scholarly journals Is There an Optimal Curative Option in HIV-Positive Men with Localized Prostate Cancer? A Systematic Review

2018 ◽  
Vol 12 (4) ◽  
pp. 169-176 ◽  
Author(s):  
John Baladakis ◽  
Marlon Perera ◽  
Damien Bolton ◽  
Nathan Lawrentschuk ◽  
Ahmed Adam
Keyword(s):  
Prostate Cancer ◽  
Treatment Options ◽  
Cochrane Library ◽  
Hiv Positive ◽  
Study Cohort ◽  
Management Algorithm ◽  
Search Terms ◽  
The Cochrane Library ◽  
Individualized Management ◽  
Surgical Treatments

Aims: We aimed to compare the outcome of curative treatment options in localised Prostate Cancer (PCa) amongst HIV positive (HIV+) men. Methods: A systematic search of the Cochrane Library of Systematic Reviews, the Scopus and PubMed databases was performed (January 1995 to November 2015) using pre-determined search terms. Outcome measures for comparison included the rate of biochemical failure (BCF), survival benefit and complications. Results: A total of 14 eligible articles were identified for inclusion, representing a total of 202 HIV+ men with PCa. Radical Prostatectomy was performed in 40/153 compared to 109/153 patients undergoing alternative (non-surgical) treatments options. Only 3 studies compared outcomes within their respective study cohort. One study (n = 10) reported BCF results with 1/2 BCF patient in the surgical arm vs. 1/8 BCF positive patients in the non-surgical arm (mean 46 months follow-up), while two other studies reported no occurrences of BCF within both arms of their studies. Conclusion: Due to paucity in the literature, there is insufficient evidence to support a certain treatment modality arm specifically for HIV+ men with localized PCa. An individualized management algorithm seems feasible within this cohort, until more definitive studies are performed.

scholarly journals Scoping review protocol: the use of telemedicine in providing opioid agonist treatment and related psychosocial supports

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e040556
Author(s):  
Des Crowley ◽  
Robyn Homeniuk ◽  
Ide Delargy
Keyword(s):  
Scoping Review ◽  
Psychosocial Support ◽  
Descriptive Analysis ◽  
Cochrane Library ◽  
Opioid Use ◽  
Opioid Agonist ◽  
Opioid Agonist Treatment ◽  
Search Terms ◽  
Medical Librarian ◽  
The Cochrane Library

IntroductionThe global opioid-related disease burden is significant. Opioid agonist treatment (OAT) can be effective in reducing illicit opioid use and fatal overdose, and improving multiple health and social outcomes. Despite evidence for its effectiveness, there are significant deficits in OAT globally. COVID-19 has required rapid adaptation of remote models of healthcare. Telemedicine is not used routinely in OAT, and little is known about the current levels of use and effectiveness. The objective of this review is to describe models of telemedicine and their efficacy.Methods and analysisThis scoping review uses the review methodology described by Arksey and O’Malley and adapted by Levac et al. The search strategy developed by the medical librarian at the Irish College of General Practitioners in conjunction with the research team will involve five databases (PubMed, EMBASE, the Cochrane Library, PsycInfo and OpenGrey) and the hand searching of reference lists. A limited initial search of two databases will be completed to refine search terms, followed by a second comprehensive search using newly refined search terms of all databases and finally hand searching references of included studies. To be included, studies must report on remote ways of providing OAT (including assessment, induction and monitoring) or related psychosocial support; be published in English after 2010. Two researchers will independently screen titles, abstracts and full-text articles considered for inclusion. Data will be extracted onto an agreed template and will undergo a descriptive analysis of the contextual or process-oriented data and simple quantitative analysis using descriptive statistics.Ethics and disseminationResearch ethics approval is not required for this scoping review. The results of this scoping review will inform the development of a national remote model of OAT. The results will be published in peer-reviewed journals and presented at relevant conferences.

