scholarly journals The Influence of Anaesthetic Drugs on the Laryngeal Motion in Dogs: A Systematic Review

Animals ◽  
2020 ◽  
Vol 10 (3) ◽  
pp. 530
Author(s):  
Elisabeth Ranninger ◽  
Marta Kantyka ◽  
Rima Nadine Bektas
Keyword(s):  
Drug Dose ◽  
Risk Of Bias ◽  
Evidence Based ◽  
Level Of Evidence ◽  
Laryngeal Function ◽  
Laryngeal Paralysis ◽  
Search Terms ◽  
Healthy Dogs ◽  
Based Medicine ◽  
Laryngeal Examination

Anaesthetic drugs are commonly used during the evaluation of laryngeal function in dogs. The aim of this review was to systematically analyse the literature describing the effects of anaesthetic drugs and doxapram on laryngeal motion in dogs and to determine which drug regime provides the best conditions for laryngeal examination. PubMed, Google Scholar, and EMBASE databases were used for the literature search up to November 2019. Relevant search terms included laryngeal motion, anaesthetic drugs and dogs. Studies were scored based on their level of evidence (LoE), according to the Oxford Centre for Evidence-based Medicine, and the quality was assessed using the risk-of-bias tool and SIGN-checklist. In healthy dogs, premedication before laryngeal examination provided better examination conditions and maintained overall adequate laryngeal motion in 83% of the studies. No difference in laryngeal motion between induction drugs was found in 73% of the studies but the effects in dogs with laryngeal paralysis remain largely unknown. Doxapram increased laryngeal motion in healthy dogs without serious side effects, but intubation was necessary for some dogs with laryngeal paralysis. Methodological characteristics varied considerably between studies, including the technique and timing of evaluation, number of assessors, study design, drug dose, combinations, route and speed of administration.

How to Search and Critique Scientific Evidence for Decision-Making

2017 ◽  
pp. 100-123
Author(s):  
Mayuree Tangkiatkumjai ◽  
Win Winit-Watjana ◽  
Li-Chia Chen
Keyword(s):  
Alternative Medicine ◽  
Complementary And Alternative Medicine ◽  
Literature Search ◽  
Scientific Evidence ◽  
Clinical Decision ◽  
Evidence Based ◽  
Search Terms ◽  
Based Medicine ◽  
Complementary And Alternative

A clinical decision on the use of complementary and alternative medicine (CAM) should be made based on evidence-based medicine (EBM) together with practitioner's knowledge and experiences. This chapter describes the process of EBM, including how to address a clinical question, do a systematic search for appropriate evidence with key search terms, appraise the evidence and make a clinical decision on CAM applications. An effective literature search should be performed by using a structured search strategy in searching biomedical and CAM databases, such as the National Center for Complementary and Alternative Medicine (CAM Citation Index). Few standard tools are recommended to evaluate the quality of CAM studies, i.e. the CONSORT extension for herbal interventions and STRICTA for RCTs of acupuncture. Additionally, some guidelines for designing RCTs in Chinese herbal medicine (CHM) can also be adopted to critique CAM literature. A clinical decision on choosing optimal CAM for patient care should be based on the current best evidence emerged from the EBM process.

scholarly journals Guiding Nipple-Areola Complex Reconstruction: Literature Review and Proposal of a New Decision-Making Algorithm

2020 ◽  
Author(s):  
Guido Paolini ◽  
Guido Firmani ◽  
Francesca Briganti ◽  
Michail Sorotos ◽  
Fabio Santanelli di Pompeo
Keyword(s):  
Decision Making ◽  
Patient Satisfaction ◽  
Patient Selection ◽  
Evidence Based Medicine ◽  
Evidence Based ◽  
Patient Factors ◽  
Level Of Evidence ◽  
Areola Complex ◽  
Complex Reconstruction ◽  
Based Medicine

