in the US, and peaks up to 1.5% in developing countries. Estimation of the economic burden of epilepsy is of pivotal relevance to enable a rational distribution of healthcare resources. This is especially so with the introduction of the newer antiepileptic drugs (AEDs), the marketing of vagal-nerve stimulators and the resurgence of new surgical treatment options, which have the potential to considerably increase the costs of treating epilepsy.A systematic literature review was performed to identify studies that evaluated direct and indirect costs of epilepsy. Using a standardized assessment form, information on the study design, methodological framework and data sources were extracted from each publication and systematically reported. We identified 22 studies worldwide on costs of epilepsy. The majority of the studies reflected the costs of epilepsy in Europe (three studies each for the UK and Italy, one study each for Germany, the Netherlands, Switzerland, France and the EU) and the US (four studies), but studies were also available from India (two), Hong Kong, Oman, Burundi, Chile and Mexico. The studies utilized different frameworks to evaluate costs. All used a bottom-up approach; however, only 12 studies (55%) evaluated direct as well as indirect costs. The range for the mean annual direct costs lay between 40 International Dollar purchasing power parities (PPP-$) in rural Burundi and PPP-$4748 (adjusted to 2006 values) in a German epilepsy centre. Recent studies suggest AEDs are becoming the main contributor to direct costs. The mean indirect costs ranged between 12% and 85% of the total annual costs. Epilepsy is a cost-intensive disorder. A reliable comparison of the different COI
PURPOSE: Hirschsprung\\'s disease is characterised by the congenital absence of ganglion cells beginning in the distal rectum and extending proximally for varying distances. \\'Zonal aganglionosis\\' is a phenomenon involving a zone of aganglionosis occurring within normally innervated intestine. \\'Skip segment\\' Hirschsprung\\'s disease (SSHD) involves a \\'skip area\\' of normally ganglionated intestine, surrounded proximally and distally by aganglionosis. While Hirschsprung\\'s disease is believed to be the result of incomplete craniocaudal migration of neural crest-derived cells, the occurrence of SSHD has no clear embryological explanation. The aim of this study was to perform a systematic review of SSHD, reported in the literature between 1954 and 2009, in order to determine the clinical characteristics of this rare entity and its significance. METHODS: The first reported case of SSHD was published in 1954. A systematic review of SSHD cases in the literature, from 1954 to 2009, was carried out using the electronic database \\'Pubmed\\'. Detailed information was recorded regarding the age, gender, presenting symptoms and location of the skip segment in each patient. RESULTS: 24 cases of SSHD have been reported in the literature to date. 18\\/24 (75%) of these cases were males and 6\\/24 (25%) were females. Of these, 22\\/24 (92%) were cases of total colonic aganglionosis (TCA), and 2\\/24 (8%) were rectosigmoid Hirschsprung\\'s disease. Of the 22 TCA cases, 9 (41%) had a skip segment in the transverse colon, 6 (27%) in the ascending colon, 2 (9%) in the caecum and 5 (23%) had multiple skip segments. In both rectosigmoid Hirschsprung\\'s disease cases, the skip segment was in the sigmoid colon. Overall, the length of the skip segment was variable, with the entire transverse colon ganglionated in some cases. CONCLUSION: SSHD occurs predominantly in patients with TCA. The existence of a skip area of normally innervated colon in TCA may influence surgical
White, Angela; Kavanagh, David; Stallman, Helen; Klein, Britt; Kay-Lambkin, Frances; Proudfoot, Judy; Drennan, Judy; Connor, Jason; Baker, Amanda; Hines, Emily; Young, Ross
There has been a significant increase in the availability of online programs for alcohol problems. A systematic review of the research evidence underpinning these programs is timely. Our objective was to review the efficacy of online interventions for alcohol misuse. Systematic searches of Medline, PsycINFO, Web of Science, and Scopus were conducted for English abstracts (excluding dissertations) published from 1998 onward. Search terms were: (1) Internet, Web*; (2) online, computer*; (3) alcohol*; and (4) E\\effect*, trial*, random* (where * denotes a wildcard). Forward and backward searches from identified papers were also conducted. Articles were included if (1) the primary intervention was delivered and accessed via the Internet, (2) the intervention focused on moderating or stopping alcohol consumption, and (3) the study was a randomized controlled trial of an alcohol-related screen, assessment, or intervention. The literature search initially yielded 31 randomized controlled trials (RCTs), 17 of which met inclusion criteria. Of these 17 studies, 12 (70.6%) were conducted with university students, and 11 (64.7%) specifically focused on at-risk, heavy, or binge drinkers. Sample sizes ranged from 40 to 3216 (median 261), with 12 (70.6%) studies predominantly involving brief personalized feedback interventions. Using published data, effect sizes could be extracted from 8 of the 17 studies. In relation to alcohol units per week or month and based on 5 RCTs where a measure of alcohol units per week or month could be extracted, differential effect sizes to posttreatment ranged from 0.02 to 0.81 (mean 0.42, median 0.54). Pre-post effect sizes for brief personalized feedback interventions ranged from 0.02 to 0.81, and in 2 multi-session modularized interventions, a pre-post effect size of 0.56 was obtained in both. Pre-post differential effect sizes for peak blood alcohol concentrations (BAC) ranged from 0.22 to 0.88, with a mean effect size of 0.66. The available
Petkovic, Jennifer; Welch, Vivian; Tugwell, Peter
Systematic reviews are important for decision-makers. They offer many potential benefits but are often written in technical language, are too long, and do not contain contextual details which makes them hard to use for decision-making. There are many organizations that develop and disseminate derivative products, such as evidence summaries, from systematic reviews for different populations or subsets of decision-makers. This systematic review will assess the effectiveness of systematic review summaries on increasing policymakers' use of systematic review evidence and to identify the components or features of these summaries that are most effective. We will include studies of policy-makers at all levels as well as health-system managers. We will include studies examining any type of "evidence summary," "policy brief," or other products derived from systematic reviews that present evidence in a summarized form. The primary outcomes are the following: (1) use of systematic review summaries decision-making (e.g., self-reported use of the evidence in policy-making, decision-making) and (2) policy-maker understanding, knowledge, and/or beliefs (e.g., changes in knowledge scores about the topic included in the summary). We will conduct a systematic review of randomized controlled trials (RCTs), non-randomized controlled trials (NRCTs), controlled before-after studies (CBA), and interrupted time series (ITS) studies. The results of this review will inform the development of future systematic review summaries to ensure that systematic review evidence is accessible to and used by policy-makers making health-related decisions.
Borba, Anna Karla de Oliveira Tito; Marques, Ana Paula de Oliveira; Leal, Márcia Carréra Campos; Ramos, Roberta Souza Pereira da Silva
This is an integrative literature review which aims to identify the multi-professional scientific production on educational practices for individuals with diabetes available in the databases: Latin American Literature in Health Sciences (Literatura Latino Americana em Ciências da Saúde-LILACS), Medical Literature and Retrieval System online (Medline), Spanish Bibliographical Index in Health Sciences (Indice Bibliográfico Español en Ciencias de la Salud-Ibecs) and the Database on Nursing (Base de Dados em Enfermagem-BDENF), from 1999 to 2009. Results show that educational practices are developed mainly for adults and seniors up to 80 years of age, and involve themes that reflect the daily ife of living with diabetes. These practices are spread mainly through groups, bringing benefits not only for the individual with diabetes but also for the healthcare professional. Thus, we can see the process of changing the traditional education paradigm to a problem-based dialogical education, with a view for promoting health.
de Souza, Bárbara Verônica Cardoso; Moreira Araújo, Regilda Saraiva Dos Reis; Silva, Oskar Almeida; Faustino, Lucas Costa; Gonçalves, Maria Fabrícia Beserra; Dos Santos, Mirian Lima; Souza, Grasielly Rocha; Rocha, Lindalva Moura; Cardoso, Mônica Larissa Sousa; Nunes, Lívio César Cunha
Diabetes Mellitus has been considered an epidemic by the World Health Organization, with a high risk of morbidity and mortality. The treatment of this pathology consists in glycemic control, which can be done by oral hypoglycemic agents, insulin therapy, dietary guidance, regular physical activity, and psychosocial support. In addition, other adjuvant treatments are employed, such as phytotherapic, and one of the most used plants is Bauhinia forficata. Areas covered: In the current review, patents using Bauhinia forficata for the Diabetes Mellitus treatment have been analyzed. There were 03 patents in WIPO, 01 in Espacenet, 01 in USPTO, and 02 in INPI. Expert opinion: Patents on the adjuvant treatment of Diabetes Mellitus by Bauhinia forficata are discussed. Although there are some phytotherapy products containing this medicinal plant which has hypoglycemic effect here is still a need for the development of more products based on natural resources, for the treatment of this pathology, without side effects and with other benefits, to assist in the glycemia control in diabetic patients, and to improve their quality of life.
