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Hepatobiliary & Pancreatic Diseases... Dec 2023Post-hepatectomy liver failure (PHLF) is a leading cause of postoperative mortality after liver surgery. Due to its significant impact, it is imperative to understand... (Review)
Review
BACKGROUND
Post-hepatectomy liver failure (PHLF) is a leading cause of postoperative mortality after liver surgery. Due to its significant impact, it is imperative to understand the risk stratification and preventative strategies for PHLF. The main objective of this review is to highlight the role of these strategies in a timeline centered way around curative resection.
DATA SOURCES
This review includes studies on both humans and animals, where they addressed PHLF. A literature search was conducted across the Cochrane Library, Embase, MEDLINE/PubMed, and Web of Knowledge electronic databases for English language studies published between July 1997 and June 2020. Studies presented in other languages were equally considered. The quality of included publications was assessed using Downs and Black's checklist. The results were presented in qualitative summaries owing to the lack of studies qualifying for quantitative analysis.
RESULTS
This systematic review with 245 studies, provides insight into the current prediction, prevention, diagnosis, and management options for PHLF. This review highlighted that liver volume manipulation is the most frequently studied preventive measure against PHLF in clinical practice, with modest improvement in the treatment strategies over the past decade.
CONCLUSIONS
Remnant liver volume manipulation is the most consistent preventive measure against PHLF.
Topics: Humans; Hepatectomy; Liver Neoplasms; Liver Failure; Liver Function Tests; Postoperative Complications; Retrospective Studies
PubMed: 36973111
DOI: 10.1016/j.hbpd.2023.03.001 -
Journal of Gastrointestinal Surgery :... Nov 2023This systematic review explored different medications and methods for prevention and treatment of pouchitis after restorative proctocolectomy with ileal pouch-anal... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
This systematic review explored different medications and methods for prevention and treatment of pouchitis after restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA).
METHODS
PubMed, Scopus, and Web of Science were searched for randomized clinical trials that assessed prevention or treatment of pouchitis. The systematic review was reported in line with updated 2020 PRISMA guidelines. Risk of bias in the trials included was assessed using the ROB-2 tool and certainty of evidence was assessed using GRADE. The main outcomes were the incidence of new pouchitis episodes in the preventative studies and resolution or improvement of active pouchitis in the treatment studies.
RESULTS
Fifteen randomized trials were included. A meta-analysis of 7 trials on probiotics revealed significantly lower odds of pouchitis with the use of probiotics (RR: 0.26, 95% CI: 0.16-0.42, I = 20%, p < 0.001) and similar odds of adverse effects to placebo (RR: 2.43, 95% CI: 0.11-55.9, I = 0, p = 0.579). One trial investigated the prophylactic role of allopurinol in preventing pouchitis and found a comparable incidence of pouchitis in the two groups (31% vs 28%; p = 0.73). Seven trials assessed different treatments for active pouchitis. One recorded the resolution of pouchitis in all patients treated with ciprofloxacin versus 67% treated with metronidazole. Both budesonide enema and oral metronidazole were associated with similar significant improvement in pouchitis (58.3% vs 50%, p = 0.67). Rifaximin, adalimumab, fecal microbiota transplantation, and bismuth carbomer foam enema were not effective in treating pouchitis.
CONCLUSIONS
Probiotics are effective in preventing pouchitis after IPAA. Antibiotics, including ciprofloxacin and metronidazole, are likely effective in treating active pouchitis.
