scholarly journals P140: Risk factors for adverse outcomes in hyperglycemic patients presenting to the emergency department: a systematic review

CJEM ◽  
2018 ◽  
Vol 20 (S1) ◽  
pp. S106-S107
Author(s):  
L. Siddiqi ◽  
K. Van Aarsen ◽  
A. Iansavitchene ◽  
J. W. Yan
Keyword(s):  
Systematic Review ◽  
Protective Factors ◽  
Quality Assessment ◽  
Research Question ◽  
Age Groups ◽  
Adverse Outcomes ◽  
Assessment Scale ◽  
Patient Specific ◽  
Diabetic Patients ◽  
The Past

Introduction: Hyperglycemia is a significant cause of morbidity and mortality, often resulting in adverse outcomes such as recurrent ED visits, hospitalization or death. The objective of this study was to perform a systematic review to identify predictors of these adverse outcomes among patients who present to the ED with hyperglycemia. Methods: Electronic searches of Medline and EMBASE were conducted for studies published in English between the years 1946 and June 2017. Studies with patients presenting to the ED with hyperglycemia were eligible for inclusion. Both adult and pediatric populations were included, as were diabetic and non-diabetic patients. Two reviewers independently screened all titles and abstracts for relevance to the research question. If consensus could not be reached, full-length manuscripts were reviewed. For any discrepancy, a third reviewer was consulted, and disagreement was resolved through discussion. Study quality was assessed using the Newcastle-Ottawa Quality Assessment Scale. Study- and patient-specific data were then extracted and presented descriptively in the systematic review. Results: Thirteen observational studies were included, with a combined total of 664,829 patients. The studies scored between 5 to 8 on the Quality Assessment Scale out of a possible total of 8. Predictors of adverse outcomes included patients in both older and younger (< 25) age groups, history of diabetes, multiple comorbidities, patients requiring insulin, sepsis and hyperlactatemia, access to a family physician, a sentinel hyperglycemia visit in the past month, and triage glucose level > 20 mmol/L. Protective factors included no admissions in the past year, care from a diabetes team while in hospital, systolic blood pressure between 90-150 mmHg and heart rate > 110 bpm. Conclusion: This systematic review found eight predictors and four protective factors for adverse outcomes in patients presenting to the ED with hyperglycemia. These factors should be considered for easier identification of higher-risk patients for adverse outcomes in order to guide management and follow-up.

scholarly journals Failure of a numerical quality assessment scale to identify potential risk of bias in a systematic review: a comparison study

2015 ◽  
Vol 8 (1) ◽  
Author(s):  
Seán R O’Connor ◽  
Mark A Tully ◽  
Brigid Ryan ◽  
Judy M Bradley ◽  
George D Baxter ◽  
...  
Keyword(s):  
Systematic Review ◽  
Quality Assessment ◽  
Potential Risk ◽  
Risk Of Bias ◽  
Assessment Scale ◽  
Comparison Study

scholarly journals Including the Nordic hamstring exercise in injury prevention programmes halves the rate of hamstring injuries: a systematic review and meta-analysis of 8459 athletes

2019 ◽  
Vol 53 (21) ◽  
pp. 1362-1370 ◽  
Author(s):  
Nicol van Dyk ◽  
Fearghal P Behan ◽  
Rod Whiteley
Keyword(s):  
Systematic Review ◽  
Injury Prevention ◽  
Risk Ratio ◽  
Injury Risk ◽  
Meta Analysis ◽  
Research Question ◽  
Age Groups ◽  
Eligibility Criteria ◽  
Hamstring Injuries ◽  
Prevention Programmes

