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Journal of Obstetrics and Gynaecology :... Aug 2020We performed a comprehensive systematic review of acute pyelonephritis in pregnancy using PubMed, SCOPUS, ClinicalTrials.gov, and Ovid from inception to April 2018....
We performed a comprehensive systematic review of acute pyelonephritis in pregnancy using PubMed, SCOPUS, ClinicalTrials.gov, and Ovid from inception to April 2018. About 7796 references were screened for inclusion, and 52 references from 1908 to 2017 were included. One hundred seven cases of acute pyelonephritis in pregnant women were reviewed. Gestational age at diagnosis was reported as 2 (2%), 43 (40%), and 51 (52%) during the first, second, and third trimesters, respectively. Maternal complications included sepsis (49%), acute respiratory distress syndrome (47%), anaemia (33%), acute kidney injury (10%), renal abscess (6%), and death (6%). 25 preterm deliveries (23%), 6 intrauterine foetal demises (6%), 4 spontaneous abortions (4%), and 8 neonatal intensive care unit admissions (7%) were reported. Microorganisms cultured included (51%), (8%), (5%), (5%), (4%), and (3%). Early diagnosis and management led to fewer complications.Impact statement Acute pyelonephritis during pregnancy can lead to adverse pregnancy outcomes and in this article, we highlight the most common outcomes previously reported. Previous studies have reported maternal adverse outcomes and only very few stressed on fetal/neonatal outcomes. The results add that not only is maternal morbidity/mortality is increased, but also increases adverse outcomes for the fetus/neonate, such as preterm delivery and fetal/neonatal demise. The implications from this article serve to increase a medical providers knowledge on how to appropriately counsel pregnant women with acute pyelonephritis. In addition, future research can aim to understand why pregnant women are more prone to morbidity and mortality compared to nonpregnant women.
Topics: Acute Disease; Adult; Female; Fetal Death; Gestational Age; Humans; Infant, Newborn; Maternal Mortality; Pregnancy; Pregnancy Complications, Infectious; Pregnancy Outcome; Pyelonephritis
PubMed: 32648533
DOI: 10.1080/01443615.2019.1647524 -
Infection and Drug Resistance 2020Urinary tract infection is one of the most common health problems during pregnancy. It is most commonly reported among pregnant women and is a known reason of morbidity... (Review)
Review
BACKGROUND
Urinary tract infection is one of the most common health problems during pregnancy. It is most commonly reported among pregnant women and is a known reason of morbidity during pregnancy worldwide, predominantly in developing countries. The etiological agents include and others. Different risk factors expose pregnant women to urinary tract infection. Drug resistance by uropathogenic bacteria is a current problem of the world. This study was aimed at reviewing the prevalence of bacterial uropathogens and their antimicrobial resistance patterns among pregnant women in developing countries in Asia and Africa, during the past decade.
METHODS
A systematic literature search was accomplished to identify published studies between January 2005 and November 2016. The literature search strategy in this paper included searching PubMed, PMC, Science Direct, Springer open, Google scholar and BioMed Central databases.
RESULTS
The overall prevalence of UTI among pregnant women was 13.5%. Both Gram-positive and Gram-negative bacteria were isolated from all eligible studies. Gram-negative bacteria (83.7%) accounted for majority of infections while Gram positives accounted for 15.9%. Among the isolated bacteria, was the most predominant uropathogen; it was shown to be present in all 26 eligible studies that were included in this review. Four studies from Africa and four from Asia were reviewed for antimicrobial resistance patterns of uropathogenic bacteria. In most of the regions, almost all the bacterial uropathogens had high resistance to ampicillin (67.2%) whereas all the strains showed relative sensitivity to ciprofloxacin (71.2%), nitrofurantoin (65%) and ceftriaxone (74.1%).
CONCLUSION
The prevalence of UTI in the selected regions of the two continents is different. A significant prevalence of UTI among pregnant women is mainly observed in Africa and Asia. Uropathogenic bacteria showed resistance to antimicrobial drugs that are regularly used in developing countries. This may show the need to incorporate culture and drug susceptibility tests into the routine antenatal care for pregnant women and drug resistance should be monitored.
