scholarly journals Physical therapies for the conservative treatment of the trigger finger: a narrative review

2020 ◽  
Author(s):  
Paola Emilia Ferrara ◽  
Sefora Codazza ◽  
Giulio Maccauro ◽  
Gianfranco Zirio ◽  
Giorgio Ferriero ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Conservative Management ◽  
Literature Search ◽  
Treatment Protocol ◽  
Optimal Treatment ◽  
Trigger Finger ◽  
Cochrane Library ◽  
Sudden Release ◽  
Physical Therapies

Trigger finger (TF) disorder is a sudden release or locking of a finger during flexion or extension. Treatments for this disease are conservative and surgical, including NSAIDs, hand splints, corticosteroid injections, physical therapies and percutaneous or open surgery. However, the effectiveness about the optimal treatment of TF is still in lack of evidence. The aim of this study is to investigate the effectiveness of physical therapies as conservative treatment for trigger finger. A comprehensive literature search of the MEDLINE (via PubMed), Cochrane Library Databases and PEDro databases has been conducted without limits because few papers were published about this argument. The literature search identified four papers in PubMed. Two types of physical therapies were used in the conservative management of trigger finger: external shock wave therapy (ESWT) in three papers, and ultrasound therapy (UST) in one paper. ESWT is an effective and safe therapy for the conservative management of TF. It seems to reduce pain and trigger severity and to improve functional level and quality of life. UST has proven to be useful to prevent the recurrence of TF symptoms. Even if the results suggest the effectiveness of ESWT and UST for TF, future studies are necessary to understand the characteristics of the optimal treatment protocol for trigger finger.

Would integrating women's professional care of pelvic organ prolapse improve the symptoms and quality of life: an integrative literature review

2020 ◽  
Vol 28 (2) ◽  
pp. 119-133
Author(s):  
Nicola Davies ◽  
Teresa Burdett
Keyword(s):  
Quality Of Life ◽  
Pelvic Organ Prolapse ◽  
Conservative Treatment ◽  
Conservative Management ◽  
Integrated Approach ◽  
Pelvic Organ ◽  
Social Implications ◽  
Content Type ◽  
Practical Implications

PurposeIntegrated healthcare is a central tenant of the NHS Long Term Plan (NHS, 2019). NICE in 2019 published guidelines; advising the integration of multidisciplinary professionals which may lead to an improvement in conservative treatment methods of pelvic organ prolapse. Therefore, current literature on the conservative treatments for pelvic organ prolapse needs to be reviewed to ascertain if an integrated approach would improve the symptoms and quality of life for women.Design/methodology/approachA systematic review of the literature between 2013 and 2018 was implemented. Papers included were written in English, peer-reviewed and consisted of treatments of pelvic organ prolapse in women. Papers containing surgical interventions, postpartum participants, reviews, evaluations, guidelines, follow-up studies, focusing on cost effectiveness, sexual function were excluded.FindingsSeven studies in total were included, and two overarching themes were identified: quality of life after treatment and the effect of conservative treatment on pelvic organ prolapse symptoms. The literature suggested that integrating care had a more positive outcome on pelvic organ symptoms and quality of life.Research limitations/implicationsTo develop a robust enhanced model of care for conservative treatment of pelvic organ prolapse through more mixed method or qualitative research, that incorporates integrative treatment methods with collaboration from multidisciplinary professionals.Practical implicationsThe practical implications of integrating the conservative management of pelvic organ prolapse is the communication between the multidisciplinary team must be exceptional to ensure everyone understands and agrees the treatment that is being provided to patient. Also, effective teamwork is important to ensure the patient receives the best care with input from the correct disciplines. The multi-professional team will need to have regular meetings to discuss and implement care plans for patients that might prove difficult to schedule due to differing commitments and priorities. This must be overcome to insure a successful and effective integrated approach to pelvic organ prolapse is delivered.Social implicationsThe social implications of integrating the professional approach to women's care of pelvic organ prolapse involves reducing the severity of the symptoms therefore, increasing the quality of life. This may result in the reduction of surgical intervention due to the patient being satisfied with the conservative management. Through integrating the management of the prolapse the patient will receive an accessible individualised care plan pathway that focuses on treating or reducing the impact of the symptoms that are bothersome to the patient whilst managing patient expectations. Patients will also, be reassured by the number of multi-disciplinary professionals involved in their care.Originality/valueGlobal integration of conservative treatments and multidisciplinary-professionals specialising in pelvic organ prolapse and pelvic floor dysfunction is needed.