Research questionDoes the Nordic hamstring exercise (NHE) prevent hamstring injuries when included as part of an injury prevention intervention?DesignSystematic review and meta-analysis.Eligibility criteria for selecting studiesWe considered the population to be any athletes participating in any sporting activity, the intervention to be the NHE, the comparison to be usual training or other prevention programmes, which did not include the NHE, and the outcome to be the incidence or rate of hamstring injuries.AnalysisThe effect of including the NHE in injury prevention programmes compared with controls on hamstring injuries was assessed in 15 studies that reported the incidence across different sports and age groups in both women and men.Data sourcesMEDLINE via PubMed, CINAHL via Ebsco, and OpenGrey.ResultsThere is a reduction in the overall injury risk ratio of 0.49 (95% CI 0.32 to 0.74, p=0.0008) in favour of programmes including the NHE. Secondary analyses when pooling the eight randomised control studies demonstrated a small increase in the overall injury risk ratio 0.52 (95% CI 0.32 to 0.85, p=0.0008), still in favour of the NHE. Additionally, when studies with a high risk of bias were removed (n=8), there is an increase of 0.06 in the risk ratio to 0.55 (95% CI 0.34 to 0.89, p=0.006).ConclusionsProgrammes that include the NHE reduce hamstring injuries by up to 51%. The NHE essentially halves the rate of hamstring injuries across multiple sports in different athletes.Trial registration numberPROSPERO CRD42018106150.

scholarly journals The Effect of Metformin on Mortality Among Diabetic Cancer Patients: A Systematic Review and Meta-analysis

2017 ◽  
Vol 1 (1) ◽  
Author(s):  
Xun Cao ◽  
Yaopan Wu ◽  
Jing Wang ◽  
Kuiyuan Liu ◽  
Xin Wang
Keyword(s):  
Breast Cancer ◽  
Systematic Review ◽  
Cancer Patients ◽  
Fixed Effects ◽  
Meta Analysis ◽  
Cancer Site ◽  
Diabetic Patients ◽  
Metformin Treatment ◽  
Breast Cancer Patients ◽  
The Past

Abstract Background Most data suggest that cancer patients with diabetes have worse outcomes, which may be reversed with metformin. Metformin might modulate the clinical outcomes of diabetic cancer patients. We performed a systematic review and meta-analysis based on published studies over the past five years to summarize the effects of metformin on diabetic cancer patients. Methods We systematically searched for studies that were published over the past five years. Then, we evaluated these studies for inclusion and extracted the relevant data. The summary risk estimates for the association between metformin treatment and all-cause mortality (ACM) and cancer-specific mortality (CSM) were analyzed using random or fixed-effects models. Stratified analyses by cancer site and country were also conducted. Results Based on the 42 studies included in our analysis (37 015 diabetic cancer patients), we found a significant benefit associated with metformin treatment on survival corresponding to 27% and 26% reductions in ACM (hazard ratio [HR] = 0.73, 95% confidence interval [CI] = 0.68 to 0.79, P < .001) and CSM (HR = 0.74, 95% CI = 0.64 to 0.86, P < .001), respectively. The ACM rates for colorectal cancer, endometrial cancer, breast cancer, prostate cancer, and ovarian cancer showed significant benefits associated with metformin treatment in our stratified analyses by cancer site. Stratified analyses by cancer site also showed a significant reduction in CSM for breast cancer. This association between metformin treatment and reduced CSM for diabetic breast cancer patients was also observed in our country subgroup analyses. Conclusions We found an association between metformin exposure and reduced ACM and CSM in diabetic patients with cancer. Our findings suggest that metformin treatment could be an effective treatment option for diabetic cancer patients.

scholarly journals Genetic Variants Associated with the Occurrence and Progression of Adolescent Idiopathic Scoliosis: A Systematic Review Protocol

2021 ◽  
Author(s):  
Elizabeth A. Terhune ◽  
Patricia C Heyn ◽  
Christi R Piper ◽  
Nancy Hadley-Miller
Keyword(s):  
Systematic Review ◽  
Idiopathic Scoliosis ◽  
Quality Assessment ◽  
Data Transfer ◽  
Data Extraction ◽  
Treatment Options ◽  
Age Groups ◽  
Assessment Tools ◽  
Spinal Curvature