PubMed: 32547115
DOI: 10.2147/IDR.S250654 -
Journal of Psychiatric Research Sep 2020Early studies reported a prolactin surge during electroconvulsive therapy (ECT). The aim of this study is to review and meta-analyze data on ECT-related prolactin... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Early studies reported a prolactin surge during electroconvulsive therapy (ECT). The aim of this study is to review and meta-analyze data on ECT-related prolactin changes.
METHOD
A systematic review and meta-analysis was conducted for trials investigating prolactin changes in ECT-treated patients using standard mean differences (SMD, 95% confidence intervals). Subgroup analyses included comparisons of ECT-related prolactin changes in women vs. men, patients receiving different anesthetics, bilateral vs. unilateral and high-vs. low-dose ECT.
RESULTS
In six trials including 109 ECT-treated patients and 74 controls, prolactin changes were larger in ECT-treated patients than in controls (SMD = 0.89, 95%CI = 0.55, 1.23, p < 0.001 and 1.03, 95%CI = 0.31, 1.75, p = 0.005 for the fixed and random-effect model respectively), despite heterogeneity in the samples (I = 72%, τ = 0.62). Effects were led by differences in patients premedicated with methohexital (SMD = 1.14, 95%CI = 0.7, 1.57, p < 0.001 for both fixed and random-effect model). A meta-regression reported significant age effects (coefficient estimate 2.32, 95%CI = -0.73, 3.91, p < 0.01). Additionally, prolactin changes were larger in ECT-treated women than men (SMD = 0.88, 95%CI = 0.58, 1.18, p < 0.001 and 0.99, 95%CI = 0.22, 1.75, p = 0.012 for the fixed and random effect model). Bilateral ECT-treated patients had larger increase than unilateral ECT-treated patients (SMD = -0.81, 95%CI = -1.35, -0.27, p = 0.003 and -0.86, 95%CI = -1.46, -0.25, p = 0.006 for the fixed and random-effect model). Comparisons between high- and low-dose ECT-treated patients could not be conducted. The quality of the studies was overall poor, with four exceptions.
DISCUSSION
Patients receiving ECT had larger prolactin increases than controls. Increases were larger in methohexital-premedicated patients, women vs. men and patients with bilateral vs. unilateral ECT.
Topics: Electroconvulsive Therapy; Female; Humans; Male; Prolactin
PubMed: 32516627
DOI: 10.1016/j.jpsychires.2020.05.024 -
Systematic Reviews Apr 2020Epilepsy affects nearly 50 million people worldwide. Self-management is critical for individuals with epilepsy in order to maintain optimal physical, cognitive, and...
BACKGROUND
Epilepsy affects nearly 50 million people worldwide. Self-management is critical for individuals with epilepsy in order to maintain optimal physical, cognitive, and emotional health. Implementing and adopting a self-management program requires considering many factors at the person, program, and systems levels. We conducted a systematic review of qualitative and mixed-methods studies to identify facilitators and barriers that impact implementation and adoption of self-management programs for adults with epilepsy.
METHODS
We used established systematic review methodologies for qualitative and mixed-methods studies. We included studies addressing facilitators (i.e., factors that aided) or barriers (i.e., factors that impeded) to implementation and adoption of self-management interventions for adults with epilepsy. We conducted a narrative thematic synthesis to identify facilitators and barriers.
RESULTS
The literature search identified 2700 citations; 13 studies met eligibility criteria. Our synthesis identified five themes that categorize facilitators and barriers to successful implementation epilepsy self-management: (1) relevance, intervention content that facilitates acquisition of self-management skills; (2) personalization, intervention components that account for the individual's social, physical, and environmental characteristics; (3) intervention components, components and dosing of the intervention; (4) technology considerations, considerations that account for individual's use, familiarity with, and ownership of technology; and (5) clinician interventionist, role and preparation of the individual who leads intervention. We identified facilitators in 11 of the 13 studies and barriers in 11 of the 13 studies and classified these by social-ecological level (i.e., patient/caregiver, program, site/system).
CONCLUSION
Identification of facilitators and barriers at multiple levels provides insight into disease-specific factors that influence implementation and adoption of self-management programs for individuals with epilepsy. Our findings indicate that involving individuals with epilepsy and their caregivers in intervention development, and then tailoring intervention content during the intervention, can help ensure the content is relevant to intervention participants. Our findings also indicate the role of the clinician (i.e., the individual who provides self-management education) is important to intervention implementation, and key issues with clinicians were identified as barriers and opportunities for improvement. Overall, our findings have practical value for those seeking to implement and adopt self-management interventions for epilepsy and other chronic illnesses.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO registration number is CRD42018098604.