Abstract Background Nipple-areola complex reconstruction (NAR) most commonly represents the finishing touch to breast reconstruction (BR). Nipple presence is particularly relevant to the patient’s psyche, beyond any shadow of doubt. Many reconstructive options have been described in time. Surgery is easy, but final result is often disappointing on the long run. Methods The goal of this manuscript is to analyze and classify knowledge concerning NAR techniques and the factors that influence success, and then to elaborate a practical evidence-based algorithm. Out of the 3136 available articles as of August 8th, 2020, we selected 172 manuscripts that met inclusion criteria, which we subdivided into 5 main topics of discussion, being the various NAR techniques; patient factors (including patient selection, timing and ideal position); dressings; potential complications and finally, outcomes/patient satisfaction. Results We found 92 articles describing NAR techniques, 41 addressing patient factors (out of which 17 discussed patient selection, 14 described ideal NAC location, 10 described appropriate timing), 10 comparing dressings, 7 studying NAR complications, and 22 addressing outcomes and patient satisfaction. We elaborated a comprehensive decision-making algorithm to help narrow down the choice among NAR techniques, and choose the correct strategy according to the various scenarios, and particularly the BR technique and skin envelope. Conclusions No single NAR technique provides definitive results, which is why we believe there is no “end-all be-all solution”. NAR must be approached as a case-by-case situation. Furthermore, despite NAR being such a widely discussed topic in scientific literature, we still found a lack of clinical trials to allow for more thorough recommendations to be elaborated. Level of Evidence III This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266

scholarly journals Systematic Review and Expert Consensus on the Use of Orthoses (Splints and Casts) with Adults and Children after Burn Injury to Determine Practice Guidelines

2019 ◽  
Vol 41 (3) ◽  
pp. 503-534
Author(s):  
Ingrid S Parry ◽  
Jeffrey C Schneider ◽  
Miranda Yelvington ◽  
Patricia Sharp ◽  
Michael Serghiou ◽  
...  
Keyword(s):  
Systematic Review ◽  
Practice Guidelines ◽  
Practice Guideline ◽  
Burn Injury ◽  
Expert Consensus ◽  
Evidence Based ◽  
Level Of Evidence ◽  
Rehabilitation Professionals ◽  
Adults And Children ◽  
Based Medicine

Abstract The objective of this review was to systematically evaluate the available literature addressing the use of orthoses (splints and casts) with adult and pediatric burn survivors and determine whether practice guidelines could be proposed. This review provides evidence-based recommendations specifically for rehabilitation professionals who are responsible for burn survivor rehabilitation. A summary recommendation was made after the literature was retrieved using a systematic review and critical appraisal by multiple authors. The level of evidence of the literature was determined in accordance with the Oxford Centre for Evidence-based Medicine criteria. Due to the low level of evidence in the available literature, only one practice guideline could be recommended: orthotic use should be considered as a treatment choice for improving range of motion or reducing contracture in adults who have sustained a burn injury. To address the rehabilitation-specific gaps found in the literature regarding orthotic use in burn rehabilitation and provide guidance to clinicians, a formal expert consensus exercise was conducted as a final step to the project. The resultant manuscript provides a summary of the literature regarding orthotic use with burn patients, one practice guideline, proposed orthotic terminology and additional practice recommendations based on expert opinion. The limitations in the current literature are also discussed, and suggestions are made for future studies in the area of orthotic use after burn injury.

scholarly journals Role of Fascial Connectivity in Musculoskeletal Dysfunctions: A Narrative Review

2020 ◽  
Author(s):  
M.S. Ajimsha ◽  
Pramod D. Shenoy ◽  
Neeraj Gampawar
Keyword(s):  
Physical Therapists ◽  
Narrative Review ◽  
Evidence Based ◽  
Level Of Evidence ◽  
Field Methods ◽  
Depth Analysis ◽  
Muscle Fascia ◽  
Therapy Services ◽  
Specific Muscle ◽  
Based Medicine

Introduction: Musculoskeletal dysfunctions happen to be the most common reason for referral to physiotherapy and manual therapy services. Therapists may use several articular and/or soft tissue concepts/approaches to evaluate and treat such dysfunctions that may include integration of myofascial system. Despite the research in this area spanning more than three decades, the role played by fascia has not received its duly deserved attention, owing to the lack of definitive research evidence. The concept of ‘fascial connectivity’ evolved two decades ago from a simple anatomical hypothesis called ‘myofascial meridians’. Since then it has been widely researched, as conceptually it makes more sense for functional movements than ‘single-muscle’ theory. Researchers have been exploring its existence and role in musculoskeletal dysfunctions and clinicians continue to practice based on anecdotal evidence. This narrative review attempts to gather available evidence, in order to support and facilitate further research that can enhance evidence based practice in this field. Methods: A search of most major databases was conducted with relevant keywords that yielded 272 articles as of December 2019. Thirty five articles were included for final review with level of evidence ranging from 3b to 2a (as per Center of Evidence Based Medicine’s scoring). Results: Findings from cadaveric, animal and human studies supports the claim of fascial connectivity to neighboring structures in the course of specific muscle-fascia chains that may have significant clinical implications. Current research (level 2) supports the existence of certain myofascial connections and their potential role in the manifestation of musculoskeletal dysfunctions and their treatment. Conclusion: Although these reviews and trials yield positive evidence for the objective reality/existence of fascial connectivity and continuity, several aspects need further exploration and in-depth analysis, which could not be evidenced entirely in this review. Manual and physical therapists may utilize the concept of fascial connectivity as a convincing justification to deal with clinical problems, but need to remain vigilant that functional implications are still being investigated.

