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Skin Research and Technology : Official... Jul 2022The objective of this review is to examine the reliability and measurement error of devices that measure transepidermal water loss (TEWL).
OBJECTIVE
The objective of this review is to examine the reliability and measurement error of devices that measure transepidermal water loss (TEWL).
INTRODUCTION
TEWL is a physiological property of skin which increases when the epidermis is damaged. It is, therefore, a commonly utilised measure of skin barrier integrity. Devices measuring TEWL are available as open, semi-open or closed chamber. Studies of reliability examine the consistency of measurement, and/or responsiveness whereas measurement error scores in absolute terms the amount of error due to sources of variation.
INCLUSION CRITERIA
Studies examining the reliability and/or measurement error of TEWL measurement devices were included. Studies that only report on measurement of TEWL outcomes without examination of reliability and/or measurement error were excluded.
METHODS
The search strategy aimed to locate published and unpublished studies. Databases searched included PubMed, Embase, CINAHL and Web of Science, utilising identified keywords and limited to studies in English. Grey literature sources were searched to identify any unpublished documents. Study selection using the inclusion criteria was then assessed by two reviewers for methodological quality utilising the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) risk of bias tool to assess the reliability and measurement error of outcome measurement instruments.
RESULTS
A total of 22 devices were examined in the 38 included studies. The quality of study design was on average rated as 'Adequate' however reliability and measurement error statistical methods were on average rated as 'Doubtful'.
DISCUSSION AND CONCLUSION
TEWL measurement devices were found to demonstrate good reliability and frequently correlated with other devices. However, measurement error was highly variable but improves under in vitro conditions. Future research should consider risk of bias factors when designing studies.
Topics: Epidermis; Humans; Reproducibility of Results; Skin; Water; Water Loss, Insensible
PubMed: 35411958
DOI: 10.1111/srt.13159 -
Cerebrovascular Diseases (Basel,... 2020Hyponatremia is a common electrolyte disorder in patients with stroke, which leads to various fatal complications. We performed a systematic review and meta-analysis to... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
Hyponatremia is a common electrolyte disorder in patients with stroke, which leads to various fatal complications. We performed a systematic review and meta-analysis to investigate the outcomes of acute stroke patients with hyponatremia.
METHODS
We searched MEDLINE, EMBASE, and the Cochrane Library databases for relevant literature in English published up to March 2020. Two review authors independently screened and selected the studies by assessing the eligibility and validity based on the inclusion criteria. Mortality at 90 days was set as the primary end point, and in-hospital mortality and length of hospital stay were set as the secondary end points. We conducted the data synthesis and analyzed the outcomes by calculating the odds ratio (OR) and mean difference.
RESULTS
Of 835 studies, 15 studies met the inclusion criteria (n = 10,745). The prevalence rate of stroke patients with hyponatremia was 7.0-59.2%. They had significantly higher 90-day mortality (OR, 1.73; 95% confidence interval (CI), 1.24-2.42) and longer length of hospital stay (mean difference, 10.68 days; 95% CI, 7.14-14.22) than patients without hyponatremia. Patients with hyponatremia had a higher tendency of in-hospital mortality than those without hyponatremia (OR, 1.61; 95% CI, 0.97-2.69).
CONCLUSIONS
The development of hyponatremia in the clinical course of stroke is associated with higher short-term mortality and a longer hospital stay. Although the causal relationship is unclear, hyponatremia could be a significant predictor of poor outcomes after stroke.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Biomarkers; Female; Hospital Mortality; Humans; Hyponatremia; Length of Stay; Male; Middle Aged; Risk Assessment; Risk Factors; Sodium; Stroke; Time Factors; Treatment Outcome; Water-Electrolyte Balance; Young Adult
PubMed: 33017822
DOI: 10.1159/000510751 -
Experimental Dermatology Oct 2022Trans-epidermal water loss (TEWL), the total non-eccrine sweat water evaporating from a given area of epidermis over time, is a measurement of skin barrier integrity....