Effect of Statins on the Risk of Different Stages of Prostate Cancer: A Meta-Analysis

2021 ◽  
pp. 1-9
Author(s):  
Yun Li ◽  
Xuan Cheng ◽  
Jia-lian Zhu ◽  
Wen-wen Luo ◽  
Huai-rong Xiang ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Lower Risk ◽  
Advanced Prostate Cancer ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Low Grade ◽  
High Grade ◽  
The Cochrane Library ◽  
The Relationship ◽  
Comprehensive Literature Search

<b><i>Introduction:</i></b> The aim of this article was to investigate the relationship between statins and the risk of different stages or grades of prostate cancer. <b><i>Methods:</i></b> A comprehensive literature search was performed for articles published until December 18, 2020, on the PubMed, Embase, and the Cochrane Library databases. The pooled relative risk (RR) and 95% confidence interval (CI) were then analyzed using the STATA.16.0 software. <b><i>Results:</i></b> A total of 588,055 patients from 14 studies were included in the analysis. We found that the use of statins expressed a significant correlation with a lower risk of advanced prostate cancer (RR = 0.81, 95% CI: 0.73–0.91; RR = 0.86, 95% CI: 0.75–0.99, respectively). However, no evidence suggested that the use of statins was beneficial for the prevention of localized prostate cancer incidence. Similarly, the pooled results also revealed no association between the use of statins and the risk of high-grade and low-grade prostate cancer. <b><i>Conclusion:</i></b> It has been found that the use of statins is associated with a lower risk of advanced prostate cancer but was not related to the risk of localized, low-grade, or high-grade prostate cancer.

scholarly journals Does Conservative Kidney Management Offer a Quantity or Quality of Life Benefit Compared to Dialysis? A Systematic Review

2021 ◽  
Author(s):  
Buur Louise Engelbrecht ◽  
Madsen Jens Kristian ◽  
Eidemak Inge ◽  
Krarup Elizabeth ◽  
Lauridsen Thomas Guldager ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Treatment Options ◽  
Symptom Burden ◽  
Place Of Death ◽  
Cochrane Library ◽  
Elderly Individuals ◽  
Secondary Outcomes ◽  
The Cochrane Library

Abstract Background Patients with stage 5 chronic kidney disease (CKD5) collaborate with their clinicians when choosing their future treatment modality. Most elderly patients with CKD5 may only have two treatment options: dialysis or conservative kidney management (CKM). The objective of this systematic review was to investigate whether CKM offers a quantity or quality of life benefit compared to dialysis for some patients with CKD5.MethodsThe databases MEDLINE, EMBASE, the Cochrane Library, and CINAHL were systematically searched for studies comparing patients with CKD5 treated with CKM or dialysis. The primary outcomes were mortality and quality of life (QoL). Hospitalization, symptom burden, and place of death were secondary outcomes. For studies reporting hazard ratios, pooled values were calculated, and forest plots conducted.ResultsTwenty-four primary studies, all observational, were identified. All studies except one reported an increased mortality in patients treated with CKM (pooled hazard ratio 0.53, 95% confidence interval 0.41-0.69). For patients aged ≥ 80 years and for elderly individuals with comorbidities, results were ambiguous. In most studies, CKM seemed advantageous for QoL and secondary outcomes. Findings were limited by the heterogeneity of studies and biased outcomes favouring dialysis.ConclusionsIn general, patients with CKD5 live for a shorter time on CKM than on dialysis. In patients aged ≥ 80 years old, and in elderly individuals with comorbidities, the survival benefits of dialysis seem to be lost. Regarding QoL, symptom burden, hospitalization, and place of death, CKM may have advantages. Higher quality studies are needed to guide patients and clinicians in the decision-making process.

CASTRATION-RESISTANT PROSTATE CANCER: NEW PERSPECTIVES IN PHARMACOLOGICAL TREATMENT

2019 ◽  
Vol 25 (1) ◽  
pp. 49-58
Author(s):  
Dmitry A. Andreev ◽  
A. A Zavyalov ◽  
A. V Govorov ◽  
K. A. Kokushkin ◽  
M. Y Davidovskaya
Keyword(s):  
Prostate Cancer ◽  
Clinical Trials ◽  
Treatment Options ◽  
Specific Treatment ◽  
Cochrane Library ◽  
Cancer Drug ◽  
Castration Resistant Prostate Cancer ◽  
Optimal Sequence ◽  
Treatment Algorithms ◽  
Castration Resistant

