scholarly journals Does Oral Chlorhexidine Mouth Care Prior to Intubation Impact Ventilator-Associated Pneumonia? A Systematic Review

2021 ◽  
Author(s):  
Hannah Rothhaar
Keyword(s):  
Systematic Review ◽  
Cardiac Surgery ◽  
Selection Process ◽  
Proper Time ◽  
Oral Care ◽  
Ventilator Associated Pneumonia ◽  
Inclusion Criteria ◽  
Mouth Care ◽  
Application Procedure ◽  
Meta Analyses

Background: Chlorhexidine gluconate (CHG) is a broad-spectrum antiseptic agent that has become widely used for mouth care in intubated patients. Many studies have found it to be effective in the prevention of ventilator-associated pneumonia (VAP) when used after intubation; however, there is very limited research exploring the proper time to initiate CHG. Purpose: The purpose of this systematic review was to determine if the use of oral care with CHG prior to intubation impacts the incidence of VAP. Methods: The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) was used to guide the selection process of articles and the Critical Appraisal Skills Programme (CASP) was used to critically appraise the randomized control trials (RCTs) selected for this systematic review. Four randomized RCTs met inclusion criteria. Results: Three of the four RCTs which met inclusion criteria, Houston et al. (2002), DeRiso et al. (1996), and Lin et al. (2015), showed an improvement in VAP rates with the use of preintubation CHG in cardiac surgery patients. Only one RCT, the Munro et al. (2015) study, showed no benefit; this was the only study that included non-cardiac surgery patients. Conclusion: Based on the results of this systematic review, it can only be recommended that cardiac surgery patients receive CHG prior to or after intubation; however, more research needs to be done to determine the most effective dosing, frequency, and CHG application procedure. In addition, further study exploring the safety of administering CHG prior to intubation in noncardiac surgery patients is needed.

Adverse Effects of Natural Products: A Brief Pre-Systematic Review

2020 ◽  
Vol 01 ◽  
Author(s):  
Carla Pires ◽  
Ana Fernandes
Keyword(s):  
Systematic Review ◽  
Adverse Event ◽  
Natural Products ◽  
Adverse Events ◽  
In Vitro Study ◽  
Google Scholar ◽  
Inclusion Criteria ◽  
Exclusion Criteria ◽  
Meta Analyses

Background: Natural products are commonly used for treating health problems. These products may be associated with adverse events, which are defined as "noxious and unintended response to a medicinal product" by the European Medicine Agency. Objectives: To identify studies describing at least one adverse event (or with potential to promote an adverse event) related to the use of natural products, as well as to describe the involved product(s) and adverse event(s). Methods: A pre-systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria. Keywords: "natural product(s)" and ["adverse drug reaction(s)" or "adverse effect(s)"]. Screened databases: PubMed, SciELO, DOAJ and Google Scholar. Inclusion criteria: papers describing at least one adverse event associated with the use of natural products and published between 2017 and 2019. Exclusion criteria: Repeated studies, reviews and papers written in other languages than English, Portuguese, French or Spanish. Results: 104 studies were identified (20 PubMed; 0 SciELO; 2 DOAJ; 82 Google Scholar), but only 10 were selected (4 PubMed and 6 Google Scholar): 1 in-vitro study; 2 non-clinical studies, 1 study reporting in-vitro and clinical data and 5 studies were cases reports. Globally, 997 reports of adverse drug reactions with natural products were identified, mainly non-severe cases. Conclusion: Since a limited number of studies was found, we conclude that adverse events due to natural products may be underreported, or natural products may have a good safety profile. This review contributes for assuring the safety of natural products consumers, by evaluating the knowledge/information on the potential adverse events and interactions of these products.

scholarly journals Emotion Recognition in Adults With a History of Childhood Maltreatment: A Systematic Review