Abstract BackgroundAdolescent idiopathic scoliosis (AIS) is a structural lateral spinal curvature of ≥ 10° with rotation. Approximately 2–3% of children in most populations are affected with AIS, and this condition is responsible for approximately $1.1 billion in surgical costs to the U.S. healthcare system. Although a genetic factor for AIS has been demonstrated for decades, with multiple loci identified across populations, treatment options have remained limited to bracing and surgery.MethodsThe databases MEDLINE (via PubMed), Embase, Google Scholar, and Ovid MEDLINE will be searched and limited to articles in English. We will conduct title and abstract, full-text, and data extraction screening through Covidence, followed by data transfer to a custom REDCap database. Quality assessment will be confirmed by multiple reviewers. Studies containing variant-level data (i.e. GWAS, exome sequencing) for AIS subjects and controls will be considered. Outcomes of interest will include presence/absence of AIS, scoliosis curve severity, scoliosis curve progression, and presence/absence of nucleotide-level variants. Analyses will include odds ratios and relative risk assessments, and subgroup analysis (i.e. males vs. females, age groups) may be applied. Quality assessment tools will include GRADE and Q-Genie for genetic studies.DiscussionIn this systematic review we seek to evaluate the quality of genetic evidence for AIS to better inform research efforts, to ultimately improve the quality of patient care and diagnosis.Systematic review registrationPROSPERO registration #CRD42021243253

The clinical and biomechanical effects of subthreshold random noise on the plantar surface of the foot in diabetic patients and elder people: A systematic review

2016 ◽  
Vol 40 (6) ◽  
pp. 658-667 ◽  
Author(s):  
Masumeh Bagherzadeh Cham ◽  
Mohammad Ali Mohseni-Bandpei ◽  
Mahmood Bahramizadeh ◽  
Saeed Kalbasi ◽  
Akbar Biglarian
Keyword(s):  
Systematic Review ◽  
Quality Assessment ◽  
Methodological Quality ◽  
Assessment Tool ◽  
Random Noise ◽  
Diabetic Patients ◽  
Plantar Surface ◽  
Published Evidence ◽  
Evidence Database ◽  
Elder People

Background:Central nervous system receives information from foot mechanoreceptors in order to control balance and perform movement tasks. Subthreshold random noise seems to improve sensitivity of the cutaneous mechanoreceptor.Objectives:The purpose of this study was to systematically review published evidence conducted to evaluate the clinical and biomechanical effects of subthreshold random noise on the plantar surface of the foot in diabetic patients and elder people.Study design:Systematic review.Methods:A literature search was performed in PubMed, Scopus, ScienceDirect, Web of Knowledge, CINAHL, and EMBASE databases based on population, intervention, comparison, outcomes, and study method. Quality of studies was assessed using the methodological quality assessment tool, using Physiotherapy Evidence Database scale.Results:In all, 11 studies were selected for final evaluation based on inclusion criteria. Five studies evaluated the effects of subthreshold random noise in diabetic patients and six in elder people. In seven studies, biomechanical (balance and gait parameters) effects and in four studies clinical (pressure and vibration sensations) effects of subthreshold random noise were investigated. All reviewed studies were scored fair (2) to good (9) quality in terms of methodological quality assessment using Physiotherapy Evidence Database scale.Conclusion:The results indicated that subthreshold random noise improves balance and sensation in diabetic patients and elder people. Also gait variables can be improved in elder people with subthreshold random noise. However, further well-designed studies are needed.Clinical relevanceThe previous studies reported that subthreshold random noise may improve gait, balance, and sensation, but more studies are needed to evaluate the long-term effect of subthreshold random noise in shoe or insole for daily living tasks in diabetic patients and elder people.

scholarly journals Depression in Patients with Tinnitus: A Systematic Review

2019 ◽  
Vol 161 (1) ◽  
pp. 28-35 ◽  
Author(s):  
James W. Salazar ◽  
Karl Meisel ◽  
Eric R. Smith ◽  
Aaron Quiggle ◽  
David B. McCoy ◽  
...  
Keyword(s):  
Systematic Review ◽  
Quality Assessment ◽  
Web Of Science ◽  
Response Rate ◽  
Substantial Proportion ◽  
Assessment Scale ◽  
Data Sources ◽  
High Quality ◽  
Threats To Validity ◽  
Prevalence Of Depression