Trans-epidermal water loss (TEWL), the total non-eccrine sweat water evaporating from a given area of epidermis over time, is a measurement of skin barrier integrity. Skin diseases (e.g., psoriasis and atopic dermatitis) often result in transient increases in TEWL, so, knowledge of "normal" TEWL values may be used to predict disease progression in dermatological settings. Variables such as age, race and anatomic location have been suggested to affect TEWL, but current regulatory agencies have failed to control for additional variables of interest. Thus, this review summarizes variables that may cause TEWL variation. A comprehensive literature search was performed using Embase, PubMed and Web of Science to find human studies that provided data on variables affecting TEWL. 31 studies, analysing 22 affecting TEWL, were identified. Variables causing increased TEWL were mask-use (n = 1), dry eye disease (n = 1), chronic venous disease (n = 1), coronary artery disease (n = 1), age (infants vs adults) (n = 4), nourishment in infants (n = 1), stress within individuals (n = 2), Body Mass Index (n = 2), bathing versus showering (n = 2) and scratching/friction (n = 1). Variables with decreases in TEWL were genetic variability with SNPs on chromosome 9q34.3 (n = 1) and cancer-cachexia (n = 1). We summarized 12 variables that impact TEWL and are not typically controlled for in experimental settings. Therefore, defining normal TEWL may currently be problematic. Thus, regulatory agencies should provide stricter guidelines on proper measurement of TEWL to minimize human introduced TEWL variation, and we should continue to examine factors impacting individual skin integrity.
Topics: Adult; Dermatitis, Atopic; Epidermis; Humans; Infant; Skin; Water; Water Loss, Insensible
PubMed: 35753062
DOI: 10.1111/exd.14635 -
Ultrasound in Medicine & Biology May 2021Lung ultrasonography is accurate in detecting pulmonary edema and overcomes most limitations of traditional diagnostic modalities. Whether use of lung...
Lung ultrasonography is accurate in detecting pulmonary edema and overcomes most limitations of traditional diagnostic modalities. Whether use of lung ultrasonography-guided management has an effect on cumulative fluid balances and other clinical outcomes remains unclear. In this systematic review, we included 12 studies using ultrasonography guided-management with a total of 2290 patients. Four in-patient studies found a reduced cumulative fluid balance (ranging from -0.3 L to -2.4 L), whereas three out-patient studies found reduction in dialysis dry weight (ranging from -2.6 kg to -0.2 kg) compared with conventionally managed patients. None of the studies found adverse effects related to hypoperfusion. The use of lung ultrasonography-guided management was not associated with other clinical outcomes. This systematic review shows that lung ultrasonography-guided management, exclusively or in concert with other diagnostic modalities, is associated with a reduced cumulative fluid balance. Studies thus far have not shown a consistent effect on clinical outcomes.
Topics: Humans; Lung; Pulmonary Edema; Renal Dialysis; Treatment Outcome; Ultrasonography; Water-Electrolyte Balance
PubMed: 33637390
DOI: 10.1016/j.ultrasmedbio.2021.01.024 -
Neuro-oncology Advances 2022The impact of anti-angiogenic therapy (AAT) on patients with glioblastoma (GBM) is unclear due to a disconnect between radiographic findings and overall survivorship. MR...
BACKGROUND
The impact of anti-angiogenic therapy (AAT) on patients with glioblastoma (GBM) is unclear due to a disconnect between radiographic findings and overall survivorship. MR spectroscopy (MRS) can provide clinically relevant information regarding tumor metabolism in response to AAT. This review explores the use of MRS to track metabolic changes in patients with GBM treated with AAT.
METHODS
We conducted a systematic literature review in accordance with PRISMA guidelines to identify primary research articles that reported metabolic changes in GBMs treated with AAT. Collected variables included single or multi-voxel MRS acquisition parameters, metabolic markers, reported metabolic changes in response to AAT, and survivorship data.
RESULTS
Thirty-five articles were retrieved in the initial query. After applying inclusion and exclusion criteria, 11 studies with 262 patients were included for qualitative synthesis with all studies performed using multi-voxel H MRS. Two studies utilized P MRS. Post-AAT initiation, shorter-term survivors had increased choline (cellular proliferation marker), increased lactate (a hypoxia marker), and decreased levels of the short echo time (TE) marker, myo-inositol (an osmoregulator and gliosis marker). MRS detected metabolic changes as soon as 1-day after AAT, and throughout the course of AAT, to predict survival. There was substantial heterogeneity in the timing of scans, which ranged from 1-day to 6-9 months after AAT initiation.