2021 ◽  
pp. 152483802110294
Author(s):  
Annie Bérubé ◽  
Jessica Turgeon ◽  
Caroline Blais ◽  
Daniel Fiset
Keyword(s):  
Systematic Review ◽  
Child Maltreatment ◽  
Emotion Recognition ◽  
Childhood Maltreatment ◽  
Mental Health Problems ◽  
Inclusion Criteria ◽  
History Of Childhood ◽  
History Of ◽  
Effects On Children ◽  
Meta Analyses

Child maltreatment has many well-documented lasting effects on children. Among its consequences, it affects children’s recognition of emotions. More and more studies are recognizing the lasting effect that a history of maltreatment can have on emotion recognition. A systematic literature review was conducted to better understand this relationship. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol was used and four databases were searched, MEDLINE/PubMed, PsycINFO, EMBASE, and FRANCIS, using three cross-referenced key words: child abuse, emotion recognition, and adults. The search process identified 23 studies that met the inclusion criteria. The review highlights the wide variety of measures used to assess child maltreatment as well as the different protocols used to measure emotion recognition. The results indicate that adults with a history of childhood maltreatment show a differentiated reaction to happiness, anger, and fear. Happiness is less detected, whereas negative emotions are recognized more rapidly and at a lower intensity compared to adults not exposed to such traumatic events. Emotion recognition is also related to greater brain activation for the maltreated group. However, the results are less consistent for adults who also have a diagnosis of mental health problems. The systematic review found that maltreatment affects the perception of emotions expressed on both adult and child faces. However, more research is needed to better understand how a history of maltreatment is related to adults’ perception of children’s emotions.

scholarly journals Effectivity of Psychotherapy Interventions for Anxiety in Medical Students: A Systematic Review

2021 ◽  
Vol 9 (F) ◽  
pp. 453-463
Author(s):  
Andrian Fajar Kusumadewi ◽  
Carla Raymondalexas Marchira ◽  
Widyandana Widyandana ◽  
Ronny Tri Wirasto
Keyword(s):  
Systematic Review ◽  
Medical Students ◽  
Systematic Reviews ◽  
Depression And Anxiety ◽  
Inclusion Criteria ◽  
Meta Analyses ◽  
And Behavior ◽  
Anxiety Depression ◽  
Suicidal Ideas ◽  
Psychotherapy Interventions

BACKGROUND: The mental health of medical students has long been a topic of concern in many countries. Much research in Europe reported that around 30% of medical students suffered from anxiety. Anxiety disorders have significant physical and emotional consequences. Various studies show that excessive, unmanaged stress related to poor academic performance in medical students leads to cynical personalities, lack of empathy, and suicidal ideas. AIM: This study aimed to identify studies for psychotherapy interventions carried out in medical students and analyze each impact on anxiety level in medical students. METHODS: This systematic review was conducted with evidence sourced from 2000 to 2020. The review process followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The study was registered with the Prospective Registering of Systematic Reviews database (Protocol ID: CRD42020180650). RESULTS: Twenty-three studies meet the inclusion criteria, and there are various psychotherapy interventions to deal with anxiety. Most studies reported that students who received mindfulness-based interventions reported lower anxiety, depression, and stress. CONCLUSION: There are various interventions carried out to decrease stress levels, depression, and anxiety in medical students. The most effective psychotherapy was found in cognitive and behavior intervention and mindfulness intervention.

scholarly journals Factors Influencing Intention to Work while Ill: A Systematic Review

2021 ◽  
Vol 45 (6) ◽  
pp. 1016-1030
Author(s):  
Hanizah Mohd Yusoff ◽  
Hanani Nabilah Mohd Sobri ◽  
Vevya Sundaram
Keyword(s):  
Systematic Review ◽  
Web Of Science ◽  
Selection Process ◽  
Behavioral Control ◽  
Subjective Norms ◽  
Perceived Behavioral Control ◽  
Inclusion Criteria ◽  
Factors Influencing ◽  
Facilitators And Barriers ◽  
Initial Knowledge