ObjectiveTinnitus is a condition that causes distress and impairment across cognitive, functional, and psychiatric spectra. In the psychiatric realm, tinnitus has long been associated with depression. To better characterize the co-occurrence of depression and tinnitus, we performed a systematic review of the prevalence of depression among patients with tinnitus.Data SourcesWe comprehensively examined original studies reporting the prevalence of depression in adult populations with tinnitus, as indexed in the PubMed and Web of Science databases and published from January 2006 to August 2016.Review MethodsAll identified articles were reviewed independently by 2 researchers, with a third reviewer for adjudication. Included studies were evaluated for threats to validity across 3 domains—representativeness, response rate, and ascertainment of outcome—on a 4-point modified Newcastle-Ottawa Quality Assessment Scale.ResultsTwenty-eight studies were included, representing 15 countries and 9979 patients with tinnitus. Among the included studies, the median prevalence of depression was 33%, with an interquartile range of 19% to 49% and an overall range of 6% to 84%. Studies were high quality overall, with a mean score of 3.3 (SD = 0.76), and 89% utilized a validated tool to ascertain depression.ConclusionsWe conducted one of the largest contemporary comprehensive reviews, which suggests a 33% prevalence of depression among patients with tinnitus. Our review reaffirms that a substantial proportion of patients with tinnitus have depression, and we recommend that all who treat tinnitus should screen and treat their patients for depression, if present.

scholarly journals Prognostic implications of left ventricular strain by speckle-tracking echocardiography in population-based studies: a systematic review protocol of the published literature

BMJ Open ◽  
2018 ◽  
Vol 8 (7) ◽  
pp. e023346 ◽  
Author(s):  
Lamia Al Saikhan ◽  
Chloe Park ◽  
Rebecca Hardy ◽  
Alun Hughes
Keyword(s):  
Systematic Review ◽  
Cohort Studies ◽  
Quality Assessment ◽  
Speckle Tracking ◽  
Speckle Tracking Echocardiography ◽  
Data Extraction ◽  
Population Based ◽  
Left Ventricular ◽  
Adverse Outcomes ◽  
Community Dwelling

IntroductionLeft ventricular (LV) strain by speckle-tracking echocardiography (STE) is a comparatively new prognostic marker. Meta-analyses relating LV strain by STE to outcomes have been conducted in selected patient-based populations with established or suspected cardiovascular (CV) diseases. However, the evidence related to population-based studies of community-dwelling individuals is uncertain. The aim of this study is to provide a comprehensive systematic review and analysis of the current available literature regarding LV strain by STE as a predictor of adverse outcomes in population-based studies.Methods and analysesThesaurus and text-word searching will be used to search two online databases (MEDLINE and EMBASE) and additional sources will be identified from citation metrics and reference lists’ search. Dual search results’ screening, data extraction and quality assessment will be performed. Cohort studies of community/population-based samples who have had STE and followed up longitudinally for mortal and morbid events, and published in English and peer-reviewed journals will be included. Primary outcome will be all-cause mortality whereas secondary outcomes will be composite cardiac and CV end points. Risk of bias will be assessed using Newcastle-Ottawa Quality Assessment Scale of cohort studies that will be modified as appropriate. Any arising discrepancies will be discussed and resolved through consensus.Ethics and disseminationEthical approval is not required as this is a protocol for a systematic review. The findings of this study will be presented at scientific conferences and published in a peer-reviewed journal. Any amendments to the protocol will be documented and updated in the PROSPERO registry.PROSPERO registration numberCRD42018090302.