CONCLUSIONS
Multi-voxel MRS at intermediate and short TE can serve as a robust prognosticator of outcomes of patients with GBM who are treated with AAT.
PubMed: 35892047
DOI: 10.1093/noajnl/vdac103 -
International Journal of Molecular... Nov 2019Several environmental factors, such as drought, salinity, and extreme temperatures, negatively affect plant growth and development, which leads to yield losses. The... (Comparative Study)
Comparative Study Meta-Analysis
Several environmental factors, such as drought, salinity, and extreme temperatures, negatively affect plant growth and development, which leads to yield losses. The tolerance or sensitivity to abiotic stressors are the expression of a complex machinery involving molecular, biochemical, and physiological mechanisms. Here, a meta-analysis on previously published RNA-Seq data was performed to identify the genes conferring tolerance to chilling, osmotic, and salt stresses, by comparing the transcriptomic changes between tolerant and susceptible rice genotypes. Several genes encoding transcription factors (TFs) were identified, suggesting that abiotic stress tolerance involves upstream regulatory pathways. A gene co-expression network defined the metabolic and signalling pathways with a prominent role in the differentiation between tolerance and susceptibility: (i) the regulation of endogenous abscisic acid (ABA) levels, through the modulation of genes that are related to its biosynthesis/catabolism, (ii) the signalling pathways mediated by ABA and jasmonic acid, (iii) the activity of the "Drought and Salt Tolerance" TF, involved in the negative regulation of stomatal closure, and (iv) the regulation of flavonoid biosynthesis by specific MYB TFs. The identified genes represent putative key players for conferring tolerance to a broad range of abiotic stresses in rice; a fine-tuning of their expression seems to be crucial for rice plants to cope with environmental cues.
Topics: Dehydration; Disease Resistance; Gene Expression Profiling; Gene Expression Regulation, Plant; Oryza; Osmoregulation; Plant Proteins; Salt Tolerance; Transcription Factors
PubMed: 31726733
DOI: 10.3390/ijms20225662 -
Worldviews on Evidence-based Nursing Dec 2019The charting of daily fluid balances and measurement of body weight changes are two noninvasive methods commonly used in the intensive care unit for estimating body...
BACKGROUND
The charting of daily fluid balances and measurement of body weight changes are two noninvasive methods commonly used in the intensive care unit for estimating body fluid status. The determination of body fluid status plays an important role in the management of critically ill patients where aggressive fluid resuscitation is often required. This can adversely affect patient outcomes if changes in fluid distribution are not detected early in patients who are susceptible to fluid overload.
AIM
To synthesize the best available evidence on the accuracy of daily fluid balance charting compared with the measurement of body weight for the estimation of body fluid status in critically ill adult patients.
METHODS
The review considered studies that investigated the accuracy of charting daily fluid balances or changes in body weight measurements or used both noninvasive methods in the estimation of body fluid status. The search sought to identify published, English language studies from 1980 until February 2018. Databases searched included MEDLINE, CINAHL, EMBASE, TRIP, Scopus, TROVE, ProQuest Dissertations, Australian and New Zealand Trials Registry, and Cochrane Central Register of Clinical Trials. Three reviewers independently assessed retrieved studies that matched inclusion criteria using standardized critical appraisal instruments.
RESULTS
The review included 13 cohort studies. Effectiveness of daily fluid balance charting was affected by inaccuracies observed in seven studies. Inability to obtain consecutive daily body weight measurements reduced the accuracy of monitoring changes in five studies. Seven studies found measurement of daily fluid balance inconsistent with changes in body weight.
LINKING EVIDENCE TO ACTION
The accuracy of charting fluid balance is suspect. Measurement of body weight is hard to accomplish. A combination of the two commonly used methods is more likely to be effective in estimating body fluid status than reliance on one single approach.
Topics: Adult; Body Weight; Critical Illness; Humans; Intensive Care Units; Statistics as Topic; Water-Electrolyte Balance
PubMed: 31811748
DOI: 10.1111/wvn.12394