Objectives: The aim of this systematic review was to identify factors influencing workers' intention to work while ill, using the Theory of Planned Behavior (TPB) as a theoretical framework. Methods: A systematic search of articles was carried out from PubMed, Scopus, and Web of Science databases. Eligibility of each article was assessed using PRISMA guidelines. Overall, 22 articles met the inclusion criteria after the selection process and were included in this review. Results: The factors fit into 3 constructs: (1) attitude (good and bad consequences of working while ill), (2) subjective norms (descriptive and injunctive norms on working while ill), and (3) perceived behavioral control (facilitators and barriers of working while ill). Conclusions: The TPB is a practical theory to conceptualize and understand the factors influencing workers' intention to work while ill. These findings provide initial knowledge on the development of a framework to measure workers' intention to work while ill and to propose appropriate interventions for workers with chronic illness.

Use of Augmented Reality in Reconstructive Microsurgery: A Systematic Review and Development of the Augmented Reality Microsurgery Score

2019 ◽  
Vol 36 (04) ◽  
pp. 261-270
Author(s):  
Yasser Al Omran ◽  
Ali Abdall-Razak ◽  
Catrin Sohrabi ◽  
Tiffanie-Marie Borg ◽  
Hayat Nadama ◽  
...  
Keyword(s):  
Systematic Review ◽  
Augmented Reality ◽  
Systematic Reviews ◽  
Real World ◽  
Digital Information ◽  
Inclusion Criteria ◽  
Qualitative Synthesis ◽  
Reconstructive Microsurgery ◽  
User Access ◽  
Meta Analyses

Abstract Background Augmented reality (AR) uses a set of technologies that overlays digital information into the real world, giving the user access to both digital and real-world environments in congruity. AR may be specifically fruitful in reconstructive microsurgery due to the dynamic nature of surgeries performed and the small structures encountered in these operations. The aim of this study was to conduct a high-quality preferred reporting items for systematic reviews and meta-analyses (PRISMA) and assessment of multiple systematic reviews 2 (AMSTAR 2) compliant systematic review evaluating the use of AR in reconstructive microsurgery. Methods A systematic literature search of Medline, EMBASE, and Web of Science databases was performed using appropriate search terms to identify all applications of AR in reconstructive microsurgery from inception to December 2018. Articles that did not meet the objectives of the study were excluded. A qualitative synthesis was performed of those articles that met the inclusion criteria. Results A total of 686 articles were identified from title and abstract review. Five studies met the inclusion criteria. Three of the studies used head-mounted displays, one study used a display monitor, and one study demonstrated AR using spatial navigation technology. The augmented reality microsurgery score was developed and applied to each of the AR technologies and scores ranged from 8 to 12. Conclusion Although higher quality studies reviewing the use of AR in reconstructive microsurgery is needed, the feasibility of AR in reconstructive microsurgery has been demonstrated across different subspecialties of plastic surgery. AR applications, that are reproducible, user-friendly, and have clear benefit to the surgeon and patient, have the greatest potential utility. Further research is required to validate its use and overcome the barriers to its implementation.

scholarly journals Interventions Delivered in the Community Pharmacy to Manage Allergic Rhinitis- A Systematic Review of the Literature

Pharmacy ◽  
2020 ◽  
Vol 8 (2) ◽  
pp. 80
Author(s):  
Jéssica José ◽  
Biljana Cvetkovski ◽  
Vicky Kritikos ◽  
Rachel Tan ◽  
Sinthia Bosnic-Anticevich ◽  
...  
Keyword(s):  
Systematic Review ◽  
Allergic Rhinitis ◽  
Community Pharmacy ◽  
Selection Process ◽  
Symptom Control ◽  
Review Of The Literature ◽  
Inclusion Criteria ◽  
The Impact ◽  
Valuable Role