Clinical Music Study Quality Assessment Scale

2018 ◽  
Author(s):  
Artur Jaschke ◽  
Laura H. P. Eggermont ◽  
Sylka Uhlig ◽  
Erik J. A. Scherder
Keyword(s):  
Quality Assessment ◽  
Assessment Scale ◽  
Study Quality ◽  
Music Study ◽  
Study Quality Assessment

A literature review on firms' internationalisation through e-commerce

2019 ◽  
pp. 121-143
Author(s):  
Riccardo Resciniti ◽  
Federica De Vanna
Keyword(s):  
Systematic Review ◽  
Literature Review ◽  
International Business ◽  
Decision Process ◽  
Foreign Markets ◽  
New Markets ◽  
Integrative Framework ◽  
The Past ◽  
The Relationship

The rise of e-commerce has brought considerable changes to the relationship between firms and consumers, especially within international business. Hence, understanding the use of such means for entering foreign markets has become critical for companies. However, the research on this issue is new and so it is important to evaluate what has been studied in the past. In this study, we conduct a systematic review of e-commerce and internationalisation studies to explicate how firms use e-commerce to enter new markets and to export. The studies are classified by theories and methods used in the literature. Moreover, we draw upon the internationalisation decision process (antecedents-modalities-consequences) to propose an integrative framework for understanding the role of e-commerce in internationalisation

Assessment of the Multifactorial Effect on Antimicrobial Sensitivity in Positive Staphylococcus Aureus Clinical Isolates from Assir Region, Saudi Arabia

2012 ◽  
Vol 13 (2) ◽  
pp. 152-159 ◽  
Author(s):  
Nazar M Abdalla ◽  
Waleed O Haimour ◽  
Amani A Osman ◽  
Hassan Abdul Aziz
Keyword(s):  
Staphylococcus Aureus ◽  
Saudi Arabia ◽  
Culture Media ◽  
Meca Gene ◽  
Laboratory Data ◽  
Age Groups ◽  
Clinical Isolates ◽  
Diabetic Patients ◽  
Staph Aureus ◽  
Antimicrobial Sensitivity

General objectives: This study aimed at assessment of factors affecting antimicrobial sensitivity in Staphylococcus aureus clinical isolates from Assir region, Saudi Arabia. Materials and Methods: In this study, eighty one patients presented with Staph. aureus infections either nosocomial or community acquired infections were involved by collecting nasal swabs from them at Aseer Central Hospital General Lab. These patients were from all age groups and from males and females during the period of Jan 2011- Jun 2011. These samples were undergone variable laboratory procedures mainly; bactech, culture media, antibiotics sensitivity test using diffusion disc test (MIC) and molecular (PCR) for detection of mec A gene. Clinical and laboratory data were recorded in special formats and analyzed by statistical computer program (SPSS). Results: Showed that; Descriptive and analytical statistical analysis were performed and final results were plotted in tables. In Staph aureus MecA gene positive cases (50) showed: Oxacillin/ Mithicillin, Ciprofloxacin and Fusidin resistant in diabetic patients were 13, 26.0%, 9, 18% and 7, 14% respectively and in non diabetic patients were 37, 74.0%, 22, 44% and 20, 40% respectively. While no sensitivity in diabetic and non diabetic patients using Oxacillin/ Mithicillin. In Staph aureus MecA gene negative cases (31) showed: Oxacillin/ Mithicillin, sensitivity in diabetic patients (5, 16.1%) and in non diabetic were (26, 83.9%). While no resistant in diabetic and non diabetic patients. In Ciprofloxacin and Fusidin resistant in diabetic patients were 1, 3.2% and 1, 3.2% respectively and in non diabetic patients were 12, 38.7% and 7, 22.6%respectively. Erythromycin in Staph aureus ( MecA gene) positive cases (50) showed: resistant in age (0-15) years were (5, 10%), (16-50) years were (16, 32%) and ( ›50 years) were (12, 24%). Erythromycin in Staph aureus (MecA gene) negative cases (31) showed: resistant in age (0-15) years were (6, 19.3%), (16-50) years were (5, 16.1%) and ( ›50 years) were (3, 9.7%). Conclusion: Drugs resistance is a major progressive multifactorial problem facing the treatment of Staph aureus infections. DOI: http://dx.doi.org/10.3329/jom.v13i2.12750 J Medicine 2012; 13 : 152-159

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