scholarly journals Opioids in Post-stroke Pain: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 11 ◽  
Author(s):  
Damiana Scuteri ◽  
Elisa Mantovani ◽  
Stefano Tamburin ◽  
Giorgio Sandrini ◽  
Maria Tiziana Corasaniti ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Dose Response ◽  
Analgesic Effect ◽  
Literature Search ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Post Stroke ◽  
Pain Syndromes

Background: Post-stroke pain is one of the most common sequelae of stroke, which stands among the leading causes of death and adult-acquired disability worldwide. The role and clinical efficacy of opioids in post-stroke pain syndromes is still debated.Objectives: Due to the important gap in knowledge on the management of post-stroke pain, this systematic review aimed at assessing the efficacy of opioids in post-stroke pain syndromes.Methods: A literature search was conducted on databases relevant for medical scientific literature, i.e. PubMed/MEDLINE, Scopus, Web of Science and Cochrane Library databases from databases inception until August 31st, 2020 for clinical trials assessing the effects of opioids and opioid antagonists on pain reduction and pain related symptoms in patients with post-stroke pain syndromes. Studies assessing the effects of other medications (e.g., tricyclic antidepressant, pregabalin) or non - pharmacological management strategies (e.g., neurostimulation techniques) were excluded. The selected studies have been subjected to examination of the risk of bias.Results: The literature search retrieved 83,435 results. After duplicates removal, 34,285 articles were title and abstract screened. 25 full texts were assessed and 8 articles were identified to be eligible for inclusion in the qualitative summary and narrative analysis, of which three were placebo-controlled and two were dose-response. Among placebo-controlled studies, two evaluated the analgesic effect of morphine and one assessed the effects of the opioid antagonist naloxone on patients with central post-stroke pain. With regard to dose-response studies, both were on patients with central post-stroke pain, one assessing the efficacy of levorphanol, and the other on naloxone. Seven out of eight included studies showed an overall slight analgesic effect of opioids, with less consistent effects on other pain-related symptoms (e.g., mood, quality of life). The randomized controlled trials were subjected to meta-analysis and rating of the quality of evidence for the two outcomes considered according to GRADE (Grading of Recommendations, Assessment, Development and Evaluations) system. The overall results are inconclusive because of the small number of studies and of patients.Conclusions: The limited number of the included studies and their heterogeneity in terms of study design do not support the efficacy of opioids in post-stroke pain and in pain-related outcomes. Large double-blind randomized clinical trials with objective assessment of pain and related symptoms are needed to further investigate this topic.

scholarly journals The impact of patient, intervention, comparison, outcome (PICO) as a search strategy tool on literature search quality: a systematic review

2018 ◽  
Vol 106 (4) ◽  
Author(s):  
Mette Brandt Eriksen ◽  
Tove Faber Frandsen
Keyword(s):  
Literature Search ◽  
Search Strategy ◽  
Information Science ◽  
Evaluation Research ◽  
Reading Program ◽  
Cochrane Library ◽  
Secondary Outcome ◽  
Medical Library ◽  
The Impact