Topics: Humans; Pouchitis; Metronidazole; Colitis, Ulcerative; Randomized Controlled Trials as Topic; Proctocolectomy, Restorative; Ciprofloxacin; Anastomosis, Surgical
PubMed: 37815701
DOI: 10.1007/s11605-023-05841-3 -
Dental and Medical Problems 2023White spot lesions (WSLs) are one of the most common adverse effects following comprehensive fixed orthodontic treatment. The purpose of this review was to evaluate... (Review)
Review
White spot lesions (WSLs) are one of the most common adverse effects following comprehensive fixed orthodontic treatment. The purpose of this review was to evaluate recent studies addressing the prevention and treatment of these lesions. Electronic databases were searched for English-written studies published between 2015 and October 2020 involving randomized clinical trials aiming at prevention or treatment of orthodontically induced WSLs using the following keywords in their title or abstracts: randomized clinical trial OR randomized controlled trial AND white spot OR caries OR demineralization OR decalcification OR remineralization. From the 23 papers which met the inclusion criteria, 11 were on preventive methods, while 12 addressed treatment protocols. However, most of the reviewed studies had a high risk of bias. The results of this review strongly support the importance of oral hygiene observation in preventing WSLs. Sodium fluoride varnish 5% was confirmed to be effective in the treatment of these lesions, as well as in the prevention of WSLs in patients with suboptimal oral hygiene. In addition, immediate CO2 laser irradiation after bonding can effectively prohibit formation of WSLs during orthodontic treatment. The literature also illustrates a promising masking effect of resin infiltration for the treatment of WSLs. However, little scientific evidence supports the effectiveness of Casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) against WSLs, although more clinical trials with long-term follow-up are needed. Oral hygiene maintenance is crucial in the prevention of WSLs, and 5% sodium fluoride varnish and CO2 laser irradiation are recommended in patients with compromised oral hygiene. In the case of WSL formation, fluoride varnish and resin infiltration are effective treatment modalities.
Topics: Humans; Cariostatic Agents; Fluorides, Topical; Tooth Remineralization; Dental Caries; Sodium; Randomized Controlled Trials as Topic
PubMed: 37815515
DOI: 10.17219/dmp/140964 -
International Journal of Environmental... Jul 2021Given the extent of workaholism identified in the literature, it seems essential to consider effective preventive measures. The purpose of this article is to summarize... (Review)
Review
INTRODUCTION
Given the extent of workaholism identified in the literature, it seems essential to consider effective preventive measures. The purpose of this article is to summarize literature data on possible collective and individual preventive measures against workaholism, especially in occupational medicine.
METHOD
We conducted a systematic literature review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
RESULTS
155 articles were retrieved in March 2019, but only 15 well-designed studies providing concrete measures to prevent workaholism were included. The various measures were classified using the traditional distinction between three levels of prevention. At the first level of prevention, workaholism can be avoided by implementing a protective organizational culture. The second level of prevention rather focuses on individual training and counselling to address the negative consequences of workaholism. Finally, the third level of prevention combines cognitive and behavioral interventions that enable professional and social reintegration of workaholics.
DISCUSSION
This literature review confirms the multifactorial origin of workaholism and the involvement of organizational factors, supporting the necessary contribution of companies in its prevention. This review also reinforces the growing perception of workaholism as a behavioral addiction. Occupational physicians play a key role in this preventive approach as they can influence both working conditions and individual care. The highlighted preventive measures seem to be not only favorable to workaholics, but also to companies.
CONCLUSION
This review provides field tools that can be used at the various levels of workaholism prevention. Nevertheless, intervention studies are required to confirm the effectiveness of the measures presented.
Topics: Behavior, Addictive; Occupational Medicine; Occupations
PubMed: 34281048
DOI: 10.3390/ijerph18137109 -
Journal of Gastroenterology Aug 2022This meta-analysis aimed to compare the incidence of gallstone formation, subsequent biliary disease and the need for cholecystectomy in untreated patients and patients... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
This meta-analysis aimed to compare the incidence of gallstone formation, subsequent biliary disease and the need for cholecystectomy in untreated patients and patients treated with ursodeoxycholic acid (UDCA) following bariatric surgery.
METHODS
Randomized controlled trials (RCTs) comparing UDCA and controls for the prevention of gallstone formation after bariatric surgery published until February 2022 were selected and subjected to a systematic review and meta-analysis. Articles were searched in the MEDLINE, Web of Science and Cochrane Trials Register databases. Meta-analysis was performed with Review Manager 5.0.