Prostate cancer remains one of the most actual problems in oncourology due to its high prevalence and resistance to therapy. Within 5 years of active treatment and follow-up, the castration-resistant prostate cancer (CRPC) develops in 10-20% of patients. This type of disease course resists treatments and leads to death. Medical resources distinguish two different forms of CRPC: non-metastatic and metastatic. Such separation is critically important because each of two forms requires different treatment algorithms. This paper summarizes the main outlines of foreign clinical guidelines and reviews the new treatment options for non-metastatic and metastatic CRPC as wells as the design and results of key clinical trials on drug efficiency. To prepare the review, the comprehensive literature search was conducted using PubMed/Medline, the Cochrane Library, EMBASE, CyberLeninka, e-library databases. The search line included phrases containing the following words: prostate cancer, castration-resistant prostate cancer, drug therapy, treatment algorithms, clinical studies, etc. In accordance to foreign guidelines, it is essential to determine the high risk patients with non-metastatic CRPC and promptly apply new therapeutic options including apalutamide and enzalutamide, which have proven being effective in clinical trials as therapies that attenuate the transition of the non-metastatic CRPC to the metastatic stage. Foreign medical guidelines propose to apply a wider set of treatment algorithms for patients with metastatic CRPC, for instance: considerations on possibilities to use the cabazitaxel instead of docetaxel in the 1st line therapy in patients with pre-existing mild peripheral neuropathy, etc. as well as new therapies - pembrolizumab and sipuleucel-T. The issues regarding the selection of patients with CRPC for specific treatment algorithms and defining the optimal sequence of therapeutic regimens as well as combining various regimens with minimizing toxic effects and maximizing patient benefits remain unsolved.

scholarly journals A systematic review of patient reported outcomes and patient experience in enhanced recovery after orthopaedic surgery

2014 ◽  
Vol 96 (2) ◽  
pp. 89-94 ◽  
Author(s):  
EL Jones ◽  
TW Wainwright ◽  
JD Foster ◽  
JRA Smith ◽  
RG Middleton ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Length Of Stay ◽  
Patient Experience ◽  
Enhanced Recovery ◽  
Cochrane Library ◽  
Search Terms ◽  
Included Patient ◽  
Patient Reported ◽  
Hip And Knee Arthroplasty ◽  
The Cochrane Library

Introduction Orthopaedic enhanced recovery after surgery (ERAS) providers are encouraged to estimate the actual benefit of ERAS according to the patient’s opinion by using patient generated data alongside traditional measures such as length of stay. The aim of this paper was to systemically review the literature on the use of patient generated information in orthopaedic ERAS across the whole perioperative pathway. Methods Publications were identified using Embase™, MEDLINE®, AMED, CINAHL® (Cumulative Index to Nursing and Allied Health Literature), the Cochrane Library and the British Nursing Index. Search terms related to experiences, acceptance, satisfaction or perception of ERAS and quality of life (QoL). Findings Of the 596 abstracts found, 8 papers were identified that met the inclusion criteria. A total of 2,208 patients undergoing elective hip and knee arthroplasty were included. Patient satisfaction was reported in 6 papers. Scores were high in all patients and not adversely affected by length of stay. QoL was reported in 2 papers and showed that QoL scores continued to increase up to 12 months following ERAS. Qualitative methods were used in one study, which highlighted problems with support following discharge. There is a paucity of data reporting on patient experience in orthopaedic ERAS. However, ERAS does not compromise patient satisfaction or QoL after elective hip or knee surgery. The measurement of patient experience should be standardised with further research.

scholarly journals COVID-19 Pandemic and Clinical Oncology Concerns

2020 ◽  
Vol 8 (6) ◽  
pp. 442-454
Author(s):  
Hyunjo Kim ◽  
Jae-Hoon Song
Keyword(s):  
Cancer Patients ◽  
Clinical Oncology ◽  
Ground Glass Opacity ◽  
Cochrane Library ◽  
Tumor Treatment ◽  
Search Terms ◽  
Information Status ◽  
The Common ◽  
Novel Coronavirus ◽  
The Cochrane Library

Purpose: The purpose of this review article is concerns on thatcancer patients are regarded as a highly vulnerable group in the currentCoronavirus Disease 2019 (COVID-19) pandemic.Methods: A literature search was performed using the PubMeddatabase and the Cochrane library. Search terms included ”novel coronavirus”or “2019-nCoV” and “clinical oncology”. Authors re- viewedcancer registry information, status, and treatments.Results: COVID-19-infected cancer patients were included and the lastanti-tumor treatment was within 14 days, it significantly increased therisk of developing severe events. Lung cancer was the most frequentcancer type. The common chest computed tomography (CT) findingswere ground- glass opacity and patchy consolidation. A total of patientshad severe events and the mortality rate was high. Furthermore, patchyconsolidation on CT on admission was associated with a higher risk ofdeveloping severe events.Conclusions: Cancer patients show deteriorating conditions and pooroutcomes from the COVID-19 infection. It is recommended that cancerpatients receiving anti-tumor treatments should have vigorous screeningfor COVID-19 infection and should avoid treatments causing immunosuppression or have their dosages decreased in case of COVID-19infection.

