-
Advanced Emergency Nursing Journal 2017Postoperative residual neuromuscular blockade is associated with an increased risk of respiratory insufficiency, aspiration, and potential pulmonary complications. The... (Review)
Review
Postoperative residual neuromuscular blockade is associated with an increased risk of respiratory insufficiency, aspiration, and potential pulmonary complications. The standard of care for reversal of residual block centers on anticholinesterases such as neostigmine. However, these medications provide inconsistent or inadequate effect while being associated with potentially severe adverse effects. Sugammadex, a modified γ-cyclodextrine compound, is a recently approved agent for the reversal of blockade with aminosterodial neuromuscular blockers. Randomized controlled trials, in addition to a meta-analysis and a systematic review, have published results indicating faster and more consistent reversal of blockade while leading to fewer adverse events.
Topics: Humans; Neuromuscular Blockade; Neuromuscular Nondepolarizing Agents; Sugammadex; gamma-Cyclodextrins
PubMed: 29095176
DOI: 10.1097/TME.0000000000000170 -
Scandinavian Journal of Pain Oct 2016Chronic pain is a potentially disabling condition affecting one in three people through impaired physical function and quality of life. While the psychosocial impact of... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND AND AIMS
Chronic pain is a potentially disabling condition affecting one in three people through impaired physical function and quality of life. While the psychosocial impact of chronic pain is already well established, little is known about the potential biological consequences. Chronic pain may be associated with an increased prevalence of cardiovascular disease, an effect that has been demonstrated across a spectrum of chronic pain conditions including low back pain, pelvic pain, neuropathic pain and fibromyalgia. The aim of this study was to review and summarize the evidence for a link between chronic pain and cardiovascular disease. We sought to clarify the nature of the relationship by examining the basis for a dose-response gradient (whereby increasing pain severity would result in greater cardiovascular disease), and by evaluating the extent to which potentially confounding variables may contribute to this association.
METHODS
Major electronic databases MEDLINE, EMBASE, Psychinfo, Cochrane, ProQuest and Web of Science were searched for articles reporting strengths of association between chronic pain (pain in one or more body regions, present for three months or longer) and cardiovascular outcomes (cardiovascular mortality, cardiac disease, and cerebrovascular disease). Meta-analysis was used to pool data analysing the association between chronic pain and the three principal cardiovascular outcomes. The impact of pain severity, and the role of potentially confounding variables were explored narratively.
RESULTS
The searches generated 11,141 studies, of which 25 matched our inclusion criteria and were included in the review. Meta-analysis (of unadjusted study outcomes) demonstrated statistically significant associations between chronic pain and mortality from cardiovascular diseases: pooled odds ratio 1.20, (95% confidence intervals 1.05-1.36); chronic pain and cardiac disease: pooled odds ratio 1.73 (95% confidence intervals 1.42-2.04); and chronic pain and cerebrovascular disease: pooled odds ratio 1.81 (95% confidence intervals 1.51-2.10). The systematic review also found evidence supporting a dose-response relationship, with greater pain intensity and distribution producing a stronger association with cardiovascular outcomes. All of the included studies were based on observational data with considerable variation in chronic pain taxonomy, methodology and study populations. The studies took an inconsistent and incomplete approach in their adjustment for potentially confounding variables, making it impossible to pool data after adjustments for confounding variables, so it cannot be concluded that these associations are causal.
CONCLUSIONS
Our review supports a possible dose-response type of association between chronic pain and cardiovascular disease, supported by a range of observational studies originating from different countries. Such research has so far failed to satisfactorily rule out that the association is due to confounding variables. What is now needed are further population based longitudinal studies that are designed to allow more robust exploration of a cause and effect relationship.
IMPLICATIONS
Given the high prevalence of chronic pain in developed and developing countries our results highlight a significant, but underpublicized, public health concern. Greater acknowledgement of the potentially harmful biological consequences of chronic pain may help to support regional, national and global initiatives aimed at reducing the burden of chronic pain.
Topics: Cardiovascular Diseases; Chronic Pain; Fibromyalgia; Humans; Neuralgia; Quality of Life
PubMed: 28850537
DOI: 10.1016/j.sjpain.2016.06.005 -
Obstetrical & Gynecological Survey Apr 2018Measurement of cervical dilation is one of the major indicators of labor progression. At present, the criterion standard for this evaluation is digital examination,... (Meta-Analysis)
Meta-Analysis Review
IMPORTANCE
Measurement of cervical dilation is one of the major indicators of labor progression. At present, the criterion standard for this evaluation is digital examination, which results are sometimes inaccurate and extremely dependent on the subject (ie, obstetrician or midwife) experience.