RESULTS
Eleven randomized controlled studies were included, with a total of 2363 randomized patients and 2217 patients analysed in the UDCA group versus 1415 randomized patients and 1257 patients analysed in the control group. Considering analysed patients, prophylactic use of UDCA was significantly associated with decreased (i) gallstone formation (OR = 0.25, 95% CI = 0.21-0.31), (ii) symptomatic gallstone disease (GD) (OR = 0.29, 95% CI = 0.20-0.42) and consequently (iii) cholecystectomy rate (OR = 0.33, 95% CI = 0.20-0.55). The results were similar in ITT analysis, in the subgroup of patients undergoing sleeve gastrectomy or considering only randomized versus placebo studies.
CONCLUSIONS
Prophylactic use of UDCA after bariatric surgery prevents both gallstone formation and symptomatic GD and reduces the need for cholecystectomy.
Topics: Bariatric Surgery; Cholecystectomy; Gallstones; Humans; Obesity, Morbid; Randomized Controlled Trials as Topic; Ursodeoxycholic Acid
PubMed: 35704084
DOI: 10.1007/s00535-022-01886-4 -
Vaccine Nov 2023Tick-borne encephalitis (TBE) is an infectious disease caused by the tick-borne encephalitis virus (TBEV) in patients with symptoms of central nervous system (CNS)... (Review)
Review
BACKGROUND
Tick-borne encephalitis (TBE) is an infectious disease caused by the tick-borne encephalitis virus (TBEV) in patients with symptoms of central nervous system (CNS) inflammation. More than 25 European countries have one or more TBE-endemic areas. Although two TBE vaccines, FSME-IMMUN® and Encepur®, are commonly used in Europe, there are no published reviews of the real-world effectiveness of TBE vaccines in Europe or elsewhere.
METHODS
We searched PubMed for TBE vaccine effectiveness (VE) articles and extracted information on country, study design, study period, study population, number of TBEV-infected cases, number of participants, and VE against TBEV infection and outcomes.
RESULTS
We identified 13 studies, conducted in Austria, the Czech Republic, Latvia, Germany, and Switzerland, published in 2003-2023. One study was a cohort investigation of a milk-borne outbreak. In the other studies, 11 (91.7%) used the screening method and two (16.7%) used a case-control design (one study used both). TBE vaccines were highly effective (VE estimates >92%) against TBEV infection in all age groups. Vaccines were also highly protective against mild infections (i.e., infections in patients without symptoms of CNS inflammation), and against infections resulting in TBE and hospitalization. Vaccines were also highly protective against the most serious outcomes such as hospitalization greater than 12 days. Product-specific VE estimates were also high, though limited data were available. Studies in Austria, the Czech Republic, Latvia, and Switzerland estimated that TBE vaccines prevented >1,000 TBE cases a year, avoiding many hospitalizations and deaths, in these countries combined.
CONCLUSIONS
Published VE studies demonstrate a high real-world effectiveness of the commercially available TBE vaccines in Europe. Although cases averted have been estimated in only four countries, TBE vaccination prevents thousands of cases in Europe each year. To prevent life-threatening TBE, TBE vaccine uptake and compliance with the vaccination schedule should be increased in residents of, and travelers to, TBE-endemic countries in Europe.