scholarly journals Effectiveness of Lomustine Combined With Bevacizumab in Glioblastoma: A Meta-Analysis

2021 ◽  
Vol 11 ◽  
Author(s):  
Xing Ren ◽  
Di Ai ◽  
Tong Li ◽  
Lei Xia ◽  
Lingzhi Sun
Keyword(s):  
Clinical Trials ◽  
Meta Analysis ◽  
Treatment Options ◽  
Progression Free Survival ◽  
Cochrane Library ◽  
Control Group ◽  
Subgroup Analyses ◽  
Group A ◽  
Group 2 ◽  
The Cochrane Library

Introduction: Despite surgical and chemotherapeutical treatment options, the prognosis for glioblastoma (GBM) remains poor. Some studies have found that using lomustine plus bevacizumab to treat GBM can prolong overall survival (OS) and progression-free survival (PFS). The aim of this study was to explore the efficacy of the two drugs in combination treatment of GBM using a meta-analysis of the existing literature to help settle the ongoing debate.Materials and Methods: PubMed, EMBASE, and the Cochrane Library were searched for the effectiveness of lomustine plus bevacizumab in GBM literature, updated on June 6, 2020. The main outcomes analyzed included PFS and OS; the effects of this drug combination on the 6-month PFS, which represents the percentage of patients who had PFS for 6 months, were also analyzed. All the data were pooled: OS and PFS with the mean difference (MD) and 6-month PFS with the risk ratio (RR). Because there were different control groups and dose groups, two subgroup analyses were run to ensure they were comparable. All statistical analyses were performed using the Review Manager Version 5.3 software.Results: Six clinical trials were identified which included 1,095 patients (treatment group: 516; control group: 579). The group treated with lomustine and bevacizumab showed an improvement in OS (MD =1.37; 95% CI, 0.49–2.25; p = 0.002), PFS (MD = 0.23; 95% CI, 0.13–0.34; p &lt; 0.00001), and 6-month PFS (RR = 2.29; 95% CI, 1.43–3.65; p = 0.0005). Two subgroup analyses of the main outcome, OS, show that the results of Control group A (p = 0.01) and Dose group 2 (p = 0.003) are significantly different from those of the other control or dose groups.Conclusion: This study shows that lomustine and bevacizumab can effectively increase OS, PFS, and 6-month PFS in patients with GBM. The encouraging results of the lomustine and bevacizumab combination therapy for GBM should be studied in more clinical trials in the future.

scholarly journals Does conservative kidney management offer a quantity or quality of life benefit compared to dialysis? A systematic review

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Buur Louise Engelbrecht ◽  
Madsen Jens Kristian ◽  
Eidemak Inge ◽  
Krarup Elizabeth ◽  
Lauridsen Thomas Guldager ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Treatment Options ◽  
Symptom Burden ◽  
Place Of Death ◽  
Cochrane Library ◽  
Elderly Individuals ◽  
Secondary Outcomes ◽  
The Cochrane Library

Abstract Background Patients with stage 5 chronic kidney disease (CKD5) collaborate with their clinicians when choosing their future treatment modality. Most elderly patients with CKD5 may only have two treatment options: dialysis or conservative kidney management (CKM). The objective of this systematic review was to investigate whether CKM offers a quantity or quality of life benefit compared to dialysis for some patients with CKD5. Methods The databases MEDLINE, EMBASE, the Cochrane Library, and CINAHL were systematically searched for studies comparing patients with CKD5 who had chosen or were treated with either CKM or dialysis. The primary outcomes were mortality and quality of life (QoL). Hospitalization, symptom burden, and place of death were secondary outcomes. For studies reporting hazard ratios, pooled values were calculated, and forest plots conducted. Results Twenty-five primary studies, all observational, were identified. All studies reported an increased mortality in patients treated with CKM (pooled hazard ratio 0.47, 95 % confidence interval 0.34–0.65). For patients aged ≥ 80 years and for elderly individuals with comorbidities, results were ambiguous. In most studies, CKM seemed advantageous for QoL and secondary outcomes. Findings were limited by the heterogeneity of studies and biased outcomes favouring dialysis. Conclusions In general, patients with CKD5 who have chosen or are on CKM live for a shorter time than patients who have chosen or are on dialysis. In patients aged ≥ 80 years old, and in elderly individuals with comorbidities, the survival benefits of dialysis seem to be lost. Regarding QoL, symptom burden, hospitalization, and place of death, CKM may have advantages. Higher quality studies are needed to guide patients and clinicians in the decision-making process.