OBJECTIVE
In this systematic and meta-analysis review, the authors have gathered the vast majority of the instruments used for measuring cervical dilation and their clinical application; main features, potentialities, and the most significant constraints are underlined for each device.
EVIDENCE ACQUISITION
Three of the most popular databases (ie, Web of Science, PubMed, and ClinicalTrials.gov) were used to identify all available cervimeters, by using single or combinations of the following keywords: "cervical," "dilation or dilatation," "cervimetry," "cervix," "uterine," "measurement," "labour or labor," "birth," and "monitoring." Only articles describing the design or a specific clinical application of an instrument for cervical dilation measurement during labor were selected.
RESULTS
Twenty-five articles were deeply investigated by classifying them in 4 different homogenous groups on the basis of the method proposed for measuring cervical dilation. Suitable devices have not been realized yet, and this is the reason why nowadays the gynecologist/obstetrician still evaluates labor progression by digital examination.
CONCLUSIONS AND RELEVANCE
Based on a critical analysis of the selected devices, ultrasound seems to be the most promising technology for future cervimetry realization; ultrasound is accurate in distance measurement, and the behind technology can be miniaturized. However, additional studies are necessary for optimizing the technology and developing an optimal solution.
Topics: Cervix Uteri; Female; Humans; Labor Stage, First; Obstetrics; Physical Examination; Pregnancy; Ultrasonography, Prenatal; Uterine Monitoring
PubMed: 29701868
DOI: 10.1097/OGX.0000000000000548 -
BMC Public Health Oct 2017Chemical irritants used in crowd control, such as tear gases and pepper sprays, are generally considered to be safe and to cause only transient pain and lacrimation.... (Review)
Review
BACKGROUND
Chemical irritants used in crowd control, such as tear gases and pepper sprays, are generally considered to be safe and to cause only transient pain and lacrimation. However, there are numerous reports that use and misuse of these chemicals may cause serious injuries. We aimed to review documented injuries from chemical irritants to better understand the morbidity and mortality associated with these weapons.
METHODS
We conducted a systematic review using PRISMA guidelines to identify injuries, permanent disabilities, and deaths from chemical irritants worldwide between January 1, 1990 and March 15, 2015. We reviewed injuries to different body systems, injury severity, and potential risk factors for injury severity. We also assessed region, context and quality of each included article.
RESULTS
We identified 31 studies from 11 countries. These reported on 5131 people who suffered injuries, two of whom died and 58 of whom suffered permanent disabilities. Out of 9261 total injuries, 8.7% were severe and required professional medical management, while 17% were moderate and 74.3% were minor. Severe injuries occurred to all body systems, with the majority of injuries impacting the skin and eyes. Projectile munition trauma caused 231 projectile injuries, with 63 (27%) severe injuries, including major head injury and vision loss. Potentiating factors for more severe injury included environmental conditions, prolonged exposure time, and higher quantities of chemical agent in enclosed spaces.
CONCLUSIONS
Although chemical weapons may have a limited role in crowd control, our findings demonstrate that they have significant potential for misuse, leading to unnecessary morbidity and mortality. A nuanced understanding of the health impacts of chemical weapons and mitigating factors is imperative to avoiding indiscriminate use of chemical weapons and associated health consequences.
Topics: Capsaicin; Cause of Death; Crowding; Humans; Risk Factors; Tear Gases; Trauma Severity Indices; Wounds and Injuries
PubMed: 29052530
DOI: 10.1186/s12889-017-4814-6 -
Neuroscience and Biobehavioral Reviews Sep 2023Neural adaptations to resistance training (RT) and their correlation with muscle strength remain partially understood. We conducted a systematic review and multivariate... (Meta-Analysis)
Meta-Analysis Review
Neural adaptations to resistance training (RT) and their correlation with muscle strength remain partially understood. We conducted a systematic review and multivariate meta-analysis to examine the effects of metronome-paced (MP), self-paced (SP), and isometric (IM) training on M1 and corticospinal pathway activity. Following MP RT, a significant increase in corticospinal excitability was observed, correlating with increased strength. Conversely, no significant relationship was found after SP or IM training. RT also reduced the duration of the cortical silent period, but this change did not predict strength changes and was not specific to any training modality. No significant effects were found for short-interval intracortical inhibition. Our findings suggest that changes in corticospinal excitability may contribute to strength gains after RT. Furthermore, the relationship between these adaptations and strength appears dependent on the type of training performed.