Objective: This review aimed to determine if the use of the patient, intervention, comparison, outcome (PICO) model as a search strategy tool affects the quality of a literature search.Methods: A comprehensive literature search was conducted in PubMed, Embase, CINAHL, PsycINFO, Cochrane Library, Web of Science, Library and Information Science Abstracts (LISA), Scopus, and the National Library of Medicine (NLM) catalog up until January 9, 2017. Reference lists were scrutinized, and citation searches were performed on the included studies. The primary outcome was the quality of literature searches and the secondary outcome was time spent on the literature search when the PICO model was used as a search strategy tool, compared to the use of another conceptualizing tool or unguided searching.Results: A total of 2,163 records were identified, and after removal of duplicates and initial screening, 22 full-text articles were assessed. Of these, 19 studies were excluded and 3 studies were included, data were extracted, risk of bias was assessed, and a qualitative analysis was conducted. The included studies compared PICO to the PIC truncation or links to related articles in PubMed, PICOS, and sample, phenomenon of interest, design, evaluation, research type (SPIDER). One study compared PICO to unguided searching. Due to differences in intervention, no quantitative analysis was performed.Conclusions: Only few studies exist that assess the effect of the PICO model vis-a-vis other available models or even vis-a-vis the use of no model. Before implications for current practice can be drawn, well-designed studies are needed to evaluate the role of the tool used to devise a search strategy. This article has been approved for the Medical Library Association’s Independent Reading Program.

scholarly journals Reported Outcomes in Published Systematic Reviews of Interdisciplinary Pain Treatment: Protocol for a Systematic Overview (Preprint)

2020 ◽  
Author(s):  
Elena Dragioti ◽  
Huan-Ji Dong ◽  
Britt Larsson ◽  
Björn Gerdle
Keyword(s):  
Systematic Reviews ◽  
Gold Standard ◽  
Pain Treatment ◽  
Treatment Protocol ◽  
Cochrane Library ◽  
Measurement Tool ◽  
Systematic Overview ◽  
Interdisciplinary Pain Treatment ◽  
Meta Analyses

BACKGROUND Interdisciplinary pain treatment (IPT) is a complex intervention; its outcomes are very diverse, as are the methodologies for handling those outcomes. This diversity may hamper evidence-based decision making. Presently, there is no gold standard recommendation of how to select reported outcomes in published systematic reviews and meta-analyses to explicitly demonstrate the effectiveness of IPT. OBJECTIVE In this systematic overview, we aim to evaluate the reported outcome domains and measurements across published systematic reviews and meta-analyses and to identify any methods, considerations, and discussion regarding the handling of the chosen outcome domains and measurements. METHODS This article describes the protocol for a systematic overview of the outcomes reported in published systematic reviews and meta-analyses of randomized control trials for the effectiveness of IPT versus any control. To this end, we searched the PubMed, Cochrane Library, and Epistemonikos databases from inception to December 2019. Two independent investigators screened the titles, the abstracts of the identified records, and the full texts of the potentially eligible systematic reviews and meta-analyses, performed data extraction according to predefined forms, and rated the quality of the included systematic reviews and meta-analyses. The quality of the included systematic reviews and meta-analyses will be rated with AMSTAR (A MeaSurement Tool to Assess systematic Reviews) 2. Data will be analyzed descriptively and stratified by AMSTAR 2. RESULTS We introduced the rationale and design of a systematic overview to summarize and map the chosen IPT outcome domains and the methods of handling these outcomes reported in published systematic reviews and meta-analyses. As of December 2019, we collected 5229 systematic reviews, of which 147 (2.81%) were examined in-depth for eligibility. Topline results are anticipated by September 2020. CONCLUSIONS The results of this study will be published as soon as they are available. Our results will fill a gap in the related literature and will be used to inform the development of a set of recommendations that can be applied in systematic reviews and hopefully serve as a gold standard. INTERNATIONAL REGISTERED REPORT PRR1-10.2196/17795

scholarly journals Study of impact of surgical intervention (adenotonsillectomy) and conservative management on quality of life in patients with SDB

2018 ◽  
Vol 4 (2) ◽  
pp. 448
Author(s):  
Arshed Ali ◽  
Jasif Nisar ◽  
Ihsan Ali ◽  
Rauf Ahmad
Keyword(s):  
Quality Of Life ◽  
Conservative Treatment ◽  
Conservative Management ◽  
Pediatric Patients ◽  
Surgical Intervention ◽  
Diagnostic Methods ◽  
Before And After ◽  
The Impact