Full Text Available In countries with low tuberculosis (TB incidence, immigrants from higher incidence countries represent the major pool of individuals with latent TB infection (LTBI. The antenatal period represents an opportunity for immigrant women to access the medical system, and hence for potential screening and treatment of LTBI. However, such screening and treatment during pregnancy remains controversial.In order to further understand the prevalence, natural history, screening and management of LTBI in pregnancy, we conducted a systematic literature review addressing the screening and treatment of LTBI, in pregnant women without known HIV infection.A systematic review of 4 databases (Embase, Embase Classic, Medline, Cochrane Library covering articles published from January 1st 1980 to April 30th 2014. Articles in English, French or Spanish with relevant information on prevalence, natural history, screening tools, screening strategies and treatment of LTBI during pregnancy were eligible for inclusion. Articles were excluded if (1 Full text was not available (2 they were case series or case studies (3 they focused exclusively on prevalence, diagnosis and treatment of active TB (4 the study population was exclusively HIV-infected.Of 4,193 titles initially identified, 208 abstracts were eligible for review. Of these, 30 articles qualified for full text review and 22 were retained: 3 cohort studies, 2 case-control studies, and 17 cross-sectional studies. In the USA, the estimated prevalence of LTBI ranged from 14 to 48% in women tested, and tuberculin skin test (TST positivity was associated with ethnicity. One study suggested that incidence of active TB was significantly increased during the 180 days postpartum (Incidence rate ratio, 1.95 (95% CI 1.24-3.07. There was a high level of adherence with both skin testing (between 90-100% and chest radiography (93-100%.. In three studies from low incidence settings, concordance between TST and an interferon
Full Text Available Abstract Background Despite abundant bereavement care options, consensus is lacking regarding optimal care for bereaved persons. Methods We conducted a systematic review, searching MEDLINE, PsychINFO, CINAHL, EBMR, and other databases using the terms (bereaved or bereavement and (grief combined with (intervention or support or counselling or therapy and (controlled or trial or design. We also searched citations in published reports for additional pertinent studies. Eligible studies had to evaluate whether the treatment of bereaved individuals reduced bereavement-related symptoms. Data from the studies was abstracted independently by two reviewers. Results 74 eligible studies evaluated diverse treatments designed to ameliorate a variety of outcomes associated with bereavement. Among studies utilizing a structured therapeutic relationship, eight featured pharmacotherapy (4 included an untreated control group, 39 featured support groups or counselling (23 included a control group, and 25 studies featured cognitive-behavioural, psychodynamic, psychoanalytical, or interpersonal therapies (17 included a control group. Seven studies employed systems-oriented interventions (all had control groups. Other than efficacy for pharmacological treatment of bereavement-related depression, we could identify no consistent pattern of treatment benefit among the other forms of interventions. Conclusions Due to a paucity of reports on controlled clinical trails, no rigorous evidence-based recommendation regarding the treatment of bereaved persons is currently possible except for the pharmacologic treatment of depression. We postulate the following five factors as impeding scientific progress regarding bereavement care interventions: 1 excessive theoretical heterogeneity, 2 stultifying between-study variation, 3 inadequate reporting of intervention procedures, 4 few published replication studies, and 5 methodological flaws of study design.
Lieuwe D J Bos
Full Text Available Ideally, invading bacteria are detected as early as possible in critically ill patients: the strain of morbific pathogens is identified rapidly, and antimicrobial sensitivity is known well before the start of new antimicrobial therapy. Bacteria have a distinct metabolism, part of which results in the production of bacteria-specific volatile organic compounds (VOCs, which might be used for diagnostic purposes. Volatile metabolites can be investigated directly in exhaled air, allowing for noninvasive monitoring. The aim of this review is to provide an overview of VOCs produced by the six most abundant and pathogenic bacteria in sepsis, including Staphylococcus aureus, Streptococcus pneumoniae, Enterococcus faecalis, Pseudomonas aeruginosa, Klebsiella pneumoniae, and Escherichia coli. Such VOCs could be used as biological markers in the diagnostic approach of critically ill patients. A systematic review of existing literature revealed 31 articles. All six bacteria of interest produce isopentanol, formaldehyde, methyl mercaptan, and trimethylamine. Since humans do not produce these VOCs, they could serve as biological markers for presence of these pathogens. The following volatile biomarkers were found for identification of specific strains: isovaleric acid and 2-methyl-butanal for Staphylococcus aureus; 1-undecene, 2,4-dimethyl-1-heptane, 2-butanone, 4-methyl-quinazoline, hydrogen cyanide, and methyl thiocyanide for Pseudomonas aeruginosa; and methanol, pentanol, ethyl acetate, and indole for Escherichia coli. Notably, several factors that may effect VOC production were not controlled for, including used culture media, bacterial growth phase, and genomic variation within bacterial strains. In conclusion, VOCs produced by bacteria may serve as biological markers for their presence. Goal-targeted studies should be performed to identify potential sets of volatile biological markers and evaluate the diagnostic accuracy of these markers in critically
Reddy, Madhuri; Gill, Sudeep S; Rochon, Paula A
Pressure ulcers are common in a variety of patient settings and are associated with adverse health outcomes and high treatment costs. To systematically review the evidence examining interventions to prevent pressure ulcers. MEDLINE, EMBASE, and CINAHL (from inception through June 2006) and Cochrane databases (through issue 1, 2006) were searched to identify relevant randomized controlled trials (RCTs). UMI Proquest Digital Dissertations, ISI Web of Science, and Cambridge Scientific Abstracts were also searched. All searches used the terms pressure ulcer, pressure sore, decubitus, bedsore, prevention, prophylactic, reduction, randomized, and clinical trials. Bibliographies of identified articles were further reviewed. Fifty-nine RCTs were selected. Interventions assessed in these studies were grouped into 3 categories, ie, those addressing impairments in mobility, nutrition, or skin health. Methodological quality for the RCTs was variable and generally suboptimal. Effective strategies that addressed impaired mobility included the use of support surfaces, mattress overlays on operating tables, and specialized foam and specialized sheepskin overlays. While repositioning is a mainstay in most pressure ulcer prevention protocols, there is insufficient evidence to recommend specific turning regimens for patients with impaired mobility. In patients with nutritional impairments, dietary supplements may be beneficial. The incremental benefit of specific topical agents over simple moisturizers for patients with impaired skin health is unclear. Given current evidence, using support surfaces, repositioning the patient, optimizing nutritional status, and moisturizing sacral skin are appropriate strategies to prevent pressure ulcers. Although a number of RCTs have evaluated preventive strategies for pressure ulcers, many of them had important methodological limitations. There is a need for well-designed RCTs that follow standard criteria for reporting nonpharmacological
Al-Amleh, B; Lyons, K; Swain, M
Zirconia is unique in its polymorphic crystalline makeup, reported to be sensitive to manufacturing and handling processes, and there is debate about which processing method is least harmful to the final product. Currently, zirconia restorations are manufactured by either soft or hard-milling processes, with the manufacturer of each claiming advantages over the other. Chipping of the veneering porcelain is reported as a common problem and has been labelled as its main clinical setback. The objective of this systematic review is to report on the clinical success of zirconia-based restorations fabricated by both milling processes, in regard to framework fractures and veneering porcelain chipping. A comprehensive review of the literature was completed for in vivo trials on zirconia restorations in MEDLINE and PubMed between 1950 and 2009. A manual hand search of relevant dental journals was also completed. Seventeen clinical trials involving zirconia-based restorations were found, 13 were conducted on fixed partial dentures, two on single crowns and two on zirconia implant abutments, of which 11 were based on soft-milled zirconia and six on hard-milled zirconia. Chipping of the veneering porcelain was a common occurrence, and framework fracture was only observed in soft-milled zirconia. Based on the limited number of short-term in vivo studies, zirconia appears to be suitable for the fabrication of single crowns, and fixed partial dentures and implant abutments providing strict protocols during the manufacturing and delivery process are adhered to. Further long-term prospective studies are necessary to establish the best manufacturing process for zirconia-based restorations.
