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Vaccines Jul 2023The neurological complications of coronavirus disease 2019 (COVID-19) infection and the side effects of vaccination include immune-mediated diseases of the central... (Review)
Review
BACKGROUND
The neurological complications of coronavirus disease 2019 (COVID-19) infection and the side effects of vaccination include immune-mediated diseases of the central nervous system (CNS) such as acute disseminated encephalomyelitis (ADEM). It is an acute-onset demyelinating disease that involves a rapid evolution and multifocal neurological deficits that develops following a viral or bacterial infection or, less frequently, following vaccination. Acute hemorrhagic leukoencephalitis (AHLE) is the hemorrhagic variant of ADEM that presents a more severe evolution which can be followed by coma and death. The objectives of this study consist in evaluating the diagnosis, clinical characteristics, imaging and laboratory features, evolution, and treatment of ADEM and AHLE following COVID-19 infection or vaccination.
METHODS
We performed a systematic review of the medical literature according to PRISMA guidelines that included ADEM cases published between 1 January 2020 and 30 November 2022 following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and vaccination and also included our own clinical experience regarding this pathology.
RESULTS
A total number of 74 patients were diagnosed with ADEM, 45 following COVID-19 infection and 29 after a SARS-CoV-2 vaccine. A total of 13 patients (17.33%) presented AHLE. The moderate form of COVID-19 presented a positive correlation with AHLE (r = 0.691, < 0.001). The existence of coma and AHLE was correlated with poor outcomes. The following more aggressive immunomodulatory therapies applied in severe cases were correlated with poor outcomes (major sequelae and death): therapeutic plasma exchange (TPE) treatment (r = 382, = 0.01) and combined therapy with corticosteroids and TPE (r = 0.337, = 0.03).
CONCLUSIONS
Vaccinations are essential to reduce the spread of the COVID-19 pandemic, and the monitoring of adverse events is an important part of the strategic fight against SARS-CoV-2. The general benefits and the overall good evolution outweigh the risks, and prompt diagnosis is associated with a better prognosis in these patients.
PubMed: 37515041
DOI: 10.3390/vaccines11071225 -
Reviews in Medical Virology May 2018We performed a systematic review on the neurological complications of chikungunya virus. Such complications are being reported increasingly, owing primarily to the scale... (Review)
Review
We performed a systematic review on the neurological complications of chikungunya virus. Such complications are being reported increasingly, owing primarily to the scale of recent epidemics but also to a growing understanding of the virus' neurovirulence. We performed a thorough literature search using PubMed and Scopus databases, summating the data on all published reports of neurological disease associated with chikungunya virus. We appraised the data for each major condition in adults, children, and neonates, as well as evaluating the latest evidence on disease pathogenesis and management strategies. The review provides a comprehensive summary for clinicians, public health officials, and researchers tackling the challenges associated with this important emerging pathogen.
Topics: Biomarkers; Chikungunya Fever; Chikungunya virus; Disease Management; Geography; Global Health; Humans; Nervous System Diseases; Symptom Assessment
PubMed: 29671914
DOI: 10.1002/rmv.1978 -
The Oncologist Feb 2020The Institute of Medicine recommends that survivorship care plans (SCPs) be included in cancer survivorship care. Our meta-analysis compares patient-reported outcomes... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The Institute of Medicine recommends that survivorship care plans (SCPs) be included in cancer survivorship care. Our meta-analysis compares patient-reported outcomes between SCP and no SCP (control) conditions for cancer survivors. Our systematic review examines the feasibility of implementing SCPs from survivors' and health care professionals' perspectives and the impact of SCPs on health care professionals' knowledge and survivorship care provision.
METHODS
We searched seven online databases (inception to April 22, 2018) for articles assessing SCP feasibility and health care professional outcomes. Randomized controlled trials comparing patient-reported outcomes for SCP recipients versus controls were eligible for the meta-analysis. We performed random-effects meta-analyses using pooled standardized mean differences for each patient-reported outcome.
RESULTS
Eight articles were eligible for the meta-analysis (n = 1,286 survivors) and 50 for the systematic review (n = 18,949 survivors; n = 3,739 health care professionals). There were no significant differences between SCP recipients and controls at 6 months postintervention on self-reported cancer and survivorship knowledge, physical functioning, satisfaction with information provision, or self-efficacy or at 12 months on anxiety, cancer-specific distress, depression, or satisfaction with follow-up care. SCPs appear to be acceptable and potentially improve survivors' adherence to medical recommendations and health care professionals' knowledge of survivorship care and late effects.
CONCLUSION
SCPs appear feasible but do not improve survivors' patient-reported outcomes. Research should ascertain whether this is due to SCP ineffectiveness, implementation issues, or inappropriate research design of comparative effectiveness studies.