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">SDB is an important cause of morbidity in children. SDB has been associated with decreased quality of life (QOL). In this study, we tried to determine The impact of surgical intervention (adenotonsillectomy) and conservative management on quality of life in patients with SDB. </span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">A total of 112 pediatric patients were included with SDB, who visited our OPD. Diagnostic methods include history and physical examination, audiotaping or videotaping, pulse oximetry. OSA 18 questionnaire was used to assess the quality of life with conservative treatment (pre and post-treatment) and after surgical intervention-before and after adenoidectomy or adenotonsillectomy.  </span></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">We had 112 patients with majority being males 69 (61.60%) and females 43 (38.30%), majority of patients were in the age group of 5-7 yrs (49.10%). In 47 patients (who underwent adenotonsillectomy/tonsillectomy), OSA-18 questionnaire was used pre-operatively, at 2 and 6 months. OSA-18 when used pre-operatively showed majority of patients 33 (70.21%) having score &gt;80, and 14 (29.79%) patients having score between 60-80. No patient was below 60 score. Mean OSA-18 score pre-operatively was 84.15. OSA-18 score at 2 months and at 6 months were 30.06 and 26.40 respectively, which showed a lot of improvement in post-operative score and hence the post –operative quality of life. In 65 patients (conservative treatment) OSA-18 was used pre-conservative, at 2 and 6 months of treatment. OSA-18 when used before conservative treatment<strong> </strong>showed majority of patients 44 (67.6 9%) having score 60-80, and 21 (32.30%) patients having score between &gt;80. No patient was below 60 score. OSA-18 score at 2 months showed improvement in 69.23% patients (&lt;40), OSA-18 at 6 months showed recurrence in 12.33% patients. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">SDB substantially impact QOL in pediatric patients. QOL significantly improves following adenotonsillectomy. There is subset of patients 12.33% with SDB in whom there was recurrence of symptoms after conservative treatment. Thus showing that conservative management is inferior to surgical management in the treatment of SDB. SDB improved after an observation period. Thus, observation with close follow-up is another treatment option.</span></p><p> </p>

scholarly journals Reported Outcomes in Published Systematic Reviews of Interdisciplinary Pain Treatment: Protocol for a Systematic Overview

10.2196/17795 ◽  
2020 ◽  
Vol 9 (5) ◽  
pp. e17795 ◽  
Author(s):  
Elena Dragioti ◽  
Huan-Ji Dong ◽  
Britt Larsson ◽  
Björn Gerdle
Keyword(s):  
Systematic Reviews ◽  
Gold Standard ◽  
Pain Treatment ◽  
Treatment Protocol ◽  
Cochrane Library ◽  
Measurement Tool ◽  
Systematic Overview ◽  
Interdisciplinary Pain Treatment ◽  
Meta Analyses

Background Interdisciplinary pain treatment (IPT) is a complex intervention; its outcomes are very diverse, as are the methodologies for handling those outcomes. This diversity may hamper evidence-based decision making. Presently, there is no gold standard recommendation of how to select reported outcomes in published systematic reviews and meta-analyses to explicitly demonstrate the effectiveness of IPT. Objective In this systematic overview, we aim to evaluate the reported outcome domains and measurements across published systematic reviews and meta-analyses and to identify any methods, considerations, and discussion regarding the handling of the chosen outcome domains and measurements. Methods This article describes the protocol for a systematic overview of the outcomes reported in published systematic reviews and meta-analyses of randomized control trials for the effectiveness of IPT versus any control. To this end, we searched the PubMed, Cochrane Library, and Epistemonikos databases from inception to December 2019. Two independent investigators screened the titles, the abstracts of the identified records, and the full texts of the potentially eligible systematic reviews and meta-analyses, performed data extraction according to predefined forms, and rated the quality of the included systematic reviews and meta-analyses. The quality of the included systematic reviews and meta-analyses will be rated with AMSTAR (A MeaSurement Tool to Assess systematic Reviews) 2. Data will be analyzed descriptively and stratified by AMSTAR 2. Results We introduced the rationale and design of a systematic overview to summarize and map the chosen IPT outcome domains and the methods of handling these outcomes reported in published systematic reviews and meta-analyses. As of December 2019, we collected 5229 systematic reviews, of which 147 (2.81%) were examined in-depth for eligibility. Topline results are anticipated by September 2020. Conclusions The results of this study will be published as soon as they are available. Our results will fill a gap in the related literature and will be used to inform the development of a set of recommendations that can be applied in systematic reviews and hopefully serve as a gold standard. International Registered Report Identifier (IRRID) PRR1-10.2196/17795