Allana Alexandre Cardoso
Full Text Available ABSTRACT Movement is a fundamental element of dance, and the dancer’s body is the raw material through which the art of dance is expressed; for this, it demands the utmost discipline in the pursuit of technical and artistic excellence. To meet the professional demands, dancers are subjected to strenuous training routines, which can lead to the development of injuries in this environment. The objective was to examine the etiology, main affected segments, prevalence, and instruments used to evaluate the lesions in studies with professional dancers and/or in comparison with similar populations. We selected articles published in the last decade in the databases BIREME, LILACS, MEDLINE EBSCO, WEB OF SCIENCE, SCOPUS (Elsevier, and PubMed, with cross-sectional, observational cohort and case control design published in Portuguese, English, or Spanish. Systematic reviews, case studies, dissertations, theses, book chapters, cross-referenced articles, and studies published outside of the last decade were not included. The search used combinations of the terms “dancing* and athletic injuries* and musculoskeletal* and pain*”. A principal investigator and two reviewers conducted the survey and analyzed all the potentially relevant articles, initially by the abstract and title. Twelve articles were included, with 1,149 participants (965 professional dancers of classical ballet, modern dance, contemporary dance, and breakdance, 104 amateur dancers, and 80 elite athletes. Nine studies found simultaneous lesions with emphasis on the foot and ankle (n=4, upper and lower limbs lesions (n=4 and lower and upper limb joints (n=1. Other studies have found lesions in the anterior cruciate ligament (n=3. There was no agreement regarding the instruments for detecting lesions in professional, pre-professional, and amateur dancers. There was a prevalence of studies aimed at classical ballet modality, evidencing a higher frequency of lower limb involvement in
Hu, Stephanie W; Bigby, Michael
To determine the efficacy of topical or systemic agents in the treatment and prevention of pityriasis versicolor. Systematic review and meta-analysis. The Cochrane Skin Group Specialized Register (to June 2008), Cochrane Central Register of Controlled Trials, MEDLINE (1950 to June 2008), EMBASE (1974 to June 2008), LILACS (to March 2009), the gray literature, and sources for registered trials to November 2008. Reference lists of all retrieved trials and review articles were checked for additional trials. Controlled trials that examined therapies used in children or adults with a clinical or microscopic diagnosis of pityriasis versicolor. The primary outcome measure included a negative result from mycological evaluation of participants with direct microscopy using potassium hydroxide smear. The secondary outcome measures were findings from Wood's light examination and a negative clinical evaluation result, with disappearance of visual signs (except pigmentary defects) and symptoms. Results of treatment and prevention of pityriasis versicolor infection in 8327 participants in 93 controlled trials were examined. Overall, trials investigating the efficacy of therapeutic and prophylactic treatments for pityriasis versicolor are poorly reported and may be of low quality. Most trials did not adequately report the methods of randomization, concealment of allocation, and blinding, and many did not use intention-to-treat analysis. Most topical treatments used to treat pityriasis versicolor are effective compared with placebo, with numbers needed to treat of 1 to 3. Data suggest that longer durations of treatment and higher concentrations of active agents produce greater cure rates. Most topical and systemic treatments used for pityriasis versicolor are effective compared with placebo. Randomized controlled clinical trials are needed to establish relative efficacy of topical and systemic agents used for treatment and prevention of pityriasis versicolor.
Full Text Available BACKGROUND: Systematic reviews (SRs should be up to date to maintain their importance in informing healthcare policy and practice. However, little guidance is available about when and how to update SRs. Moreover, the updating policies and practices of organizations that commission or produce SRs are unclear. METHODOLOGY/PRINCIPAL FINDINGS: The objective was to describe the updating practices and policies of agencies that sponsor or conduct SRs. An Internet-based survey was administered to a purposive non-random sample of 195 healthcare organizations within the international SR community. Survey results were analyzed using descriptive statistics. The completed response rate was 58% (n = 114 from across 26 countries with 70% (75/107 of participants identified as producers of SRs. Among responders, 79% (84/107 characterized the importance of updating as high or very-high and 57% (60/106 of organizations reported to have a formal policy for updating. However, only 29% (35/106 of organizations made reference to a written policy document. Several groups (62/105; 59% reported updating practices as irregular, and over half (53/103 of organizational respondents estimated that more than 50% of their respective SRs were likely out of date. Authors of the original SR (42/106; 40% were most often deemed responsible for ensuring SRs were current. Barriers to updating included resource constraints, reviewer motivation, lack of academic credit, and limited publishing formats. Most respondents (70/100; 70% indicated that they supported centralization of updating efforts across institutions or agencies. Furthermore, 84% (83/99 of respondents indicated they favoured the development of a central registry of SRs, analogous to efforts within the clinical trials community. CONCLUSIONS/SIGNIFICANCE: Most organizations that sponsor and/or carry out SRs consider updating important. Despite this recognition, updating practices are not regular, and many organizations lack
Hicks, Angel Mier; DeRosa, Antonio; Raj, Micheal; Do, Richard; Yu, Kenneth H; Lowery, Maeve A; Varghese, Anna; O'Reilly, Eileen M
Within gastrointestinal malignancies, primary hepatocellular carcinoma and pancreatic ductal adenocarcinoma (PDAC) are frequently associated with visceral thromboses (VT). Thrombus formation in the portal (PVT), mesenteric (MVT), or splenic vein (SVT) system leads to portal hypertension and intestinal ischemia. VT in PDAC may convey a risk of increased distal thrombosis and poses therapeutic uncertainty regarding the role of anticoagulation. An increasing number of reports describe VT associated with PDAC. It is possible that early diagnosis of these events may help reduce morbidity and speculatively improve oncologic outcomes. To perform a systematic review to study PVT, MVT, and SVT associated with PDAC, and to provide a comprehensive review. Medline/PubMed, Embase, Web of Science, Scopus, and the Cochrane Library. Data Extraction and Assessment: Two blinded independent observers extracted and assessed the studies for diagnosis of PVT, MVT, and SVT in PDAC. Studies were restricted to English-language literature published between 2007 and 2016. Eleven articles were identified. Five case reports and 7 retrospective studies were found, with a total of 127 patients meeting the inclusion criteria. The mean age at diagnosis was 64 years. PVT was found in 35% (n = 46), SVT in 52% (n = 65), and MVT in 13% (n = 15). Mean follow-up time was 26 months. Only 3 of the selected articles studied the impact of anticoagulation in VT. All patients with nonvisceral thrombosis (eg, deep-vein thrombosis, pulmonary emboli) were therapeutically treated; in contrast, patients with VT only rarely received treatment. VT in PDAC is a frequent finding at diagnosis or during disease progression. Evidence to guide treatment choices is limited, and current management is based on inferred experience from nononcologic settings. Anticoagulation appears to be safe in VT, with most of the large studies recommending a careful assessment for patients at a high risk of bleeding. Copyright © 2017
Tofte, Josef N; CarlLee, Tyler L; Holte, Andrew J; Sitton, Sean E; Weinstein, Stuart L
A systematic review. The aim of this study was to provide an evidence-based recommendation for when and how to employ imaging studies when diagnosing back pain thought to be caused by spondylolysis in pediatric patients. Spondylolysis is a common structural cause of back pain in pediatric patients. The radiologic methods and algorithms used to diagnose spondylolysis are inconsistent among practitioners. A literature review was performed in PubMed and Cochrane databases using the search terms "spondylolysis," "pediatric," "adolescent," "juvenile," "young," "lumbar," "MRI," "bone scan," "CT," and "SPECT." After inclusion criteria were applied, 13 articles pertaining to diagnostic imaging of pediatric spondylolysis were analyzed. Ten papers included sensitivity calculations for comparing imaging performance. The average sensitivity of magnetic resonance imaging (MRI) with computed tomography (CT) as the standard of reference was 81.4%. When compared with single-photon emission CT (SPECT), the average sensitivity of CT was 85% and the sensitivity of MRI was 80%. Thirteen studies made a recommendation as to how best to perform diagnostic imaging of patients with clinically suspected spondylolysis. When compared with two-view plain films, bone scans had seven to nine times the effective radiation dose, while four-view plain films and CT were approximately double. Of the diagnostic methods examined, MRI was the most expensive followed by CT, bone scan, four-view plain films, and two-view plain films. Due to their efficacy, low cost, and low radiation exposure, we find two-view plain films to be the best initial study. With unusual presentations or refractory courses, practitioners should pursue advanced imaging. MRI should be used in early diagnosis and CT in more persistent courses. However, the lack of rigorous studies makes it difficult to formulate concrete recommendations. 3.
Furlan, A.D.; Pennick, V.; Bombardier, C.; van Tulder, M.W.