Topics: Adult; Epilepsy; Humans; Self-Management
PubMed: 32334641
DOI: 10.1186/s13643-020-01322-9 -
BMC Infectious Diseases Mar 2020Otitis media is inflammation of the middle ear, comprising a spectrum of diseases. It is the commonest episode of infection in children, which often occurs after an... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Otitis media is inflammation of the middle ear, comprising a spectrum of diseases. It is the commonest episode of infection in children, which often occurs after an acute upper respiratory tract infection. Otitis media is ranked as the second most important cause of hearing loss and the fifth global burden of disease with a higher incidence in developing worlds like Sub-Saharan Africa and South Asia. Therefore, this systematic review is aimed to quantitatively estimate the current status of bacterial otitis media, bacterial etiology and their susceptibility profile in sub-Saharan Africa.
METHODS
A literature search was conducted from major databases and indexing services including EMBASE (Ovid interface), PubMed/MEDLINE, Google Scholar, ScienceDirect, Cochrane Library, WHO African Index-Medicus and others. All studies (published and unpublished) addressing the prevalence of otitis media and clinical isolates conducted in sub-Saharan Africa were included. Format prepared in Microsoft Excel was used to extract the data and data was exported to Stata version 15 software for the analyses. Der-Simonian-Laird random-effects model at a 95% confidence level was used for pooled estimation of outcomes. The degree of heterogeneity was presented with I statistics. Publication bias was presented with funnel plots of standard error supplemented by Begg's and Egger's tests. The study protocol is registered on PROSPERO with reference number ID: CRD42018102485 and the published methodology is available from http://www.crd.york.ac.uk/CRD42018102485.
RESULTS
A total of 33 studies with 6034 patients were included in this study. All studies have collected ear swab/discharge samples for bacterial isolation. The pooled isolation rate of bacterial agents from the CSOM subgroup was 98%, patients with otitis media subgroup 87% and pediatric otitis media 86%. A univariate meta-regression analysis indicated the type of otitis media was a possible source of heterogeneity (p-value = 0.001). The commonest isolates were P. aeruginosa (23-25%), S. aureus (18-27%), Proteus species (11-19%) and Klebsiella species. High level of resistance was observed against Ampicillin, Amoxicillin-clavulanate, Cotrimoxazole, Amoxicillin, and Cefuroxime.
CONCLUSION
The analysis revealed that bacterial pathogens like P. aeruginosa and S. aureus are majorly responsible for otitis media in sub-Saharan Africa. The isolates have a high level of resistance to commonly used drugs for the management of otitis media.
Topics: Africa South of the Sahara; Bacterial Infections; Child; Drug Resistance, Bacterial; Humans; Otitis Media; Prevalence; Pseudomonas Infections; Pseudomonas aeruginosa; Staphylococcal Infections; Staphylococcus aureus
PubMed: 32183752
DOI: 10.1186/s12879-020-4950-y -
Oral Radiology Jan 2021Proteus syndrome (PS) is an extremely rare disorder with asymmetric and disproportionate bone overgrowth. Craniofacial abnormalities in PS are less frequent than... (Review)
Review
OBJECTIVES
Proteus syndrome (PS) is an extremely rare disorder with asymmetric and disproportionate bone overgrowth. Craniofacial abnormalities in PS are less frequent than skeletal abnormalities. Although there are recognized oral and maxillofacial manifestations of PS, few case reports describing these manifestations are available. Thus, the objective of this systematic review and case report is to describe oral and maxillofacial manifestations of PS and to report a PS case.
METHODS
A 31-year-old male presented with restricted mouth opening and pain during mastication. A panoramic radiograph and an occlusal radiograph were obtained. Reports with relevant keywords were assessed. Data were summarized and demonstrated using a critical appraisal checklist for case reports.
RESULTS
The panoramic radiograph demonstrated unilateral overgrowth of the mandible, impacted teeth, and deciduous prolonged retention. Thirteen PS case reports were identified.