Prealbumin: The clinical utility and analytical methodologies

2020 ◽  
pp. 000456322093188
Author(s):  
Ruvini NK Ranasinghe ◽  
Milly Biswas ◽  
Royce P Vincent
Keyword(s):  
Clinical Practice ◽  
Prognostic Marker ◽  
Clinical Utility ◽  
High Sensitivity ◽  
Clinical History ◽  
Short Review ◽  
Cochrane Library ◽  
Search Terms ◽  
General Search ◽  
The Cochrane Library

Prealbumin is a small protein which has been widely evaluated as a nutritional and a prognostic marker. The small size and concentration of prealbumin in blood proposes challenges on measuring it with high sensitivity and specificity. Over the years, a number of analytical methodologies have been developed, which may help establish prealbumin as a useful biomarker in routine clinical practice. The aim of the short review was to explore the current literature on the clinical utility of prealbumin and the advances made in the analytical methodologies of prealbumin. We searched MEDLINE, EMBASE and the Cochrane Library for articles published between January 1980 and July 2019, with the general search terms of ‘prealbumin’, ‘prognostic marker’, ‘nutritional marker’, ‘analytical methodologies’ and ‘malnutrition’. Additionally, we selected relevant articles and comprehensive overviews from reference lists of identified studies. The routine use of prealbumin in clinical practice remains debatable; however; it can complement clinical history, anthropometric assessment and physical examination to assess malnutrition with more certainty. Consensus on the clinical applications of prealbumin in the management of malnutrition is warranted.

Removal of Hardware After Syndesmotic Screw Fixation: A Systematic Literature Review

2016 ◽  
Vol 10 (3) ◽  
pp. 252-257 ◽  
Author(s):  
Kempland C. Walley ◽  
Kurt J. Hofmann ◽  
Brian T. Velasco ◽  
John Y. Kwon
Keyword(s):  
Systematic Review ◽  
Controlled Trial ◽  
Cochrane Library ◽  
Management Options ◽  
Radiographic Outcomes ◽  
Search Terms ◽  
Syndesmotic Screw ◽  
Retrospective Cohort Studies ◽  
Removal Of Hardware ◽  
The Cochrane Library

Background. While trans-syndesmotic fixation with metal screws is considered the gold standard in treating syndesmotic injuries, controversy exists regarding the need and timing of postoperative screw removal. Formal recommendations have not been well established in the literature and clinical practice is highly variable in this regard. The purpose of this systematic review is to critically examine the most recent literature regarding syndesmotic screw removal in order to provide surgeons an evidence-based approach to management of these injuries. Methods. The Cochrane Library and PubMed Medline databases were explored using search terms for syndesmosis and screw removal between October 1, 2010 and June 1, 2016. Results. A total of 9 studies (1 randomized controlled trial and 8 retrospective cohort studies) were found that described the outcomes of either retained or removed syndesmotic screws. Overall, there was no difference in functional, clinical or radiographic outcomes in patients who had their syndesmotic screw removed. There was a higher likelihood of recurrent syndesmotic diastasis when screws were removed between 6 and 8 weeks. There was a higher rate of postoperative infections when syndesmotic screws were removed without administering preoperative antibiotics. Conclusion. Removal of syndesmotic screws is advisable mainly in cases of patient complaints related to the other implanted perimalleolar hardware or malreduction of the syndesmosis after at least 8 weeks postoperatively. Broken or loose screws should not be removed routinely unless causing symptoms. Antibiotic prophylaxis is recommended on removal. Radiographs should be routinely obtained immediately prior to removal and formal discussions should be had with patients prior to surgery to discuss management options if a broken screw is unexpectedly encountered intraoperatively. Radiographs and/or computed tomography imaging should be obtained after syndesmotic screw removal when indicated for known syndesmotic malreduction. Levels of Evidence: Level IV: Systematic review

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