STUDY DESIGN. Method guidelines for systematic reviews of trials of treatments for neck and back pain. OBJECTIVE. To help review authors design, conduct and report systematic reviews of trials in this field. SUMMARY OF BACKGROUND DATA. In 1997, the Cochrane Back Review Group published Method
Nicholls, Adam R; Polman, Remco C J
The aim of this paper was to systematically review the literature on coping in sport, examining evidence for both the trait and process perspectives, the types of coping strategies used by athletes, gender differences, age-related differences, and coping effectiveness. A comprehensive literature search of SPORTdiscus, PsychLIT, and PsychINFO in November 2004 yielded 64 studies spanning 16 years (1988 - 2004). The results indicated that athletes use a variety of coping strategies. Forty-six papers supported or adopted the process perspective (Lazarus, 1999; Lazarus & Folkman, 1984). There were also gender and age-related differences. Evidence was found to support three of the different models of coping effectiveness (goodness-of-fit approach, choice of coping strategy, and automacity). Based on this evidence, future research should address some of the methodological and measurement limitations of the sport psychology coping literature. In particular, prospective research designs that minimize the time delay between recall and the stressful experience are required to assess how coping changes over time. More attention to developmental issues to guide the formulation of sport-specific models to enhance our theoretical understanding is also required. Finally, coping effectiveness should be examined both in the short and long term, as a greater understanding of coping effectiveness has the potential to make a significant impact on applied practice.
Sara Mota Borges Bottino
Full Text Available Cyberbullying is a new form of violence that is expressed through electronic media and has given rise to concern for parents, educators and researchers. In this paper, an association between cyberbullying and adolescent mental health will be assessed through a systematic review of two databases: PubMed and Virtual Health Library (BVS. The prevalence of cyberbullying ranged from 6.5% to 35.4%. Previous or current experiences of traditional bullying were associated with victims and perpetrators of cyberbullying. Daily use of three or more hours of Internet, web camera, text messages, posting personal information and harassing others online were associated with cyberbullying. Cybervictims and cyberbullies had more emotional and psychosomatic problems, social difficulties and did not feel safe and cared for in school. Cyberbullying was associated with moderate to severe depressive symptoms, substance use, ideation and suicide attempts. Health professionals should be aware of the violent nature of interactions occurring in the virtual environment and its harm to the mental health of adolescents.
Marcelo do Amaral Ferreira
Full Text Available OBJECTIVE: A systematic review on nickel-titanium wires was performed. The strategy was focused on Entrez-PubMed-OLDMEDLINE, Scopus and BioMed Central from 1963 to 2008. METHODS: Papers in English and French describing the behavior of these wires and laboratorial methods to identify crystalline transformation were considered. A total of 29 papers were selected. RESULTS: Nickel-titanium wires show exceptional features in terms of elasticity and shape memory effects. However, clinical applications request a deeper knowledge of these properties in order to allow the professional to use them in a rational manner. In addition, the necessary information regarding each alloy often does not correspond to the information given by the manufacturer. Many alloys called "superelastic" do not present this effect; they just behave as less stiff alloys, with a larger springback if compared to the stainless steel wires. CONCLUSIONS: Laboratory tests are the only means to observe the real behavior of these materials, including temperature transition range (TTR and applied tensions. However, it is also possible to determine in which TTR these alloys change the crystalline structure.
Keen, H I; Wakefield, R J; Conaghan, P G
Ultrasonography has been increasingly utilised to aid the understanding and management of rheumatic conditions. In recent years there has been a focus on the validity and utility of ultrasonography in demonstrating joint pathology, although this has largely focused on inflammatory arthritis. To undertake a systematic review of the published literature evaluating ultrasonography as an assessment tool in osteoarthritis. Medline and Pubmed were searched to identify original manuscripts, published before June 2008, utilising ultrasonography to assess the joints of cohorts of subjects with osteoarthritis. Data were extracted from manuscripts meeting the inclusion criteria, with a particular focus on the pathology imaged, the definitions used, scoring systems and their metric properties. Forty-seven studies were identified that utilised ultrasonography to assess structural pathology in osteoarthritis. Doppler function was only assessed in 10 studies and contrast agents in one. There was heterogeneity with regard to the pathology examined, the definition of pathology, quantification and the reporting of these factors. There was also a lack of construct and criterion validity and data demonstrating reliability and sensitivity to change. Whereas there is increasing evidence of the validity of ultrasonography in detecting structural pathology in inflammatory arthritis, more work is required to develop standardised definitions of pathology and to demonstrate the validity of ultrasonography in osteoarthritis.
Galán Gil, Sónnica; Peñarrocha Diago, Maria; Peñarrocha Diago, Miguel
Malignant mental neuropathy (MMN) is a neurological manifestation of cancer, characterized by the presence of hypoesthesia or anesthesia restricted to the territory of the mental branch of the mandibular nerve. A systematic review of the literature has been made on MMN, analyzing the etiology, pathogeny, clinical characteristics, complementary tests and the prognosis. Sixteen studies, providing 136 cases were selected. Breast cancer and lymphomas were the most frequently associated malignant diseases. The most frequent pathogenic mechanisms producing neurological involvement were: peripherally, mandibular lesions; and centrally, tumors at the base of the cranium. Regarding clinical characteristics, manifestation of MMN was the primary symptom of malignant disease in 27.7% of cases, and a first symptom of recurrence in 37.7%. The group of selected studies included 50 orthopantomographs, 9 mandibular computed tomographies and 50 radiographic examinations of the cranial region. The most affected region was the mandible. The appearance of MMN is an ominous prognosis for the progression of the disease, with a mortality of 78.5% within a mean of 6.9 months.
Bottino, Sara Mota Borges; Bottino, Cássio M C; Regina, Caroline Gomez; Correia, Aline Villa Lobo; Ribeiro, Wagner Silva
Cyberbullying is a new form of violence that is expressed through electronic media and has given rise to concern for parents, educators and researchers. In this paper, an association between cyberbullying and adolescent mental health will be assessed through a systematic review of two databases: PubMed and Virtual Health Library (BVS). The prevalence of cyberbullying ranged from 6.5% to 35.4%. Previous or current experiences of traditional bullying were associated with victims and perpetrators of cyberbullying. Daily use of three or more hours of Internet, web camera, text messages, posting personal information and harassing others online were associated with cyberbullying. Cybervictims and cyberbullies had more emotional and psychosomatic problems, social difficulties and did not feel safe and cared for in school. Cyberbullying was associated with moderate to severe depressive symptoms, substance use, ideation and suicide attempts. Health professionals should be aware of the violent nature of interactions occurring in the virtual environment and its harm to the mental health of adolescents.
Hillier, Susan; Immink, Maarten; Thewlis, Dominic
Proprioception is a vital aspect of motor control and when degraded or lost can have a profound impact on function in diverse clinical populations. This systematic review aimed to identify clinically related tools to measure proprioceptive acuity, to classify the construct(s) underpinning the tools, and to report on the clinimetric properties of the tools. We searched key databases with the pertinent search terms, and from an initial list of 935 articles, we identified 57 of relevance. These articles described 32 different tools or methods to quantify proprioception. There was wide variation in methods, the joints able to be tested, and the populations sampled. The predominant construct was active or passive joint position detection, followed by passive motion detection and motion direction discrimination. The clinimetric properties were mostly poorly evaluated or reported. The Rivermead Assessment of Somatosensory Perception was generally considered to be a valid and reliable tool but with low precision; other tools with higher precision are potentially not clinically feasible. Clinicians and clinical researchers can use the summary tables to make more informed decisions about which tool to use to match their predominant requirements. Further discussion and research is needed to produce measures of proprioception that have improved validity and utility. © The Author(s) 2015.
Sawin, Erika Metzler; Sobel, Linda L; Annan, Sandra L; Schminkey, Donna L
Intimate partner violence (IPV) is a global public health and criminal justice concern with significant impacts; especially high rates are seen among rural Hispanic American (HA) communities, the fastest growing population in the United States. They experience additional barriers to care including extreme poverty, lesser education, gender norms, and language and immigration issues. A systematic literature review was conducted using Cooper's framework to identify evidence supporting associations between interventions and prevention, reduction, and elimination of IPV among rural HA women. Searches conducted on databases including CINAHL, PubMed, Medline, Women's Studies International, MedicLatina, and JSTOR used the MeSH terms Hispanic Americans (Latino/a and Hispanic), domestic violence, and intimate partner violence. Selected studies were published between January 1, 2000, and January 1, 2014. Of the 617 yielded articles, only 6 met the inclusion criteria. Of these, none closely examined rurality or provided valid and reliable measures of outcomes, instead reporting program descriptions and suggested interventions. We identify key findings to guide program, screening, and tool development. Our study identifies a gap in knowledge, research, and effective practices and issues a call for action to create evidence-based tools to prevent, reduce, and eliminate IPV in these underserved populations.