CONCLUSIONS
Proteus syndrome oral and maxillofacial manifestations may include dental agenesis, impacted teeth, malocclusion, asymmetric dental growth and maturation, frontal line displacement, asymmetric tongue enlargement, mandibular hemihypertrophy and asymmetry, presence of exostoses/hyperostosis, degenerative changes in the temporomandibular joint, alterations of maxillary and mandibular vertical and/or horizontal growth, and enlargement of mandibular canal and foramen. The PROSPERO systematic review registration number is CRD42019140942.
Topics: Adult; Humans; Male; Mandible; Maxilla; Proteus Syndrome; Radiography, Panoramic; Tooth, Impacted
PubMed: 31734933
DOI: 10.1007/s11282-019-00416-y -
Games For Health Journal Apr 2020A systematic review of health interventions using avatars ( = 18) was conducted to provide comprehensive knowledge of the effectiveness of using avatars to promote...
A systematic review of health interventions using avatars ( = 18) was conducted to provide comprehensive knowledge of the effectiveness of using avatars to promote healthy behaviors, specifically in relationship to healthy eating and exercising. Two researchers identified field or laboratory studies that had quantified study results, which were published in peer-reviewed journals in English from January 2000 to March 2019. Databases (PsychInfo, PubMed, and Web of Science), forward reference, and manual searches were used to identify the studies. Search terms included avatar, the Proteus effect, exercise, and diet, among others. Two field interventions and 16 laboratory studies were identified. Information on sample characteristics, technologies used, study design and conditions pertaining to avatars, outcome measures, results, and conclusion were extracted. Six different avatar characteristics used to elicit health outcomes were identified, which are the similarity with the user, avatar body size, self-domain (e.g., ideal-self), customizability, body transformation, and avatar's behaviors. Only a few studies had a no-avatar control group; thus, it was not possible to conclude whether employing avatars in health interventions increases the effectiveness of the interventions in comparison to not using an avatar. The results indicate that using an avatar that is physically active, fit, and similar-looking (to the user) is effective in eliciting healthy behaviors.
Topics: Health Behavior; Healthy Lifestyle; Humans; Video Games
PubMed: 31724888
DOI: 10.1089/g4h.2018.0134 -
United European Gastroenterology Journal Oct 2019Inflammatory bowel diseases (IBDs) and chronic rheumatic diseases (CRDs) are systemic chronic disorders sharing common genetic, immune and environmental factors. About... (Comparative Study)
Comparative Study
INTRODUCTION
Inflammatory bowel diseases (IBDs) and chronic rheumatic diseases (CRDs) are systemic chronic disorders sharing common genetic, immune and environmental factors. About half of patients with IBD develop rheumatic ailments and microscopic intestinal inflammation is present in up to half of CRD patients. IBD and CRD patients also share a common therapeutic armamentarium. Disequilibrium in the complex realm of microbes (known as dysbiosis) that closely interact with the gut mucosal immune system has been associated with both IBD and CRD (spondyloarthritis and rheumatoid arthritis). Whether dysbiosis represents an epiphenomenon or a prodromal feature remains to be determined.
METHODS
In an attempt to further investigate whether specific gut dysbiosis may be the missing link between IBD and CRD in patients developing both diseases, we performed here a systematic literature review focusing on studies looking at bacterial microbiota in CRD and/or IBD patients.
RESULTS
We included 80 studies, with a total of 3799 IBD patients without arthritis, 1084 CRD patients without IBD, 132 IBD patients with arthropathy manifestations and 12 spondyloarthritis patients with IBD history. Overall, this systematic review indicates that an increase in s, and genera, as well as a decrease in genera and species belonging to Verrucomicrobia and Fusobacteria phyla are common features in IBD and CRD patients, whereas dozens of bacterial species are specific features of CRD and IBD.
CONCLUSION
Further work is needed to understand the functions of bacteria and of their metabolites but also to characterize fungi and viruses that are commonly found in these patients.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Child; Chronic Disease; Dysbiosis; Female; Gastrointestinal Microbiome; Humans; Inflammation; Inflammatory Bowel Diseases; Intestinal Mucosa; Intestines; Male; Microbiota; Middle Aged; Rheumatic Diseases; Young Adult
PubMed: 31662859
DOI: 10.1177/2050640619867555