scholarly journals Pre-menstrual Dysphoric Disorder: A Review

2019 ◽  
Vol 1 (1) ◽  
pp. 32-36 ◽  
Author(s):  
Dahuja Malvika ◽  
Agarwal Supriya
Keyword(s):  
Treatment Protocol ◽  
Premenstrual Dysphoric Disorder ◽  
Reproductive Age ◽  
Sexual History ◽  
Cochrane Library ◽  
Significant Implication ◽  
Women Of Reproductive Age ◽  
Indian Women ◽  
Reproductive Age Group

Introduction: Premenstrual dysphoric disorder (PMDD) is a distressing disorder amongst women of reproductive age group with significant implication in the productivity and quality of life of women who suffer from it. It is generally neglected as it is mostly undifferentiated from premenstrual symptoms—milder presentation of the same spectrum of problem but of lesser intensity and impairment. Objective: Here, in this article, we aim to highlight various studies and the research done on PMDD in the context of Indian women. Method: Reviewing the last 40 years’ database including Medline (PUBMED), Cochrane Library, EMBASE, Trip, Psych INFO, CINAHL, the Allied and Complementary Medicine Database (AMED), and the British Nursing Index. Results: PMDD is a troublesome disorder, often underdiagnosed. A thorough history including menstrual and sexual history, conducting a thorough physical examination, assessing the comorbidities, and finally using a proper and structured treatment protocol for managing the condition are recommended. Sertraline is the most widely studied drug which is found to be effective in PMDD.

Olfaction, pheromones and life

2013 ◽  
Vol 127 (12) ◽  
pp. 1156-1159 ◽  
Author(s):  
E E Hoskison
Keyword(s):  
Quality Of Life ◽  
Old Age ◽  
Human Evolution ◽  
Literature Search ◽  
Cochrane Library ◽  
The Cochrane Library

AbstractBackground:From an evolutionary standpoint, olfaction is one of the oldest senses, and one that affects all aspects of life. This review discusses the influence of olfaction and pheromones on life.Methods:A literature search was conducted using MEDLINE (1966–2012), Embase (1988–2012), The Cochrane Library (1993–2013) and Ovid (1966–2012).Results:Olfaction plays an important role in life, from infancy through to adulthood and declining health in old age. Culture, memories and emotions, which add to life's complexity and overall enjoyment, are also influenced by olfaction.Conclusion:Olfaction has a chronological influence on life, affecting all aspects from the cradle to the grave; it plays a role in the quality of life as a key ingredient of human evolution, survival and enjoyment.

scholarly journals A Comparison of Treatment Options for Carpal Boss: A Critically Appraised Topic

2021 ◽  
Vol 7 (2) ◽  
Author(s):  
Megan Collins ◽  
Matthew Rivera
Keyword(s):  
Conservative Treatment ◽  
Range Of Motion ◽  
Case Studies ◽  
Conservative Management ◽  
Surgical Intervention ◽  
Case Reports ◽  
Treatment Options ◽  
Surgical Interventions ◽  
Increased Risk