IMPLICATIONS FOR PRACTICE
Several organizations recommend that cancer survivors receive a survivorship care plan (SCP) after their cancer treatment; however, the impact of SCPs on cancer survivors and health care professionals is unclear. This systematic review suggests that although SCPs appear to be feasible and may improve health care professionals' knowledge of late effects and survivorship care, there is no evidence that SCPs affect cancer survivors' patient-reported outcomes. In order to justify the ongoing implementation of SCPs, additional research should evaluate SCP implementation and the research design of comparative effectiveness studies. Discussion may also be needed regarding the possibility that SCPs are fundamentally ineffective.
Topics: Cancer Survivors; Humans; Neoplasms; Patient Care Planning; Survivors; Survivorship
PubMed: 32043786
DOI: 10.1634/theoncologist.2019-0184 -
PLoS Neglected Tropical Diseases Jul 2023Nocardia species can cause local or disseminated infection. Prompt diagnosis and appropriate treatment of nocardiosis are required, because it can cause significant... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Nocardia species can cause local or disseminated infection. Prompt diagnosis and appropriate treatment of nocardiosis are required, because it can cause significant morbidity and mortality. Knowledge of local species distribution and susceptibility patterns is important to appropriate empiric therapy. However, knowledge on the epidemiology and antimicrobial susceptibility profiles of clinical Nocardia species remains limited in China.
METHODS
The data of isolation of Nocardia species were collected from databases such as Pubmed, Web of Science, Embase as well as Chinese databases (CNKI, Wanfang and VIP). Meta-analysis was performed using RevMan 5.3 software. Random effect models were used and tested with Cochran's Q and I2 statistics taking into account the possibility of heterogeneity between studies.
RESULTS
In total, 791 Nocardia isolates were identified to 19 species levels among all the recruited studies. The most common species were N. farcinica (29.1%, 230/791), followed by N. cyriacigeorgica (25.3%, 200/791), N. brasiliensis (11.8%, 93/791) and N. otitidiscaviarum (7.8%, 62/791). N. farcinica and N. cyriacigeorgica were widely distributed, N. brasiliensis mainly prevalent in the south, N. otitidiscaviarum mainly distributed in the eastern coastal provinces of China. Totally, 70.4% (223/317) Nocardia were cultured from respiratory tract specimens, 16.4% (52/317) from extra-pulmonary specimens, and 13.3% (42/317) from disseminated infection. The proportion of susceptible isolates as follows: linezolid 99.5% (197/198), amikacin 96.0% (190/198), trimethoprim-sulfamethoxazole 92.9% (184/198), imipenem 64.7% (128/198). Susceptibility varied by species of Nocardia.
CONCLUSIONS
N. farcinica and N. cyriacigeorgica are the most frequently isolated species, which are widely distributed in China. Pulmonary nocardiosis is the most common type of infection. Trimethoprim-sulfamethoxazole can still be the preferred agent for initial Nocardia infection therapy due to the low resistance rate, linezolid and amikacin could be an alternative to treat nocardiosis or a choice in a combination regimen.
Topics: Humans; Nocardia; Anti-Bacterial Agents; Trimethoprim, Sulfamethoxazole Drug Combination; Linezolid; Amikacin; Microbial Sensitivity Tests; Drug Resistance, Bacterial; Nocardia Infections; China
PubMed: 37428800
DOI: 10.1371/journal.pntd.0011432 -
Implementation Science : IS Dec 2016Systematic reviews are important for decision makers. They offer many potential benefits but are often written in technical language, are too long, and do not contain... (Review)
Review
BACKGROUND
Systematic reviews are important for decision makers. They offer many potential benefits but are often written in technical language, are too long, and do not contain contextual details which make them hard to use for decision-making. There are many organizations that develop and disseminate derivative products, such as evidence summaries, from systematic reviews for different populations or subsets of decision makers. This systematic review aimed to (1) assess the effectiveness of evidence summaries on policymakers' use of the evidence and (2) identify the most effective summary components for increasing policymakers' use of the evidence. We present an overview of the available evidence on systematic review derivative products.
METHODS
We included studies of policymakers at all levels as well as health system managers. We included studies examining any type of "evidence summary," "policy brief," or other products derived from systematic reviews that presented evidence in a summarized form. The primary outcomes were the (1) use of systematic review summaries in decision-making (e.g., self-reported use of the evidence in policymaking and decision-making) and (2) policymakers' understanding, knowledge, and/or beliefs (e.g., changes in knowledge scores about the topic included in the summary). We also assessed perceived relevance, credibility, usefulness, understandability, and desirability (e.g., format) of the summaries.