Hugo Fabiano Fernandes Novaes
Full Text Available Objective To conduct a systematic review on single scrotal incision orchiopexy. Materials and Methods A search was performed using Pubmed, through which 16 articles were selected out of a total of 133. The following conditions were considered exclusion criteria: other surgical methods such as an inguinal procedure or a laparoscopic approach, retractile testes, or patients with previous testicular or inguinal surgery. Results A total of 1558 orchiopexy surgeries initiated with a transcrotal incision were analyzed. Patients' ages ranged between 5 months and 21 years. Thirteen studies used high scrotal incisions, and low scrotal incisions were performed in the remainder of the studies. In 55 cases (3.53%, there was a need for inguinal incision. Recurrence was observed in 9 cases, testicular atrophy in 3, testicular hypotrophy in 2, and surgical site infections in 13 cases. High efficacy rates were observed, varying between 88% and 100%. Conclusions Single scrotal incision orchiopexy proved to be an effective technique and is associated with low rates of complications.
Schmidt, Julia C; Sahrmann, Philipp; Weiger, Roland; Schmidlin, Patrick R; Walter, Clemens
Consideration of the biologic width in restorative dentistry seems to be important for maintaining periodontal health. To evaluate the dimensions of the biologic width in humans. A systematic literature search was performed for publications published by 28 September 2012 using five different electronic databases; this search was complemented by a manual search. Two reviewers conducted the study selection, data collection, and validity assessment. The PRISMA criteria were applied. From 615 titles identified by the search strategy, 14 publications were included and six were suitable for meta-analyses. Included studies were published from the years 1924 to 2012. They differed with regard to measurements of the biologic width. Mean values of the biologic width obtained from two meta-analyses ranged from 2.15 to 2.30 mm, but large intra- and inter-individual variances (subject sample range: 0.2 - 6.73 mm) were observed. The tooth type and site, the presence of a restoration and periodontal diseases/surgery affected the dimensions of the biologic width. Pronounced heterogeneity among studies regarding methods and outcome measures exists. No universal dimension of the biologic width appears to exist. Establishment of periodontal health is suggested prior to the assessment of the biologic width within reconstructive dentistry. © 2013 John Wiley & Sons A/S.
Pennisi, Paola; Tonacci, Alessandro; Tartarisco, Gennaro; Billeci, Lucia; Ruta, Liliana; Gangemi, Sebastiano; Pioggia, Giovanni
Social robotics could be a promising method for Autism Spectrum Disorders (ASD) treatment. The aim of this article is to carry out a systematic literature review of the studies on this topic that were published in the last 10 years. We tried to address the following questions: can social robots be a useful tool in autism therapy? We followed the PRISMA guidelines, and the protocol was registered within PROSPERO database (CRD42015016158). We found many positive implications in the use of social robots in therapy as for example: ASD subjects often performed better with a robot partner rather than a human partner; sometimes, ASD patients had, toward robots, behaviors that TD patients had toward human agents; ASDs had a lot of social behaviors toward robots; during robotic sessions, ASDs showed reduced repetitive and stereotyped behaviors and, social robots manage to improve spontaneous language during therapy sessions. Therefore, robots provide therapists and researchers a means to connect with autistic subjects in an easier way, but studies in this area are still insufficient. It is necessary to clarify whether sex, intelligence quotient, and age of participants affect the outcome of therapy and whether any beneficial effects only occur during the robotic session or if they are still observable outside the clinical/experimental context. © 2015 International Society for Autism Research, Wiley Periodicals, Inc.
El Ghoch, Marwan; Soave, Fabio; Calugi, Simona; Dalle Grave, Riccardo
Background: Eating disorders are health problems that are particularly prevalent in adolescents and young adults. They are associated with considerable physical health and psychosocial morbidity, and increased risk of mortality. We set out to conduct a systematic review to determine their effect on physical fitness in the general population and on sport performance in athletes. Methods/Design: A systematic review of the relevant peer-reviewed literature was performed. For inclusion, articles ...
Cohen, J?r?mie F; Korevaar, Dani?l A; Wang, Junfeng; Spijker, Ren?; Bossuyt, Patrick M
Background Chinese biomedical databases contain a large number of publications available to systematic reviewers, but it is unclear whether they are used for synthesizing the available evidence. Methods We report a case of two systematic reviews on the accuracy of anti-cyclic citrullinated peptide for diagnosing rheumatoid arthritis. In one of these, the authors did not search Chinese databases; in the other, they did. We additionally assessed the extent to which Cochrane reviewers have searc...
Vassar, Matt; Atakpo, Paul; Kash, Melissa J
Objective: Manual searches are supplemental approaches to database searches to identify additional primary studies for systematic reviews. The authors argue that these manual approaches, in particular hand-searching and perusing reference lists, are often considered the same yet lead to different outcomes. Methods: We conducted a PubMed search for systematic reviews in the top 10 dermatology journals (January 2006–January 2016). After screening, the final sample comprised 292 reviews. Sta...
Runge-Ranzinger, S; McCall, P J; Kroeger, A; Horstick, O
Objectives To review the evidence for the application of tools for dengue outbreak prediction/detection and trend monitoring in passive and active disease surveillance systems in order to develop recommendations for endemic countries and identify important research needs. Methods This systematic literature review followed the protocol of a review from 2008, extending the systematic search from January 2007 to February 2013 on PubMed, EMBASE, CDSR, WHOLIS and Lilacs. Data reporting followed th...
Full Text Available BACKGROUND: Transmission of tuberculosis (TB in prisons has been reported worldwide to be much higher than that reported for the corresponding general population. METHODS AND FINDINGS: A systematic review has been performed to assess the risk of incident latent tuberculosis infection (LTBI and TB disease in prisons, as compared to the incidence in the corresponding local general population, and to estimate the fraction of TB in the general population attributable (PAF% to transmission within prisons. Primary peer-reviewed studies have been searched to assess the incidence of LTBI and/or TB within prisons published until June 2010; both inmates and prison staff were considered. Studies, which were independently screened by two reviewers, were eligible for inclusion if they reported the incidence of LTBI and TB disease in prisons. Available data were collected from 23 studies out of 582 potentially relevant unique citations. Five studies from the US and one from Brazil were available to assess the incidence of LTBI in prisons, while 19 studies were available to assess the incidence of TB. The median estimated annual incidence rate ratio (IRR for LTBI and TB were 26.4 (interquartile range [IQR]: 13.0-61.8 and 23.0 (IQR: 11.7-36.1, respectively. The median estimated fraction (PAF% of tuberculosis in the general population attributable to the exposure in prisons for TB was 8.5% (IQR: 1.9%-17.9% and 6.3% (IQR: 2.7%-17.2% in high- and middle/low-income countries, respectively. CONCLUSIONS: The very high IRR and the substantial population attributable fraction show that much better TB control in prisons could potentially protect prisoners and staff from within-prison spread of TB and would significantly reduce the national burden of TB. Future studies should measure the impact of the conditions in prisons on TB transmission and assess the population attributable risk of prison-to-community spread. Please see later in the article for the Editors' Summary.
Full Text Available Abstract Background As every healthcare intervention carries some risk of harm, clinical decision making needs to be supported by a systematic assessment of the balance of benefit to harm. A systematic review that considers only the favourable outcomes of an intervention, without also assessing the adverse effects, can mislead by introducing a bias favouring the intervention. Much of the current guidance on systematic reviews is directed towards the evaluation of effectiveness; but this differs in important ways from the methods used in assessing the safety and tolerability of an intervention. A detailed discussion of why, how and when to include adverse effects in a systematic review, is required. Methods This discussion paper, which presupposes a basic knowledge of systematic review methodology, was developed by consensus among experienced reviewers, members of the Adverse Effects Subgroup of The Cochrane Collaboration, and supplemented by a consultation of content experts in reviews methodology, as well as those working in drug safety. Results A logical framework for making decisions in reviews that incorporate adverse effects is provided. We explore situations where a comprehensive investigation of adverse effects is warranted and suggest strategies to identify practicable and clinically useful outcomes. The advantages and disadvantages of including observational and experimental study designs are reviewed. The consequences of including separate studies for intended and unintended effects are explained. Detailed advice is given on designing electronic searches for studies with adverse effects data. Reviewers of adverse effects are given general guidance on the assessment of study bias, data collection, analysis, presentation and the interpretation of harms in a systematic review. Conclusion Readers need to be able to recognize how strategic choices made in the review process determine what harms are found, and how the findings may affect
Williams, A; Biffen, A; Pilkington, N; Arrick, L; Williams, R J; Smith, M E; Smith, M; Birchall, J
The management of epistaxis requires an understanding of haematological factors that may complicate its treatment. This systematic review includes six distinct reviews examining the evidence supporting epistaxis-specific management strategies relating to warfarin, direct oral anticoagulants, heparin, antiplatelet agents, tranexamic acid and transfusion. A systematic review of the literature was performed using a standardised methodology and search strategy. Limited numbers of articles were identified in each systematic review, with level 1 evidence only regarding the use of tranexamic acid. No studies met the inclusion criteria within the heparin, direct oral anticoagulants or transfusion systematic reviews. Many studies were limited by small sample sizes and significant risk of bias. The management of major bleeding and transfusion practice is well documented in national guidance from multiple sources. The guidelines include advice on anticoagulants, antiplatelet agents and tranexamic acid. In the absence of more specific evidence, these guidelines should be applied in the management of epistaxis.