Topics: Humans; Animals; Encephalitis, Tick-Borne; Viral Vaccines; Europe; Vaccination; Milk; Inflammation; Encephalitis Viruses, Tick-Borne
PubMed: 37858450
DOI: 10.1016/j.vaccine.2023.10.014 -
Acta Ophthalmologica Jun 2015Endophthalmitis is one of the most feared complications after cataract surgery. The aim of this systematic review was to evaluate the effect of intracameral and topical... (Meta-Analysis)
Meta-Analysis Review
Endophthalmitis is one of the most feared complications after cataract surgery. The aim of this systematic review was to evaluate the effect of intracameral and topical antibiotics on the prevention of endophthalmitis after cataract surgery. A systematic literature review in the MEDLINE, CINAHL, Cochrane Library and EMBASE databases revealed one randomized trial and 17 observational studies concerning the prophylactic effect of intracameral antibiotic administration on the rate of endophthalmitis after cataract surgery. The effect of topical antibiotics on endophthalmitis rate was reported by one randomized trial and one observational study. The quality and design of the included studies were analysed using the Cochrane risk of bias tool. The quality of the evidence was evaluated using the GRADE approach. We found high-to-moderate quality evidence for a marked reduction in the risk of endophthalmitis with the use of intracameral antibiotic administration of cefazolin, cefuroxime and moxifloxacin, whereas no effect was found with the use of topical antibiotics or intracameral vancomycin. Endophthalmitis occurred on average in one of 2855 surgeries when intracameral antibiotics were used compared to one of 485 surgeries when intracameral antibiotics were not used. The relative risk (95% CI) of endophthalmitis was reduced to 0.12 (0.08; 0.18) when intracameral antibiotics were used. The difference was highly significant (p < 0.00001). Intracameral antibiotic therapy is the best choice for preventing endophthalmitis after cataract surgery. We did not find evidence to conclude that topical antibiotic therapy prevents endophthalmitis.
Topics: Anterior Chamber; Anti-Bacterial Agents; Cataract Extraction; Endophthalmitis; Eye Infections, Bacterial; Humans; Postoperative Complications
PubMed: 25779209
DOI: 10.1111/aos.12684 -
Complementary Therapies in Medicine Jun 2019Echinacea preparations are commonly used to prevent and treat upper respiratory tract infection. (Meta-Analysis)
Meta-Analysis
BACKGROUND
Echinacea preparations are commonly used to prevent and treat upper respiratory tract infection.
OBJECTIVES
To assess current evidence for the safety and efficacy of echinacea containing preparations in preventing and treating upper respiratory tract infection.
DATA SOURCES
MEDLINE, EMBASE, CAB extracts, Web of Science, Cochrane DARE, clinicaltrials.gov and the WHO ICTRP - 1980 to present day.
ELIGIBILITY CRITERIA
Randomised double-blind placebo-controlled trials using an echinacea preparation to prevent or treat upper respiratory tract infections.
PARTICIPANTS AND INTERVENTIONS
Participants who are otherwise healthy of any age and sex. We considered any echinacea containing preparation.
STUDY APPRAISAL AND SYNTHESIS METHODS
We used the Cochrane collaborations tool for quality assessment of included studies and performed three meta-analyses; on the prevention, duration and safety of echinacea.
RESULTS
For the prevention of upper respiratory tract infection using echinacea we found a risk ratio of 0.78 [95% CI 0.68-0.88], for the treatment of upper respiratory tract infection using echinacea we found a mean difference in average duration of -0.45 [95% 1.85-0.94] days, finally for the safety meta-analyses we found a risk ratio of 1.09 [95% CI 0.95-1.25].
LIMITATIONS
The limitations of our review include the clinical heterogeneity - for example many different preparations were tested, the risk of selective reporting, deviations from our protocol and lack of contact with study authors.
CONCLUSIONS
Our review presents evidence that echinacea might have a preventative effect on the incidence of upper respiratory tract infections but whether this effect is clinically meaningful is debatable. We did not find any evidence for an effect on the duration of upper respiratory tract infections. Regarding the safety of echinacea no risk is apparent in the short term at least. The strength of these conclusions is limited by the risk of selective reporting and methodological heterogeneity.
IMPLICATIONS OF KEY FINDINGS
Based on the results of this review users of echinacea can be assured that echinacea preparations are safe to consume in the short term however they should not be confident that commercially available remedies are likely to shorten the duration or effectively prevent URTI. Researchers interested in the potential preventative effects of echinacea identified in this study should aim to increase the methodological strength of any further trials.