RESULTS
Our database search combined with our gray literature search yielded 10,113 references after removal of duplicates. From these, 54 were reviewed in full text, and we included six studies (reported in seven papers) as well as protocols from two ongoing studies. Two studies assessed the use of evidence summaries in decision-making and found little to no difference in effect. There was also little to no difference in effect for knowledge, understanding or beliefs (four studies), and perceived usefulness or usability (three studies). Summary of findings tables and graded entry summaries were perceived as slightly easier to understand compared to complete systematic reviews. Two studies assessed formatting changes and found that for summary of findings tables, certain elements, such as reporting study event rates and absolute differences, were preferred as well as avoiding the use of footnotes.
CONCLUSIONS
Evidence summaries are likely easier to understand than complete systematic reviews. However, their ability to increase the use of systematic review evidence in policymaking is unclear.
TRIAL REGISTRATION
The protocol was published in the journal Systematic Reviews (2015;4:122).
Topics: Administrative Personnel; Health Policy; Humans; Policy Making; Review Literature as Topic
PubMed: 27938409
DOI: 10.1186/s13012-016-0530-3 -
Health Informatics Journal Sep 2017Tailored messages are those that specifically target individuals following an assessment of their unique characteristics. This systematic review assesses the evidence... (Review)
Review
Tailored messages are those that specifically target individuals following an assessment of their unique characteristics. This systematic review assesses the evidence regarding the effectiveness of tailoring within eHealth interventions aimed at chronic disease management. OVID Medline/Embase databases were searched for randomised control trials, controlled clinical, trials, before -after studies, and time series analyses from inception - May 2014. Objectively measured clinical processes/outcomes were considered. Twenty-two papers were eligible for inclusion: 6/22 used fully tailored messaging and 16/22 used partially tailored messages. Two studies isolated tailoring as the active component. The remainder compared intervention with standard care. In all, 12/16 studies measuring clinical processes and 2/6 studies reporting clinical outcomes showed improvements, regardless of target group. Study quality was low and design did not allow for identification of interventions' active component. Heterogeneity precluded meta-analysis. This review has demonstrated that there is a lack of evidence to suggest that tailoring within an eHealth context confers benefit over non-tailored eHealth interventions.
Topics: Humans; Individuation; Information Dissemination; Information Seeking Behavior; Physicians; Telemedicine
PubMed: 27229730
DOI: 10.1177/1460458216641479 -
JMIR Human Factors Jul 2022The rapid and widespread growth of mobile technologies in low- and middle-income countries can offer groundbreaking ways of disseminating public health interventions.... (Review)
Review
BACKGROUND
The rapid and widespread growth of mobile technologies in low- and middle-income countries can offer groundbreaking ways of disseminating public health interventions. However, gender-based inequalities present a challenge for women in accessing mobile technology. Research has shown that mobile health (mHealth) interventions can affect gender relations in both positive and negative ways; however, few mHealth programs use a gender-sensitive lens when designing, implementing, or analyzing programs.
OBJECTIVE
This systematic review aims to identify and summarize the findings of qualitative research studies that explore the impact of mHealth interventions on gender relations as a result of participating in such initiatives in low- and middle-income countries.
METHODS
We performed a systematic literature review to examine empirical evidence of changes in gender relations attributed to participation in an mHealth intervention in low- and middle-income countries. Peer-reviewed articles were included based on whether they evaluated an mHealth intervention and were published between 2013 and 2020. Articles using mHealth that solely targeted health workers, did not assess a specific intervention, used mobile technology for data collection only, or were formative or exploratory in nature were excluded. The search terms were entered into 4 key electronic databases-MEDLINE, EMBASE, PsycINFO, and Scopus-generating a comprehensive list of potentially relevant peer-reviewed articles. Thematic analysis was used to identify, analyze, and report the themes that emerged from our data.
RESULTS
Of the 578 full-text articles retrieved, 14 (2.4%) were eligible for inclusion in the study. None of the articles appraised gender from the outset. The articles uncovered findings on gender relations through the course of the intervention or postprogram evaluation. Most studies took place in sub-Saharan Africa, with the remainder in South and Southeast Asia. The articles focused on maternal and child health, HIV diagnosis and treatment, and reproductive health. This review found that mHealth programs could enhance spousal communication, foster emotional support between couples, improve women's self-efficacy and autonomy in seeking health information and services, and increase their involvement in health-related decision-making. Despite the positive impacts, some mHealth interventions had an adverse effect, reinforcing the digital divide, upholding men as gatekeepers of information and sole decision-makers, and exacerbating relationship problems.
CONCLUSIONS
These results suggest that given the rapid and persistent upscale of mHealth interventions in low- and middle-income settings, it is imperative to design interventions that consider their impact on power dynamics and gender relations. Future research is needed to fill the evidence gaps on gender and mHealth, acknowledging that women are not passive beneficiaries and that they need to actively participate and be empowered by mHealth interventions.