Sargeant, J M; O'Connor, A M
This article is the first in a series of six articles related to systematic reviews in animal agriculture and veterinary medicine. In this article, we overview the methodology of systematic reviews and provide a discussion of their use. Systematic reviews differ qualitatively from traditional reviews by explicitly defining a specific review question, employing methods to reduce bias in the selection and inclusion of studies that address the review question (including a systematic and specified search strategy, and selection of studies based on explicit eligibility criteria), an assessment of the risk of bias for included studies and objectively summarizing the results qualitatively or quantitatively (i.e. via meta-analysis). Systematic reviews have been widely used to address human healthcare questions and are increasingly being used in veterinary medicine. Systematic reviews can provide veterinarians and other decision-makers with a scientifically defensible summary of the current state of knowledge on a topic without the need for the end-user to read the vast amount of primary research related to that topic. © 2014 Blackwell Verlag GmbH.
Systematic reviews aide the analysis and dissemination of evidence, using rigorous and transparent methods to generate empirically attained answers to focused research questions. Identifying all evidence relevant to the research questions is an essential component, and challenge, of systematic reviews. Gray literature, or evidence not published in commercial publications, can make important contributions to a systematic review. Gray literature can include academic papers, including theses and dissertations, research and committee reports, government reports, conference papers, and ongoing research, among others. It may provide data not found within commercially published literature, providing an important forum for disseminating studies with null or negative results that might not otherwise be disseminated. Gray literature may thusly reduce publication bias, increase reviews' comprehensiveness and timeliness, and foster a balanced picture of available evidence. Gray literature's diverse formats and audiences can present a significant challenge in a systematic search for evidence. However, the benefits of including gray literature may far outweigh the cost in time and resource needed to search for it, and it is important for it to be included in a systematic review or review of evidence. A carefully thought out gray literature search strategy may be an invaluable component of a systematic review. This narrative review provides guidance about the benefits of including gray literature in a systematic review, and sources for searching through gray literature. An illustrative example of a search for evidence within gray literature sources is presented to highlight the potential contributions of such a search to a systematic review. Benefits and challenges of gray literature search methods are discussed, and recommendations made. © 2017 Chinese Cochrane Center, West China Hospital of Sichuan University and John Wiley & Sons Australia, Ltd.
Systematic reviews aid the analysis and dissemination of evidence, using rigorous and transparent methods to generate empirically attained answers to focused research questions. Identifying all evidence relevant to the research questions is an essential component, and challenge, of systematic reviews. Grey literature, or evidence not published in commercial publications, can make important contributions to a systematic review. Grey literature can include academic papers, including theses and dissertations, research and committee reports, government reports, conference papers, and ongoing research, among others. It may provide data not found within commercially published literature, providing an important forum for disseminating studies with null or negative results that might not otherwise be disseminated. Grey literature may thusly reduce publication bias, increase reviews' comprehensiveness and timeliness and foster a balanced picture of available evidence. Grey literature's diverse formats and audiences can present a significant challenge in a systematic search for evidence. However, the benefits of including grey literature may far outweigh the cost in time and resource needed to search for it, and it is important for it to be included in a systematic review or review of evidence. A carefully thought out grey literature search strategy may be an invaluable component of a systematic review. This narrative review provides guidance about the benefits of including grey literature in a systematic review, and sources for searching through grey literature. An illustrative example of a search for evidence within grey literature sources is presented to highlight the potential contributions of such a search to a systematic review. Benefits and challenges of grey literature search methods are discussed, and recommendations made. © 2017 Chinese Cochrane Center, West China Hospital of Sichuan University and John Wiley & Sons Australia, Ltd.
Vassar, Matt; Yerokhin, Vadim; Sinnett, Philip Marcus; Weiher, Matthew; Muckelrath, Halie; Carr, Branden; Varney, Laura; Cook, Gregory
Failure to perform a comprehensive search when designing a systematic review (SR) can lead to bias, reducing the validity of review's conclusions. We examined the frequency and choice of databases used by reviewers in clinical neurology. Ninety-five SRs and/or meta-analyses were located across five prominent neurology journals between 2008 and 2014. Methods sections were reviewed, and all bibliographic databases were coded. On average, 2.59 databases were used in SR searches. Seven reviews included an information specialist, and these reviews reported a greater number of information sources used during the search process. Thirty-nine databases were reported across studies. PubMed/MEDLINE ® and EMBASE were cited most frequently. Searching too few databases may reduce the validity and generalisability of SR results. We found that the majority of systematic reviewers in clinical neurology do not search an adequate number of databases, which may yield a biased sample of primary studies and, thus, may influence the accuracy of summary effects. Systematic reviewers should aim to search a sufficient number of databases to minimise selection bias. Additionally, systematic reviewers should include information specialists in designing SR methodology, as this may improve systematic review quality. © 2017 Health Libraries Group.
Sayegh, Eli T; Strauch, Robert J
The optimal management of olecranon bursitis is ill-defined. The purposes of this review were to systematically evaluate clinical outcomes for aseptic versus septic bursitis, compare surgical versus nonsurgical management, and examine the roles of corticosteroid injection and aspiration in aseptic bursitis. The English-language literature was searched using PubMed, Cumulative Index to Nursing and Allied Health Literature, Physiotherapy Evidence Database, Allied and Complementary Medicine, and Cochrane Central Register of Controlled Trials. Analyses were performed for clinical resolution and complications after treatment of aseptic and/or septic olecranon bursitis. Twenty-nine studies containing 1278 patients were included. Compared with septic bursitis, aseptic bursitis was associated with a significantly higher overall complication rate (p = 0.0108). Surgical management was less likely to clinically resolve septic or aseptic bursitis (p = 0.0476), and demonstrated higher rates of overall complications (p = 0.0117), persistent drainage (p = 0.0194), and bursal infection (p = 0.0060) than nonsurgical management. Corticosteroid injection for aseptic bursitis was associated with increased overall complications (p = 0.0458) and skin atrophy (p = 0.0261). Aspiration did not increase the risk of bursal infection for aseptic bursitis. Based primarily on level IV evidence, nonsurgical management of olecranon bursitis is significantly more effective and safer than surgical management. The clinical course of aseptic bursitis appears to be more complicated than that of septic bursitis. Corticosteroid injection is associated with significant risks without improving the outcome of aseptic bursitis. Therapeutic IV.
Rafael Miranda Tassitano
Full Text Available The purpose of this study was to systematically review the Brazilian literature on the prevalence of obesity and associated factors in adolescents. The literature search was carried out in the electronic databases Pubmed and Bireme, using the keywords: obesity, overweight, BMI, adolescents and Brazil. The following inclusion criteria were considered: Brazilian adolescents, BMI-based obesity estimates, publication until 2007, and adequate methodology. After the examination of titles, abstracts and full texts, 27 papers fulfilled our inclusion criteria. For describing the studies, the following variables were used: type of survey, design, age range, sample size, place of data collection. For evaluating the evidence, the following indicators were used: methods used, independent variables studied, statistical analyses employed, and cut-off used for defining obesity. Most studies used cross-sectional designs (77.7% and were carried out through home interviews (51.7%. Only one study used a nationally-based sample and three used regional-based samples (Northeast and Southeast. Regardless the design, place, type of survey, age range and cut-off used, the prevalence of obesity tended to be higher in the following groups: adolescents living in the Southeast region, living in urban areas, from high socioeconomic level and from private schools. In terms of behavioral determinants of obesity, the paucity of prospective studies and the difficulties of adequately measuring physical activity and food consumption, make the results less clear. Although the number of studies has increased, it is still necessary to stimulate surveys in the North, Southeast and Mideast regions. Prospective studies are also necessary, in order to evaluate the association between obesity and behavioral exposures.
