scholarly journals Performance of Existing Definitions and Tests for the Diagnosis of Invasive Fungal Diseases other than Invasive Candidiasis and Invasive Aspergillosis in Critically Ill, Adult Patients: A Systematic Review with Qualitative Evidence Synthesis

2021 ◽  
Vol 7 (3) ◽  
pp. 176
Author(s):  
Daniele Giacobbe ◽  
Andrea Cortegiani ◽  
Ilias Karaiskos ◽  
Toine Mercier ◽  
Sofia Tejada ◽  
...  
Keyword(s):  
At Risk ◽  
Invasive Aspergillosis ◽  
Critically Ill ◽  
Systematic Reviews ◽  
Invasive Candidiasis ◽  
Fungal Diseases ◽  
Adult Patients ◽  
Qualitative Evidence Synthesis ◽  
Invasive Fungal Diseases ◽  
Populations At Risk

The Fungal Infections Definitions in Intensive Care Unit (ICU) patients (FUNDICU) project aims to provide standard sets of definitions for invasive fungal diseases (IFDs) in critically ill, adult patients, including invasive aspergillosis (IA), invasive candidiasis (IC), Pneumocystis jirovecii pneumonia (PJP), and other non-IA, non-IC IFDs. The first step of the project was the conduction of separated systematic reviews of the characteristics and applicability to critically ill, adult patients outside classical populations at risk (hematology patients, solid organ transplant recipients) of available definitions and diagnostic tests for IFDs. We report here the results of two systematic reviews exploring the performance of available definitions and tests, for PJP and for other non-IA, non-IC IFDs. Starting from 2585 and 4584 records for PJP and other IFDs, respectively, 89 and 61 studies were deemed as eligible for full-text evaluation. However, only two studies for PJP and no studies for other IFDs met the FUNDICU protocol criteria for inclusion in qualitative synthesis. Currently, there is no sufficient solid data for directly evaluating the performance of existing definitions and laboratory tests for the diagnosis of PJP and other non-IA, non-IC IFDs in critically ill adult patients outside classical populations at risk.

scholarly journals Interactive social media interventions to promote health equity: an overview of reviews

2016 ◽  
Vol 36 (4) ◽  
pp. 63-75 ◽  
Author(s):  
V. Welch ◽  
J. Petkovic ◽  
J. Pardo Pardo ◽  
T. Rader ◽  
P. Tugwell
Keyword(s):  
At Risk ◽  
Social Networks ◽  
Social Media ◽  
Socioeconomic Status ◽  
Health Outcomes ◽  
Health Equity ◽  
Systematic Reviews ◽  
Low Socioeconomic Status ◽  
Populations At Risk ◽  
Media Interventions

Introduction Social media use has been increasing in public health and health promotion because it can remove geographic and physical access barriers. However, these interventions also have the potential to increase health inequities for people who do not have access to or do not use social media. In this paper, we aim to assess the effects of interactive social media interventions on health outcomes, behaviour change and health equity. Methods We conducted a rapid response overview of systematic reviews. We used a sensitive search strategy to identify systematic reviews and included those that focussed on interventions allowing two-way interaction such as discussion forums, social networks (e.g. Facebook and Twitter), blogging, applications linked to online communities and media sharing. Results Eleven systematic reviews met our inclusion criteria. Most interventions addressed by the reviews included online discussion boards or similar strategies, either as stand-alone interventions or in combination with other interventions. Seven reviews reported mixed effects on health outcomes and healthy behaviours. We did not find disaggregated analyses across characteristics associated with disadvantage, such as lower socioeconomic status or age. However, some targeted studies reported that social media interventions were effective in specific populations in terms of age, socioeconomic status, ethnicities and place of residence. Four reviews reported qualitative benefits such as satisfaction, finding information and improved social support. Conclusion Social media interventions were effective in certain populations at risk for disadvantage (youth, older adults, low socioeconomic status, rural), which indicates that these interventions may be effective for promoting health equity. However, confirmation of effectiveness would require further study. Several reviews raised the issue of acceptability of social media interventions. Only four studies reported on the level of intervention use and all of these reported low use. More research on established social media platforms with existing social networks is needed, particularly in populations at risk for disadvantage, to assess effects on health outcomes and health equity.

Effect of stem cell injections on osteoarthritis-related structural outcomes - a systematic review

2020 ◽  
pp. jrheum.200021
Author(s):  
Jennifer Gong ◽  
Jessica Fairley ◽  
Flavia M. Cicuttini ◽  
Sultana Monira Hussain ◽  
Rakhi Vashishtha ◽  
...  
Keyword(s):  
Systematic Review ◽  
At Risk ◽  
Bone Marrow ◽  
Adipose Tissue ◽  
Stem Cell ◽  
Subchondral Bone ◽  
Evidence Synthesis ◽  
Qualitative Evidence Synthesis ◽  
Mesh Terms ◽  
Populations At Risk

Objective To systematically review the evidence for the efficacy of mesenchymal stem cell (MSC) injections in improving osteoarthritis-related structural outcomes. Methods Ovid Medline and EMBASE were searched from their inception to April 2020 using MeSH terms and key words. Independent reviewers extracted data and assessed methodological quality. Qualitative evidence synthesis was performed due to the heterogeneity in interventions and outcome measures. Results Thirteen randomised controlled trials (phase I or II) were identified, 10 in osteoarthritis populations and three in populations at risk of osteoarthritis, with low (n=9), moderate (n=3) or high (n=1) risk of bias. Seven studies used allogeneic MSCs (bone marrow 4; umbilical cord 1; placenta 1; adipose tissue 1), six studies used autologous MSCs (adipose tissue 3; bone marrow 2; peripheral blood 1). Among the 11 studies examining cartilage outcomes, 10 studies showed a benefit of MSCs on cartilage volume, morphology, quality, regeneration and repair assessed by magnetic resonance imaging, arthroscopy, or histology. The evidence for subchondral bone was consistent with all three studies in populations at risk of osteoarthritis showing beneficial effects. Sixteen unpublished, eligible trials were identified by searching trial registries, eight with actual or estimated completion date before 2016. Conclusion This systematic review of early phase clinical trials showed consistent evidence for a beneficial effect of intra-articular MSC injections on articular cartilage and subchondral bone. Due to the heterogeneity of MSCs, modest sample sizes, methodological limitations, and potential for publication bias, further work is needed before this therapy is recommended in the management of osteoarthritis.

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