Pharmacists have a valuable role in the management of allergic rhinitis (AR) at the community pharmacy level. This role has been reported extensively in numerous papers. However, a systematic review of the available literature and a comprehensive analysis of the outcomes has not been published. This systematic review aimed to evaluate the impact of interventions developed by pharmacists on clinical AR outcomes. A thorough search was performed in three electronic databases, including studies published between January 2000 and June 2019. After the selection process, only three articles met the inclusion criteria and were further analysed. Despite the scarcity of the available studies, in all of them was clear that the pharmacist plays a pivotal role in the management of AR, significantly improving the patients’ quality of life and symptom control. This systematic review also stresses the utmost importance to investigate and report practices and interventions developed by pharmacists using measurable outcomes.

scholarly journals Impact of Non-Confinement Accommodation on Farrowing Performance: A Systematic Review and Meta-Analysis of Farrowing Crates Versus Pens

Animals ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. 957 ◽  
Author(s):  
Dannielle Glencorse ◽  
Kate Plush ◽  
Susan Hazel ◽  
Darryl D’Souza ◽  
Michelle Hebart
Keyword(s):  
Systematic Review ◽  
Relative Risk ◽  
Web Of Science ◽  
Meta Analysis ◽  
Inclusion Criteria ◽  
Literature Searches ◽  
Piglet Mortality ◽  
Partial Confinement ◽  
Meta Analyses ◽  
Piglet Survival

There are conflicting reports regarding the effect of farrowing house accommodation on piglet performance. The aim of this investigation was to use a systematic review and meta-analyses to summarise the results of publications that focused on direct comparisons between full confinement conventional crates and various designs of loose-housed farrowing pens from loading until weaning. Literature searches in Scopus, BIOSIS Previews, Cab Abstracts, and Web of Science identified 6695 articles. Twenty-two publications were retained for the systematic review and individual meta-analyses after screening for inclusion criteria. The random effects meta-analyses were performed on crate versus pen for number of piglets born alive, number of stillborn piglets, pre-weaning mortality, and number of piglets weaned. Additionally, the modifiers of confinement length (no confinement from loading until weaning or partial confinement for shorter periods of time in the early stages post parturition), enrichment (no enrichment or enrichment provided), and pen size (small, medium, or large) were examined. There was a 14% increase in the relative risk of piglet mortality in farrowing pens when they were compared with crates (p = 0.0015). The number of stillborns per litter was not different between the pen and crate. However, when providing enrichment in the pens, there was an increase in stillborns within farrowing crates versus pens (p = 0.009). There was no overall effect on piglets that were born alive or number weaned. As there is no difference between piglets born alive and mortality is significantly higher in farrowing pens, a reduction in the number of piglets weaned was expected but not observed, which was possibly due to the lack of weaning details provided in the publications. This was the first systematic review and meta-analysis conducted on the performance of farrowing accommodation and identified that farrowing pens do compromise post-natal piglet survival. Future efforts should focus on improving sow comfort in the farrowing crate to maximize both piglet and sow welfare.

Oropharyngeal Decontamination with Antiseptics to Prevent Ventilator-Associated Pneumonia: Rethinking the Benefits of Chlorhexidine

2017 ◽  
Vol 38 (03) ◽  
pp. 381-390 ◽  
Author(s):  
Michael Klompas
Keyword(s):  
Mechanical Ventilation ◽  
Intensive Care ◽  
Meta Analysis ◽  
Unit Length ◽  
Oral Care ◽  
Care Practice ◽  
Equal Weight ◽  
Ventilator Associated Pneumonia ◽  
Meta Analyses ◽  
Double Blinded