Peters, Janne A; Zwerver, Johannes; Diercks, Ronald L; Elferink-Gemser, Marije T; van den Akker-Scheek, Inge
Tendinopathy, the most prevalent tendon disorder which is considered as the clinical diagnosis of pain and dysfunction, is common in sports and its prevalence is ever-increasing. Despite the lack of clarity about risk factors, various preventive interventions for tendinopathy have been investigated. The main objective of this study is to review current preventive interventions for tendinopathy in the major regions: ankle, knee, hip, groin, shoulder and elbow. A systematic literature search was conducted. The PubMed and Embase databases were explored to identify articles that met the inclusion criteria. The included studies were assessed on methodological quality and data was summarized. Ten articles were included that describe a wide variety of preventive interventions. These were divided into three categories: stretch and exercise interventions, shoe adaptations and other interventions. The methodological quality of the studies was moderate to high. Three out of ten studies showed a significant beneficial result. There is limited evidence that a long-term intervention including balance training is effective in the prevention of patellar and Achilles tendinopathy. Shoe adaptations in the form of shock absorbing insoles could have a preventive effect on Achilles tendinopathy. Hormone replacement therapy seems to reduce the risk for structural Achilles tendon changes in active post-menopausal women. No evidence was found for a positive effect of stretching exercises. Prophylactic eccentric training and stretching can increase the risk of injury in asymptomatic players with patellar tendon abnormalities. A limited amount of studies was available and more research is needed on (multifactorial) etiology, risk factors and preventive interventions. Copyright © 2015 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.
Negro, A; Delaruelle, Z; Ivanova, T A; Khan, S; Ornello, R; Raffaelli, B; Terrin, A; Reuter, U; Mitsikostas, D D
This systematic review summarizes the existing data on headache and pregnancy with a scope on clinical headache phenotypes, treatment of headaches in pregnancy and effects of headache medications on the child during pregnancy and breastfeeding, headache related complications, and diagnostics of headache in pregnancy. Headache during pregnancy can be both primary and secondary, and in the last case can be a symptom of a life-threatening condition. The most common secondary headaches are stroke, cerebral venous thrombosis, subarachnoid hemorrhage, pituitary tumor, choriocarcinoma, eclampsia, preeclampsia, idiopathic intracranial hypertension, and reversible cerebral vasoconstriction syndrome. Migraine is a risk factor for pregnancy complications, particularly vascular events. Data regarding other primary headache conditions are still scarce. Early diagnostics of the disease manifested by headache is important for mother and fetus life. It is especially important to identify "red flag symptoms" suggesting that headache is a symptom of a serious disease. In order to exclude a secondary headache additional studies can be necessary: electroencephalography, ultrasound of the vessels of the head and neck, brain MRI and MR angiography with contrast ophthalmoscopy and lumbar puncture. During pregnancy and breastfeeding the preferred therapeutic strategy for the treatment of primary headaches should always be a non-pharmacological one. Treatment should not be postponed as an undermanaged headache can lead to stress, sleep deprivation, depression and poor nutritional intake that in turn can have negative consequences for both mother and baby. Therefore, if non-pharmacological interventions seem inadequate, a well-considered choice should be made concerning the use of medication, taking into account all the benefits and possible risks.
Fitzstevens, John L; Smith, Kelsey C; Hagadorn, James I; Caimano, Melissa J; Matson, Adam P; Brownell, Elizabeth A
Human milk-associated microbes are among the first to colonize the infant gut and may help to shape both short- and long-term infant health outcomes. We performed a systematic review to characterize the microbiota of human milk. Relevant primary studies were identified through a comprehensive search of PubMed (January 1, 1964, to June 31, 2015). Included studies were conducted among healthy mothers, were written in English, identified bacteria in human milk, used culture-independent methods, and reported primary results at the genus level. Twelve studies satisfied inclusion criteria. All varied in geographic location and human milk collection/storage/analytic methods. Streptococcus was identified in human milk samples in 11 studies (91.6%) and Staphylococcus in 10 (83.3%); both were predominant genera in 6 (50%). Eight of the 12 studies used conventional ribosomal RNA (rRNA) polymerase chain reaction (PCR), of which 7 (87.5%) identified Streptococcus and 6 (80%) identified Staphylococcus as present. Of these 8 studies, 2 (25%) identified Streptococcus and Staphylococcus as predominant genera. Four of the 12 studies used next-generation sequencing (NGS), all of which identified Streptococcus and Staphylococcus as present and predominant genera. Relative to conventional rRNA PCR, NGS is a more sensitive method to identify/quantify bacterial genera in human milk, suggesting the predominance of Streptococcus and Staphylococcus may be underestimated in studies using older methods. These genera, Streptococcus and Staphylococcus, may be universally predominant in human milk, regardless of differences in geographic location or analytic methods. Primary studies designed to evaluate the effect of these 2 genera on short- and long-term infant outcomes are warranted.
Rafael Miranda Tassitano
Full Text Available http://dx.doi.org/10.5007/1980-0037.2009v11n4p449 The purpose of this study was to systematically review the Brazilian literature on the prevalence of obesity and associated factors in adolescents. The literature search was carried out in the electronic databases Pubmed and Bireme, using the keywords: obesity, overweight, BMI, adolescents and Brazil. The following inclusion criteria were considered: Brazilian adolescents, BMI-based obesity estimates, publication until 2007, and adequate methodology. After the examination of titles, abstracts and full texts, 27 papers fulfilled our inclusion criteria. For describing the studies, the following variables were used: type of survey, design, age range, sample size, place of data collection. For evaluating the evidence, the following indicators were used: methods used, independent variables studied, statistical analyses employed, and cut-off used for defining obesity. Most studies used cross-sectional designs (77.7% and were carried out through home interviews (51.7%. Only one study used a nationally-based sample and three used regional-based samples (Northeast and Southeast. Regardless the design, place, type of survey, age range and cut-off used, the prevalence of obesity tended to be higher in the following groups: adolescents living in the Southeast region, living in urban areas, from high socioeconomic level and from private schools. In terms of behavioral determinants of obesity, the paucity of prospective studies and the difficulties of adequately measuring physical activity and food consumption, make the results less clear. Although the number of studies has increased, it is still necessary to stimulate surveys in the North, Southeast and Mideast regions. Prospective studies are also necessary, in order to evaluate the association between obesity and behavioral exposures.
Marks, Michael; Jarvis, Joseph N; Howlett, William; Mabey, David C W
to report cases of late stage syphilis, including tabes dorsalis and neurosyphilis, in association with ocular disease. This is the first systematic review of the literature on neurosyphilis in Africa since the beginning of the HIV epidemic. Neurosyphilis continues to be reported as a manifestation of both early and late syphilis, but the methodological quality of the majority of the included studies was poor. Future well-designed prospective studies are needed to better delineate the incidence and clinical spectrum of neurosyphilis in Africa and to better define interactions with HIV in this setting.