Context: Carpal bossing is a bony growth or mass that typically occurs at the 2nd or 3rd carpometacarpal joint. Carpal bossing is often overlooked placing the patient at an increased risk for pain or injury, such as osteoarthritis or inflammatory joint disease if left untreated. Individuals such as combat sport athletes who experience repetitive trauma to this area are at a high risk to develop carpal bossing. The literature suggests conservative or surgical interventions to manage symptoms. The goal of this systematic review is to synthesize the current literature for clinical knowledge and intervention outcomes for carpal bossing. Methods: A systematic search of the literature was performed across 3 electronic databases (Science Direct, PubMed, and EBSCOhost) to identify articles that investigated the effects of surgical intervention or conservative management for carpal bossing. A combination of the keywords and Boolean operators (Carpal Bossing, Carpal Boss, Surgical Intervention, Wedge Resection, Excision, Conservative Treatment, and Intervention) related to the research question were used. The search was restricted to full text, human studies (including cadaveric studies) research, and manuscripts available in English. Articles were included if they examined the effect of either conservative or surgical interventions for the treatment of carpal bossing. Articles were excluded from the review if the study did not examine carpal bossing treatment options or did not include pain, range of motion, strength, or functional measures of the hand and wrist. Two independent reviewers used the Joanna Briggs Institute Checklist for Case Reports and the Checklist for Case Studies to appraise the quality of the articles. A score of 50% was used to remove low-quality studies. The Strength of Recommendation Taxonomy (SORT) method was used to grade the evidence for the articles included. Results: After the initial search, 10 articles met the inclusion criteria, while 3 were eliminated due to low quality appraisal scores. The average scores for case reports and case studies were 5.5/7 or 7.5/9 respectively. There was a total of 58 participants across the 7 studies. Generally speaking, conservative treatment reduced average daily pain and patients were able to return to full participation within 2 weeks. Conversely, patients undergoing surgical intervention experienced episodic pain, including over the surgical incision, typically averaging 2/10 on the visual analog scale. Findings from the surgical intervention showed inconsistent measurements for wrist/hand strength and range of motion. There is level C evidence on the treatment for carpal bossing. Conclusion: The limited evidence suggests conservative management may reduce pain and improve clinical outcomes. However, clinicians should consider the level C evidence with skepticism as the quality of evidence on this topic is low. Further investigations should be performed with more rigor.

Quality of life and satisfaction in surgical versus conservative treatment of nonsyndromic children with craniosynostosis

2021 ◽  
pp. 1-6
Author(s):  
Nicholas Sader ◽  
Vivek Mehta ◽  
Shannon Hart ◽  
Lori Bliss ◽  
Hanna Moore ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Conservative Treatment ◽  
Conservative Management ◽  
Univariate Analysis ◽  
Treatment Decision ◽  
Summary Score ◽  
Physical Disorder ◽  
Cross Sectional ◽  
Conservative Group

OBJECTIVE Craniosynostosis represents the second most common reason for referral to pediatric neurosurgery. However, the quality of life and neurodevelopmental impact of leaving this physical disorder uncorrected is poorly understood. METHODS This multicenter cross-sectional study identified previously managed nonsyndromic infants (< 24 months of age) with single-suture craniosynostosis at both pediatric neurosurgical centers in Alberta, Canada. The primary variable of interest was the allocated treatment (surgical vs conservative). The primary outcome was the Pediatric Quality of Life Inventory (PedsQL), a validated measure of quality of life examining physical, emotional, social, and school functioning. Treatment decision satisfaction and the reasons for selected management were quantified and collected directly from caregivers. RESULTS One hundred fourteen children met the inclusion criteria: 78% underwent surgery and 22% had conservative treatment. The most common suture affected was sagittal (54%), followed by metopic (33%), coronal (10%), and lambdoid (3%). Caregivers most commonly opted for surgery because of severe appearance (80%). Seventy-six percent and 72% of the caregivers of children with conservative management did so due to concerns of surgical risks and mild appearance, respectively. There was a statistically significant relationship between both the parents’ (p < 0.001) and the surgeon’s (p = 0.001) impression of a severe head shape and surgical management. Parental satisfaction with their child’s appearance as well as satisfaction with their treatment decision did not differ between management types. Regarding quality of life, on univariate analysis, the conservative group had a statistically higher physical summary score (p = 0.01), psychosocial summary score (p = 0.004), and mean total scale score (p = 0.003) compared to the surgical group. However, after adjusting for severity and age at consult, no significant independent associations between management type and any of the PedsQL summary scores were found. CONCLUSIONS Alberta families have a high number of children with craniosynostosis treated with conservative management. Conservatively managed infants were largely minimally affected patients, particularly those with metopic synostosis. The study found no independent association between management type (surgery vs conservative) and quality of life when adjusted for important patient factors.

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