Topics: Humans; Resistance Training; Pyramidal Tracts; Transcranial Magnetic Stimulation; Motor Cortex; Muscle Strength; Evoked Potentials, Motor; Muscle, Skeletal
PubMed: 37353049
DOI: 10.1016/j.neubiorev.2023.105289 -
Frontiers in Endocrinology 2021Dietary supplements (DS) for male infertility marketed in Italy were evaluated for composition, concentration of ingredients, and recommended daily dose. A systematic...
CONTENT
Dietary supplements (DS) for male infertility marketed in Italy were evaluated for composition, concentration of ingredients, and recommended daily dose. A systematic review of literature identified ingredients potentially effective on sperm parameters and their minimal effective daily dose (mED).
OBJECTIVE
This study was conducted in order to critically evaluate the composition and efficacy of DS marketed in Italy.
DESIGN SETTING AND PARTICIPANTS
This was a systematic review of randomized controlled trials.
EVIDENCE ACQUISITION
A formula allowed us to classify the expected efficacy of each DS, based on composition. Each DS was scored and included into three classes of expected efficacy: high, low, and none.
EVIDENCE SYNTHESIS
Among 24 supplements, 3 (12.5%) fall in high, 9 (37.5%) in lower, and 12 (50.0%) in no expected efficacy class. DS composition showed 36 substances, 18 with no literature on male fertility and 18 showing positive effect on sperm parameters, thus considered potentially active ingredients (PAI). All DS were mixtures of ingredients, containing from 2 to 17 different substances. Fifteen supplements (65.2%) contained at least 1 ingredient without evidence of efficacy and 21 formulations had PAI dosed below mED. Some PAI were associated to the improvement of specific sperm parameters.
CONCLUSIONS
DS were usually blends of many substances that are frequently employed at negligible dose or without any evidence of efficacy on male reproduction. Some ingredients have been demonstrated to be effective on specific sperm parameters by RCTs. We report a list of ingredients with potential efficacy on specific sperm parameters, aimed to allow a tailored use of DS.
PATIENT SUMMARY
The market of DS for male infertility offers products with potential efficacy in the improvement of sperm parameters but also many with uncertain effects. Based on current scientific literature, our study can help in the choice of DS that are more likely to be effective on specific sperm alterations, so providing the best supplementation for each patient.
Topics: Dietary Supplements; Humans; Infertility, Male; Italy; Male; Spermatozoa
PubMed: 35185789
DOI: 10.3389/fendo.2021.824078 -
Psychological Medicine Jan 2018Mobile mood-monitoring applications are increasingly used by mental health providers, widely advocated within research, and a potentially effective method to engage... (Review)
Review
BACKGROUND
Mobile mood-monitoring applications are increasingly used by mental health providers, widely advocated within research, and a potentially effective method to engage young people. However, little is known about their efficacy and usability in young populations.
METHOD
A systematic review addressing three research questions focused on young people: (1) what are the psychometric properties of mobile mood-monitoring applications; (2) what is their usability; and (3) what are their positive and negative clinical impacts? Findings were synthesised narratively, study quality assessed and compared with evidence from adult studies.
RESULTS
We reviewed 25 articles. Studies on the psychometric properties of mobile mood-monitoring applications were sparse, but indicate questionable to excellent internal consistency, moderate concurrent validity and good usability. Participation rates ranged from 30% to 99% across studies, and appeared to be affected by methodological factors (e.g. payments) and individual characteristics (e.g. IQ score). Mobile mood-monitoring applications are positively perceived by youth, may reduce depressive symptoms by increasing emotional awareness, and could aid in the detection of mental health and substance use problems. There was very limited evidence on potential negative impacts.
CONCLUSIONS
Evidence for the use of mood-monitoring applications in youth is promising but limited due to a lack of high-quality studies. Future work should explicate the effects of mobile mood-monitoring applications on effective self-regulation, clinical outcomes across disorders and young people's engagement with mental health services. Potential negative impacts in this population should also be investigated, as the adult literature suggests that application use could potentially increase negativity and depression symptoms.