scholarly journals Relationship between Journal Impact Factor and Levels of Evidence in Anaesthesia

2005 ◽  
Vol 33 (5) ◽  
pp. 567-570 ◽  
Author(s):  
C. R. Bain ◽  
P. S. Myles
Keyword(s):  
Impact Factor ◽  
Evidence Based Medicine ◽  
Citation Rate ◽  
Journal Ranking ◽  
Evidence Based ◽  
Publication Type ◽  
Level Of Evidence ◽  
Level 1 ◽  
Number Of Publications ◽  
Based Medicine

Evidence-based medicine uses a hierarchy of publication types according to their vulnerability to bias. A widely used measure of journal “quality” is its impact factor, which describes the citation rate of its publications. We investigated the relationship between impact factor for eight anaesthesia journals and publication type with respect to their level of evidence 1-4 using Spearman rank correlation (rho). There were 1418 original publications during 2001 included in the analysis. The number (%) of publication types according to evidence-based medicine level were: level 1: 6 (0.4%), level 2: 533 (38%) level 3: 329 (23%), level 4: 550 (39%). There was no correlation between journal ranking according to impact factor and publication type (rho=–0.03, P=0.25). The correlation between journal rank and the proportion of publications that were randomized trials was –0.35 (P<0.001). The correlation between journal rank and number of publications was 0.65 (P<0.001). The correlation between journal rank and number of level 1 or 2 studies was 0.58 (P<0.001). The overall level of evidence published in anaesthesia journals was high. Journal rank according to impact factor is related to the number of publications, but not the proportion of publications that are evidence-based medicine level 1 or 2.

Use of Statins in COVID-19 Treatment: Multiple Pathways but Minimal Evidence

2020 ◽  
Author(s):  
Adeleye JO
Keyword(s):  
Retrospective Study ◽  
Severe Acute Respiratory Syndrome ◽  
Evidence Base ◽  
Evidence Based ◽  
Specific Therapy ◽  
Level Of Evidence ◽  
New Era ◽  
Antiviral Effects ◽  
Based Medicine ◽  
Minimal Evidence

Coronavirus disease-2019(COVID-19) is an emerging viral infection of public importance and it is caused by a beta coronavirus called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). So far, it has affected about 15 million individuals and over 600 000 patients have died from it. The virus is novel and there is no approved specific therapy for the infection. This has led to the trial of different drugs to reduce the morbidity and mortality of the infection. Statins are primarily used to lower cholesterol. They also have other pleiotropic effects such as anti-inflammatory, anti-thrombotic, immunomodulatory and antiviral effects. Coincidentally, the processes that statins antagonize are the mechanisms underlying the pathogenesis of COVID-19. Therefore, it has been suggested that statins should be considered as an adjunct in the treatment of COVID-19. In the new era of evidence-based medicine, there is a need to examine the level of evidence available to support the clinically beneficial effect of statins in COVID-19 treatment. This literature review explores the strength and volume of evidence for the usage of statins in COVID-19. However, as at the time of writing this review, the evidence base is very scanty. The most quoted evidence available is a retrospective study which is a low level of evidence. Therefore, it can be concluded that there are various mechanisms identified by which statins could be useful in the treatment of COVID-19. However, the evidence for their recommendation as adjuncts for COVID-19 treatment is very weak.

Acquired Bilateral Laryngeal Paralysis Associated with Systemic Lupus Erythematosus in a Dog

2012 ◽  
Vol 48 (1) ◽  
pp. 60-65 ◽  
Author(s):  
Heather Kvitko-White ◽  
Kelley Balog ◽  
J. Catharine Scott-Moncrieff ◽  
Anthony Johnson ◽  
Gary C. Lantz
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Physical Examination ◽  
Lupus Erythematosus ◽  
Supportive Treatment ◽  
Systemic Lupus ◽  
Laryngeal Function ◽  
Laryngeal Paralysis ◽  
Biochemical Testing ◽  
Laryngeal Examination

A 4 yr old spayed female Labrador retriever was referred for acute respiratory distress and was found to have bilateral laryngeal paralysis. Physical examination and biochemical testing were consistent with systemic lupus erythematosus (SLE) and did not reveal a likely alternative cause for the laryngeal paralysis. Following immunosuppressive and supportive treatment, the dog regained normal laryngeal function. At a scheduled follow-up examination 6 wk later, normal laryngeal function was confirmed via sedated laryngeal examination. Laryngeal paralysis associated with SLE has been reported in humans, but this is the first known report of acquired laryngeal paralysis associated with SLE in the dog.