Background Information and communication technology (ICT) has transformed the health care field worldwide. One of the main drivers of this change is the electronic health record (EHR). However, there are still open issues and challenges because the EHR usually reflects the partial view of a health care provider without the ability for patients to control or interact with their data. Furthermore, with the growth of mobile and ubiquitous computing, the number of records regarding personal health is increasing exponentially. This movement has been characterized as the Internet of Things (IoT), including the widespread development of wearable computing technology and assorted types of health-related sensors. This leads to the need for an integrated method of storing health-related data, defined as the personal health record (PHR), which could be used by health care providers and patients. This approach could combine EHRs with data gathered from sensors or other wearable computing devices. This unified view of patients’ health could be shared with providers, who may not only use previous health-related records but also expand them with data resulting from their interactions. Another PHR advantage is that patients can interact with their health data, making decisions that may positively affect their health. Objective This work aimed to explore the recent literature related to PHRs by defining the taxonomy and identifying challenges and open questions. In addition, this study specifically sought to identify data types, standards, profiles, goals, methods, functions, and architecture with regard to PHRs. Methods The method to achieve these objectives consists of using the systematic literature review approach, which is guided by research questions using the population, intervention, comparison, outcome, and context (PICOC) criteria. Results As a result, we reviewed more than 5000 scientific studies published in the last 10 years, selected the most significant approaches
The use of systematic reviews in educational research is a growing phenomenon in the UK, but is highly controversial. This article argues that such reviews have a useful place in a research cycle that wishes to inform and be informed by practice and policy. It proposes and discusses a model of educational research, showing how reviews relate to…
Leibovici, Leonard; Soares-Weiser, Karla; Paul, Mical; Goldberg, Elad; Herxheimer, Andrew; Garner, Paul
Microorganisms resistant to antibiotic drugs are a threat to the health and chances of survival of patients. Systematic reviews on antibiotic drugs that ignore the topic of resistance present readers with a skewed view, emphasizing short-term efficacy or effectiveness while ignoring long-term consequences. To examine whether systematic reviews of antibiotic treatment consider resistance; if not, to find out whether data on resistance were reported in the original trials; and based on that, to offer a framework for taking resistance into account in systematic reviews. The Cochrane Database of Systematic Reviews (the Cochrane Library, 2001, issue 2); and MEDLINE, 1996-2000. (i) Systematic reviews or meta-analyses of antimicrobial therapy, published during 1996-2000. (ii) Randomized, controlled trials abstracted in systematic reviews that addressed a topic highly relevant to antibiotic resistance. We examined each systematic review, and each article, to see whether the implications of resistance were discussed; and whether data on resistance were collected. Out of 111 systematic reviews, only 44 (40%) discussed resistance. Ten reviews (9%) planned or performed collection of data on the response of patients with susceptible or resistant isolates. In 22 systematic reviews (20%), collection of data on induction of resistance was planned or performed. The topic of 41 reviews was judged highly relevant to resistance, and these reviews extracted data from 337 articles, out of which we retrieved 279 articles (83%). In 201 (72%) articles, resistance was discussed or data pertaining to it were collected. Ninety-seven articles (35%) gave actual data on resistance of pathogens to the study drugs, 71 articles (25%) data on efficacy of antibiotic drugs in patients with susceptible and resistant pathogens, and 55 articles (20%) provided data on infection or colonization with resistant strains during treatment. Most systematic reviews on antibiotic treatment ignored the issue of
Spaans, Anne J.; Van Minnen, L. Paul; Kon, Moshe; Schuurman, Arnold H.; Schreuders, A. R.; Vermeulen, Guus M.
Purpose To provide a systematic review of randomized controlled trials regarding the conservative treatment of thumb base osteoarthritis (OA). Methods A systematic literature search was conducted in the electronic bibliographic databases Medline (Pubmed) and Embase (both starting year to May 2014)
van Seben, R.; Reichardt, L.; Smorenburg, S.; Buurman, B.
This systematic review summarizes the psychometric properties of goal-setting instruments that are applied within geriatric rehabilitation. PubMed Medline and Embase were systematically searched for eligible articles. Studies were included if they were conducted in a somatic or neurological
Jeppesen, Kathrine Håland; Christiansen, Sytter; Frederiksen, Kirsten
systematically searched in PubMed, Cinahl, Scopus, Web of Science, ProQuest. Methods A systematic literature review was conducted that included quantitative and qualitative studies. Quality assessment was made in accordance with Malterud's guidelines on qualitative research and Polit and Beck's guidelines...
Printz, Trine; Rosenberg, Tine; Godballe, Christian
literature on test-retest accuracy of the automated voice range profile assessment. Study design: Systematic review. Data sources: PubMed, Scopus, Cochrane Library, ComDisDome, Embase, and CINAHL (EBSCO). Methods: We conducted a systematic literature search of six databases from 1983 to 2016. The following...
Langlois, Jean; Bellemare, Christian; Toulouse, Josée; Wells, George A.
Anatomy knowledge has been found to include both spatial and non-spatial components. However, no systematic evaluation of studies relating spatial abilities and anatomy knowledge has been undertaken. The objective of this study was to conduct a systematic review of the relationship between spatial abilities test and anatomy knowledge assessment. A…
Telleman, Gerdien; Raghoebar, Gerry M.; Vissink, Arjan; den Hartog, Laurens; Huddleston Slater, James; Meijer, Henny J. A.
P>Aim This study evaluated, through a systematic review of the literature, the estimated implant survival rate of short (<10 mm) dental implants installed in partially edentulous patients. Materials and methods A systematic search was conducted in the electronic databases of MEDLINE (1980-October
Mejàre, Ingegerd A; Klingberg, Gunilla; Mowafi, Frida K
OBJECTIVES: To identify, appraise and summarize existing knowledge and knowledge gaps in practice-relevant questions in pediatric dentistry. METHODS: A systematic mapping of systematic reviews was undertaken for domains considered important in daily clinical practice. The literature search covered...... for primary clinical research of good quality in most clinically-relevant domains in pediatric dentistry....
Anderson, Michael J.; Browning, William M.; Urband, Christopher E.; Kluczynski, Melissa A.; Bisson, Leslie J.
Background: There has been a substantial increase in the amount of systematic reviews and meta-analyses published on the anterior cruciate ligament (ACL). Purpose: To quantify the number of systematic reviews and meta-analyses published on the ACL in the past decade and to provide an overall summary of this literature. Study Design: Systematic review; Level of evidence, 4. Methods: A systematic review of all ACL-related systematic reviews and meta-analyses published between January 2004 and September 2014 was performed using PubMed, MEDLINE, and the Cochrane Database. Narrative reviews and non-English articles were excluded. Results: A total of 1031 articles were found, of which 240 met the inclusion criteria. Included articles were summarized and divided into 17 topics: anatomy, epidemiology, prevention, associated injuries, diagnosis, operative versus nonoperative management, graft choice, surgical technique, fixation methods, computer-assisted surgery, platelet-rich plasma, rehabilitation, return to play, outcomes assessment, arthritis, complications, and miscellaneous. Conclusion: A summary of systematic reviews on the ACL can supply the surgeon with a single source for the most up-to-date synthesis of the literature. PMID:27047983
Kisely, Stephen; Chang, Alice; Crowe, Jim; Galletly, Cherrie; Jenkins, Peter; Loi, Samantha; Looi, Jeffrey C; Macfarlane, Matthew D; McVie, Ness; Parker, Stephen; Power, Brian; Siskind, Dan; Smith, Geoff; Merry, Sally; Macfarlane, Stephen
Systematic reviews are one of the major building blocks of evidence-based medicine. This overview is an introduction to conducting systematic reviews and meta-analyses. Systematic reviews and meta-analyses of randomised controlled trials (RCTs) represent the most robust form of design in the hierarchy of research evidence. In addition, primary data do not have to be collected by the researcher him/herself, and there is no need for approval from an ethics committee. Systematic reviews and meta-analyses are not as daunting as they may appear to be, provided the scope is sufficiently narrow and an appropriate supervisor available. © The Royal Australian and New Zealand College of Psychiatrists 2014.
Background: A systematic review was conducted of randomized trials of workplace weight management interventions, including trials with dietary, physical activity, environmental, behavioral and incentive based components. Main outcomes were defined as change in weight-related measures. Methods: Key w...
Background: Metabolomics is a promising tool of cardiovascular biomarker discovery. We systematically reviewed the literature on comprehensive metabolomic profiling in association with incident cardiovascular disease (CVD). Methods and Results: We searched MEDLINE and EMBASE from inception to Janua...
Klaassen, K.M.G.; Dulak, M.G.; Kerkhof, P.C.M. van de; Pasch, M.C.
We systematically reviewed all available literature concerning the prevalence of onychomycosis in patients with nail psoriasis and the distribution of pathogens causing onychomycosis in this specific group of patients. Databases searched were Pubmed, EMBASE and the Cochrane Controlled Clinical Trial
Bartels, R.H.M.A.; van Tulder, M.W.; Moojen, W.A.
BACKGROUND: Cervical spondylotic myelopathy is frequently encountered in neurosurgical practice. The posterior surgical approach includes laminectomy and laminoplasty.OBJECTIVE: To perform a systematic review evaluating the effectiveness of posterior laminectomy compared with posterior laminoplasty...
Meijer, Anna; Roseman, Michelle; Milette, Katherine; Coyne, James C.; Stefanek, Michael E.; Ziegelstein, Roy C.; Arthurs, Erin; Leavens, Allison; Palmer, Steven C.; Stewart, Donna E.; de Jonge, Peter; Thombs, Brett D.
Background: Several practice guidelines recommend screening for depression in cancer care, but no systematic reviews have examined whether there is evidence that depression screening benefits cancer patients. The objective was to evaluate the potential benefits of depression screening in cancer
Ranjan, Ajenthen; Penninga, E; Jelsig, Am
This systematic review investigated the inheritance of the classical chronic myeloproliferative neoplasms (MPNs) including polycythemia vera (PV), essential thrombocythemia (ET), primary myelofibrosis (PMF) and chronic myelogenous leukemia (CML). Sixty-one articles were included and provided 135...