Topics: Adolescent; Adult; Affect; Child; Diagnosis, Computer-Assisted; Female; Humans; Male; Mental Disorders; Mobile Applications; Psychometrics; Young Adult
PubMed: 28641609
DOI: 10.1017/S0033291717001659 -
Indian Journal of Community Medicine :... 2022Not only in India but also worldwide, criminal activity has dramatically increasing day by day among youth, and it must be addressed properly to maintain a healthy... (Review)
Review
BACKGROUND
Not only in India but also worldwide, criminal activity has dramatically increasing day by day among youth, and it must be addressed properly to maintain a healthy society. This review is focused on risk factors and quantitative approach to determine delinquent behaviors of juveniles.
MATERIALS AND METHODS
A total of 15 research articles were identified through Google search as per inclusion and exclusion criteria, which were based on machine learning (ML) and statistical models to assess the delinquent behavior and risk factors of juveniles.
RESULTS
The result found ML is a new route for detecting delinquent behavioral patterns. However, statistical methods have used commonly as the quantitative approach for assessing delinquent behaviors and risk factors among juveniles.
CONCLUSIONS
In the current scenario, ML is a new approach of computer-assisted techniques have potentiality to predict values of behavioral, psychological/mental, and associated risk factors for early diagnosis in teenagers in short of times, to prevent unwanted, maladaptive behaviors, and to provide appropriate intervention and build a safe peaceful society.
PubMed: 36742966
DOI: 10.4103/ijcm.ijcm_1061_21 -
Journal of Tropical Medicine 2021Malaria remains a significant global health problem, but the development of effective antimalarial drugs is challenging due to the parasite's complex life cycle and lack... (Review)
Review
Malaria remains a significant global health problem, but the development of effective antimalarial drugs is challenging due to the parasite's complex life cycle and lack of knowledge about the critical specific stages. Medicinal plants have been investigated as adjuvant therapy for malaria, so this systematic review summarizes 46 primary articles published until December 2020 that discuss curcumin and piperine as antimalarial agents. The selected articles discussed their antioxidant, anti-inflammatory, and antiapoptosis properties, as well as their mechanism of action against species. Curcumin is a potent antioxidant, damages parasite DNA, and may promote an immune response against by increasing reactive oxygen species (ROS), while piperine is also a potent antioxidant that potentiates the effects of curcumin. Hence, combining these compounds is likely to have the same effect as chloroquine, that is, attenuate and restrict parasite development, thereby reducing parasitemia and increasing host survival. This systematic review presents new information regarding the development of a curcumin-piperine combination for future malaria therapy.
PubMed: 34671402
DOI: 10.1155/2021/9135617 -
BMC Medical Education Apr 2023Rapid demographic, epidemiological, technological, cultural/behavioural, and educational transitions, as they become more complex, demand new integrated and...
BACKGROUND
Rapid demographic, epidemiological, technological, cultural/behavioural, and educational transitions, as they become more complex, demand new integrated and complementary professional skills and abilities. Interprofessional Education (IPE) is a promising alternative to deal with these changes, especially in courses in the health area. This systematic review was to explore the potentialities and limitations of IPE, from the perspective of undergraduate students, through a thematic synthesis of qualitative studies.
METHODS
A thematic synthesis of qualitative studies was conducted. The question elaborated for this review was: "What is the impact of interprofessional education on the teaching and learning of students in the health area inserted in Higher Education Institutions?". The search strategy was performed in the electronic databases PubMed, Latin American and Caribbean Literature in Health Sciences (LILACS), Cochrane Library, and Scientific Electronic Library Online (SciELO). In addition, searches were carried out in grey literature on the ERIC platforms, ProQuest Disserts and Theses, and Academic Google. The assessment of the quality of the studies was carried out using the Critical Appraisal Skills Programme tool. Data were summarized through thematic synthesis. From the databases, 8,793 studies were identified. After standardized filters procedures, critical summaries, and assessment of relevance to the eligibility criteria, 14 articles were included.
RESULTS
The synthesis of the studies revealed the potential of this teaching approach, arranged in three analytical themes: learning from each other and about them; the value of education and interprofessional practice; patient-centred health care. On the other hand, some limitations were also identified, such as barriers related to EIP; the difficulties related to teaching methodologies.
CONCLUSION
Overcoming the identified limitations can enhance the results of the IPE, in view of its impact on the education of students and on the health care of the population.
Topics: Humans; Interprofessional Education; Students; Delivery of Health Care; Educational Status; Qualitative Research; Interprofessional Relations
PubMed: 37046287
DOI: 10.1186/s12909-023-04211-6