PP48 Risk Of Bias Of Systematic Reviews Connected To Journal Impact Factor?

2019 ◽  
Vol 35 (S1) ◽  
pp. 46-46
Author(s):  
Vanesa Huertas Carrera ◽  
Gill Worthy ◽  
Joseph Kleijnen
Keyword(s):  
Impact Factor ◽  
Systematic Reviews ◽  
Citation Index ◽  
Risk Of Bias ◽  
Evidence Based ◽  
Simple Linear Regression ◽  
Potential Association ◽  
Based Medicine ◽  
Journal Impact ◽  
Publishing Journal

IntroductionSystematic reviews (SRs) are today's cornerstone of evidence-based medicine. However, their risk of bias (ROB) may critically impact their findings. Hence, an impartial assessment of their ROB is paramount to their interpretation. The objective of this study is to evaluate the potential association between the results of the ROB assessment for a series of SRs and their corresponding journal's impact factor as determined by the citation reports.MethodsA sample of over 500 SRs and their corresponding ROB will be employed in this study. The source for these data will be the database KSR Evidence. The corresponding impact factor (IF) for the publishing journal as reported by the Science Citation Index will also be retrieved. The total of ROBIS signaling questions answered as ‘yes’ or ‘probably yes’ will be used to approximate the awarded quality (Quality) for each systematic review. An analysis of the potential correlation between Quality and the IF will be performed with a simple linear regression.ResultsResults will be presented in tables and figures. Preliminary results confirm that a statistically significant association between the suggested variables exists, though this is of low magnitude.ConclusionsFindings confirm that the ROB of an SR and the IF of the publishing journal are correlated.

scholarly journals Proposal for a 4-type Classification of Acne: An Evidence-Based Review of the Literature

2020 ◽  
Vol 14 (1) ◽  
pp. 38-43
Author(s):  
O. Prapapan ◽  
C. C. Chatchavarn ◽  
P. Suvanprakorn ◽  
H. A. M. Neumann ◽  
R. Knobler ◽  
...  
Keyword(s):  
Acne Vulgaris ◽  
Risk Of Bias ◽  
Evidence Based ◽  
Review Of The Literature ◽  
Medical Practitioners ◽  
Acne Treatment ◽  
Evidence Based Guideline ◽  
Based Medicine ◽  
Type Classification

Background: Proper evidence-based classification and grading of a disease such as acne are important in guiding medical practitioners to properly diagnose diseases and treat patients. Objective: This is a review of the present classification of acne in order to delineate modified approaches of acne treatment. Methods: The available literature was reviewed, including searches from 7 databases based on the terms “classification of acne vulgaris and pathophysiology”, according to evidence-based medicine using the Cochrane risk of bias tool. Results: From a total of 10,121 studies on acne classification, 51 full-text articles were assessed and 13 studies were included after screening for acne classification. Conclusion: The European-evidence-based guideline (EDF) classification fits best. We propose a modified classification in 4 categories to improve the management of each stage of acne.

scholarly journals Treating psychiatric symptoms and disorders with non-psychotropic medications

2019 ◽  
Vol 21 (2) ◽  
pp. 193-201
Keyword(s):  
Internal Medicine ◽  
Psychotropic Drugs ◽  
Psychiatric Symptoms ◽  
Neuropsychiatric Disorders ◽  
Psychotropic Medications ◽  
Point Of View ◽  
Evidence Based ◽  
Sufficient Data ◽  
Level Of Evidence ◽  
Based Medicine

A few drugs prescribed in internal medicine, ie, non-psychotropic drugs, can be used to treat certain neuropsychiatric disorders. For most of these situations, the level of evidence remains low. But when sufficient data becomes available, these molecules are then included in official guidelines for the treatment of neuropsychiatric disorders. In this article we review interesting drugs which may be relevant from an evidence-based medicine point of view, and could become part of psychiatric practice in the future.

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