AbstractDaily oral care with chlorhexidine for mechanically ventilated patients is ubiquitous in contemporary intensive care practice. The practice is predicated upon meta-analyses suggesting that adding chlorhexidine to daily oral care regimens can reduce ventilator-associated pneumonia (VAP) rates by up to 40%. Close analysis, however, raises three concerns: (1) the meta-analyses are dominated by studies in cardiac surgery patients in whom average duration of mechanical ventilation is < 1 day and thus their risk of VAP is very different from other populations, (2) diagnosing VAP is subjective and nonspecific yet the meta-analyses gave equal weight to blinded and nonblinded studies, potentially biasing them in favor of chlorhexidine, and (3) there is circularity between diagnostic criteria for VAP and chlorhexidine; as an antiseptic, chlorhexidine may decrease the frequency of positive respiratory cultures but fewer cultures does not necessarily mean fewer pneumonias. It is therefore important to look at other outcomes for corollary evidence on whether or not oral chlorhexidine benefits patients. An updated meta-analysis restricted to double-blinded studies in noncardiac surgery patients showed no impact on VAP rates, duration of mechanical ventilation, or intensive care unit length of stay. Instead, there was a possible signal that oral chlorhexidine may increase mortality rates. Observational data have raised similar concerns. This article will review the theoretical basis for adding chlorhexidine to oral care regimens, delineate potential biases in randomized controlled trials comparing oral care regimens with and without chlorhexidine, explore the unexpected mortality signal associated with oral chlorhexidine, and provide practical recommendations.

scholarly journals Adjuvant chemotherapy for early female breast cancer: A systematic review of the evidence for the 2014 Cancer Care Ontario systemic therapy guideline

2014 ◽  
Vol 22 ◽  
pp. 82 ◽  
Author(s):  
S. Gandhi ◽  
G.G. Fletcher ◽  
A. Eisen ◽  
M. Mates ◽  
O.C. Freedman ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Systematic Review ◽  
Endocrine Therapy ◽  
Early Breast Cancer ◽  
Systemic Therapy ◽  
Cancer Care ◽  
Cytotoxic Chemotherapy ◽  
Evidence Based ◽  
Inclusion Criteria ◽  
Meta Analyses

BackgroundThe Program in Evidence-Based Care (PEBC) of Cancer Care Ontario (CCO) has recently created an evidence-based consensus guideline on the systemic treatment of early breast cancer.  The evidence for this guideline was compiled using a systematic review to answer the question:  “What is the optimal systemic therapy for patients with early-stage, operable breast cancer, when patient and disease factors are considered?”  This question was addressed in three parts: cytotoxic chemotherapy, endocrine treatment, and human epidermal growth factor receptor 2 (HER2) directed therapy.MethodsA systematic review was performed using the MEDLINE and EMBASE databases for the period January 2008 to May 2014.  The SAGE Directory of Cancer Guidelines and websites of major oncology guideline organizations were also searched.  The basic search terms were “breast cancer” and “systemic therapy” (chemotherapy, endocrine therapy, targeted agents, ovarian suppression), and was limited to randomized controlled trials (RCTs), guidelines, systematic reviews, and meta-analyses. ResultsSeveral hundred documents were retrieved that met the inclusion criteria; the Early Breast Cancer Trialists Collaborative Group (EBCTCG) meta-analyses encompassed many of the RCTs found. Several additional studies which met the inclusion criteria were included, as well as other guidelines and systematic reviews.  Chemotherapy was largely reviewed as three classes of agents: anti-metabolite based regimens (e.g., CMF), anthracyclines, and taxane-based regimens. Single-agent chemotherapy in general is not recommended for the adjuvant treatment of breast cancer in any patient population.  Anthracycline and taxane-based polychemotherapy regimens are overall considered superior to earlier generation regimens, with the most significant impact on patient survival outcomes. Various regimens with disparate anthracycline and taxane doses and schedules are options; in general, paclitaxel given every 3 weeks is inferior. Evidence does not support the use of bevacizumab in the adjuvant setting; other systemic therapy agents such as metformin and vaccines remain under investigation. Adjuvant bisphosphonates for menopausal women will be discussed in later work.  ConclusionThe results of this systematic review represent a comprehensive compilation of high-level evidence which was the basis for the 2014 PEBC CCO guideline on systemic therapy for early breast cancer. The use of cytotoxic chemotherapy is presented here; the results addressing endocrine therapy and HER-2 targeted treatment, as well as the final clinical practice recommendations, are published separately in this issue.

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