PubMed: 35862143
DOI: 10.2196/32330 -
Journal of Patient-centered Research... 2017Patient experience data is increasingly collected worldwide; however, questions persist regarding how it is used to improve health care quality. Synthesizing information... (Review)
Review
Patient experience data is increasingly collected worldwide; however, questions persist regarding how it is used to improve health care quality. Synthesizing information from the existing literature, we have developed an empirically based framework to help organizations and managers understand what to do with patient experience feedback to improve health care quality at the organizational level. We identified six post-data collection/analysis activities, which were categorized into three main themes: 1) make sense of the data, 2) communicate and explain the data, and 3) plan for improvement. Our framework suggests that simply executing a survey will not improve performance. It is necessary that leaders understand the data, disseminate findings to all stakeholders, help staff understand the data, and then create a platform where all key stakeholders can be involved in discussing the results to generate improvement plans.
PubMed: 31413967
DOI: 10.17294/2330-0698.1416 -
Evidence-based Complementary and... 2022Acupuncture clinical practice guidelines are authoritative medical recommendations developed by evaluating and integrating acupuncture-related evidence. However, their... (Review)
Review
Acupuncture clinical practice guidelines are authoritative medical recommendations developed by evaluating and integrating acupuncture-related evidence. However, their synthesis and dissemination are not integrated, and clinical practitioners require more credible effective evidence. The study aim was to systematically review problems disseminating acupuncture clinical practice guidelines to clinical practitioners, to facilitate evidence dissemination. This systematic review included searches of PubMed, EBSCO, Web of Science, and four major Chinese electronic databases (CNKI, VIP, Wanfang Database, and SinoMed) from inception to October 26, 2021. Two independent reviewers screened the literature, extracted information, and evaluated the quality of included studies. A systematic review was subsequently performed. Eleven studies were reviewed: nine (81.8%) cross-sectional surveys and two (18.2%) systematic reviews. The evaluated clinical practice guidelines differed across studies; seven studies (63.6%) evaluated guidelines for a specific disease, one (9.1%) evaluated guidelines for acupuncture therapies (e.g., moxibustion and fire acupuncture), one (9.1%) evaluated US acupuncture guidelines and recommendations, and two (18.2%) did not describe the guideline content. The included studies used different evaluation indicators. Guideline dissemination problems included lack of guideline standardization, unclear target population, mismatch between guidelines and application environment, lack of reliable health economics evaluation, poor quality content of the recommendations, lack of linkage between recommendations and evidence, and disassociation of recommendations from clinical practice et al. The development and publishing of credible acupuncture clinical practice guidelines is urgently needed to improve the usability of guidelines and standardize and disseminate tools for analysing information to clinical practitioners and to help the domestic and international acupuncture community to apply evidence to practice. Recommendations for promoting the dissemination of acupuncture clinical practice guidelines are to define clinical events suitable for the target population, to develop recommendations relevant to clinical practice, to improve the evidence evaluation index system, and to further standardize the method and process of formulating guidelines.
PubMed: 35529926
DOI: 10.1155/2022/8334397 -
Nutrition Reviews Oct 2017Biofortification of staple crops is a promising strategy for increasing the nutrient density of diets in order to improve human health. The willingness of consumers and... (Review)
Review
Biofortification of staple crops is a promising strategy for increasing the nutrient density of diets in order to improve human health. The willingness of consumers and producers to accept new crop varieties will determine whether biofortification can be successfully implemented. This review assessed sensory acceptance and adoption of biofortified crops and the determining factors for acceptance and adoption among consumers and producers in low- and middle-income countries. PubMed, Scopus, and Web of Science were searched for published reports. Unpublished studies were identified using an internet search. From a total of 1669 records found, 72 primary human research studies published in English or Spanish met the criteria for inclusion. : Data were extracted from each identified study using a standardized form. Sensory acceptability (n = 40) was the most common topic of the studies, followed by determinants of acceptance (n = 25) and adoption (n = 21). Of crops included in the studies, sweet potato and maize were the most studied, whereas rice and pearl-millet were the least investigated. Overall, sensory acceptance was good, and availability and information on health benefits of the crops were the most important determinants of acceptance and adoption. : Changes to the sensory qualities of a crop, including changes in color, did not act as an obstacle to acceptance of biofortified crops. Future studies should look at acceptance of biofortified crops after they have been disseminated and introduced on a wide-scale.
Topics: Biofortification; Consumer Behavior; Crops, Agricultural; Diet; Food, Fortified; Humans; Micronutrients; Nutritive Value; Poverty
PubMed: 29028269
DOI: 10.1093/nutrit/nux037