PROSPERO ID
CRD42018090783.
Topics: Double-Blind Method; Echinacea; Humans; Plant Extracts; Randomized Controlled Trials as Topic; Respiratory Tract Infections
PubMed: 31126553
DOI: 10.1016/j.ctim.2019.03.011 -
Injury Prevention : Journal of the... Jun 2015Drowning remains a leading cause of preventable death in children across the world. This systematic review identifies and critically analyses studies of interventions... (Review)
Review
INTRODUCTION
Drowning remains a leading cause of preventable death in children across the world. This systematic review identifies and critically analyses studies of interventions designed to reduce fatal and non-fatal drowning events among children and adolescents or reduce the injury severity incurred by such incidents.
METHODS
A systematic search was undertaken on literature published between 1980 and 2010 relating to interventions around fatal and non-fatal drowning prevention in children and adolescents 0-19 years of age. Search methods and protocols developed and used by the WHO Global Burden of Disease Injury Expert Group were applied.
RESULTS
Seven studies fulfilled the inclusion criteria. Interventions were categorised into three themes of Education, Swimming Lessons and Water Safety, and Pool Fencing. All are possible effective strategies to prevent children from drowning, particularly young children aged 2-4 years, but very little evidence exists for interventions to reduce drowning in older children and adolescents. There were methodological limitations associated with all studies, so results need to be interpreted in the context of these.
CONCLUSIONS
Relatively few studies employ rigorous methods and high levels of evidence to assess the impact of interventions designed to reduce drowning. Studies are also limited by lack of consistency in measured outcomes and drowning terminology. Further work is required to establish efficacy of interventions for older children and adolescents. There is a need for rigorous, well-designed studies that use consistent terminology to demonstrate effective prevention solutions.
Topics: Accident Prevention; Adolescent; Child; Child, Preschool; Drowning; Humans; Infant; Infant, Newborn; Risk Factors; Young Adult
PubMed: 25189166
DOI: 10.1136/injuryprev-2014-041216 -
Journal of Gynecology Obstetrics and... Mar 2022Background Hygiene measures are recommended to prevent toxoplasmosis during pregnancy, although screening for seroconversion in pregnant women currently are debated and... (Review)
Review
Background Hygiene measures are recommended to prevent toxoplasmosis during pregnancy, although screening for seroconversion in pregnant women currently are debated and practices vary among countries. Objectives The purpose of this systematic literature review was to assess the effectiveness of hygiene measures during pregnancy to prevent toxoplasmosis infection. Search Strategy We followed the standard MOOSE and PRISMA criteria when conducting this systematic review and reporting the results. Selection criteria A systematic literature search was conducted for studies focused on congenital toxoplasmosis prevention, toxoplasmosis prevention during pregnancy, toxoplasmosis prevention and hygiene measures, which were published between 1970 and August 2020, using the databases of PubMed, Scope Med, EMBASE, and the Cochrane library. Data collection and analysis Our literature search identified 3964 articles, 3757 were excluded after review of title or abstract and 67 studies were considered relevant to the subject. We reviewed risk factors for toxoplasmosis infection during pregnancy and for congenital toxoplasmosis, preventive measures for toxoplasmosis during pregnancy, including: dietary recommendations, pet care measures, environmental measures, knowledge of risk factors and ways to control toxoplasmosis infection, knowledge of risk factors for infection by health professionals, knowledge of primary prevention measures by pregnant women. Conclusion: Hygiene measures are effective and applicable primary prevention to reduce toxoplasmosis and avoid congenital toxoplasmosis and its consequences. Funding No.
Topics: Female; Humans; Hygiene; Pregnancy; Pregnancy Complications, Parasitic; Primary Prevention; Toxoplasmosis; Toxoplasmosis, Congenital
PubMed: 34979320
DOI: 10.1016/j.jogoh.2021.102300