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Anaesthesia, Critical Care & Pain... Dec 2020Despite numerous studies, controversies about the best intraoperative FiO remain. In 2016, the World Health Organization (WHO) recommended that adult patients undergoing... (Review)
Review
Despite numerous studies, controversies about the best intraoperative FiO remain. In 2016, the World Health Organization (WHO) recommended that adult patients undergoing general anaesthesia should be ventilated intraoperatively with an 80% FiO to reduce surgical site infection (SSI). However, several data suggest that hyperoxia could have adverse effects. In order to determine the potential effect of FiO on SSI, we included in this systematic review 23 studies (among which 21 randomised controlled trials [RCT]) published between 1999 and 2020, comparing intraoperative high versus low FiO. Results were heterogeneous but most recent studies on one hand, and the largest RCTs on the other hand, reported no difference on the incidence of SSI regarding intraoperative FiO during general anaesthesia. There was also no difference in the incidence of SSI depending of intraoperative FiO in patients receiving regional anaesthesia. The review on secondary endpoints (respiratory and cardiovascular adverse events, postoperative nausea and vomiting, postoperative length-of-stay and mortality) also failed to support the use of high FiO. On the opposite, some data from follow-up analyses and registry studies suggested a possible negative effect of high intraoperative FiO on long-term outcomes. In conclusion, the systematic administration of a high intraoperative FiO in order to decrease SSI or improve other perioperative outcomes seems unjustified in the light of the evidence currently available in the literature.
Topics: Adult; Anesthesia, General; Humans; Oxygen; Postoperative Nausea and Vomiting; Postoperative Period; Surgical Wound Infection
PubMed: 33038560
DOI: 10.1016/j.accpm.2020.07.019 -
Behavioral Sleep Medicine 2021Previous studies suggested that sleep problems were related to non-suicidal self-injury. The current systematic review investigated more thoroughly this relationship....
Previous studies suggested that sleep problems were related to non-suicidal self-injury. The current systematic review investigated more thoroughly this relationship. PubMED and Embase databases were searched. The keywords were "self-injury" OR "self-harm" OR "non-suicidal self-injury" OR "self-injurious behavior" OR "self-destructive behavior" OR "self-mutilation" AND "sleep problem" OR "sleep disturbance" OR insomnia OR nightmare OR "poor sleep quality" or "sleep disorders." A total of 16 studies were included in the present review. The pattern of results indicated that sleep problems such as short sleep duration, sleep disturbances, and poor sleep quality were associated with non-suicidal self-injury. Additionally, emotional dysregulation, depression, and post-traumatic stress disorder appeared to mediate this relationship. Above all adolescents and young adults with sleep disruptions were at higher risk of non-suicidal self-injury. Interventions to improve sleep quality and sleep duration might concomitantly decrease the risk of non-suicidal self-injury.
Topics: Depression; Dreams; Emotions; Humans; Risk Factors; Self-Injurious Behavior; Sleep; Sleep Initiation and Maintenance Disorders; Sleep Wake Disorders; Stress Disorders, Post-Traumatic
PubMed: 32991212
DOI: 10.1080/15402002.2020.1822360 -
Cancers Jul 2020Colorectal cancer (CRC) is one of the most common cancers requiring early pathologic diagnosis using colonoscopy biopsy samples. Recently, artificial intelligence (AI)...
Colorectal cancer (CRC) is one of the most common cancers requiring early pathologic diagnosis using colonoscopy biopsy samples. Recently, artificial intelligence (AI) has made significant progress and shown promising results in the field of medicine despite several limitations. We performed a systematic review of AI use in CRC pathology image analysis to visualize the state-of-the-art. Studies published between January 2000 and January 2020 were searched in major online databases including MEDLINE (PubMed, Cochrane Library, and EMBASE). Query terms included "colorectal neoplasm," "histology," and "artificial intelligence." Of 9000 identified studies, only 30 studies consisting of 40 models were selected for review. The algorithm features of the models were gland segmentation ( = 25, 62%), tumor classification ( = 8, 20%), tumor microenvironment characterization ( = 4, 10%), and prognosis prediction ( = 3, 8%). Only 20 gland segmentation models met the criteria for quantitative analysis, and the model proposed by Ding et al. (2019) performed the best. Studies with other features were in the elementary stage, although most showed impressive results. Overall, the state-of-the-art is promising for CRC pathological analysis. However, datasets in most studies had relatively limited scale and quality for clinical application of this technique. Future studies with larger datasets and high-quality annotations are required for routine practice-level validation.
PubMed: 32668721
DOI: 10.3390/cancers12071884 -
BMC Complementary Medicine and Therapies Jun 2020African Potato (hypoxis hemerocallidea), is used for enhancing immune system in Southern Africa. It is among the plants of intense commercial and scientific interest;...
BACKGROUND
African Potato (hypoxis hemerocallidea), is used for enhancing immune system in Southern Africa. It is among the plants of intense commercial and scientific interest; hence, the aim of this study was to describe its chemistry and pharmacology.
METHODS
PubMed, Cochrane Controlled Trials Register (CENTRAL) and Google Scholar were searched independently for relevant literature. The last search occurred in October 2018. Other research material was obtained from Google. The following search terms were used, but not limited to: "African Potato", "hypoxis", "hemerocallidea", "rooperol." Articles that were explaining the chemistry and pharmacology of hypoxis hemerocallidea were included.
RESULTS
Thirty articles from PubMed, Cochrane and Google Scholar were eligible. Three webpages were included from Google. Results showed that the tuberous rootstock (corm) of African Potato is used traditionally to treat wasting diseases, testicular tumours, insanity, barrenness, impotency, bad dreams, intestinal parasites, urinary infection, cardiac disease and enhancing immunity. The plant contains hypoxoside, which is converted rapidly to a potent antioxidant, rooperol in the gut. The corm contains sterols, sterol glycosides, stanols, terpenoids, saponins, cardiac glycosides, tannins and reducing sugars. A dose of 15 mg/kg/day of hypoxoside is reportedly therapeutic. Preclinical studies of African Potato have shown immunomodulation, antioxidant, antinociceptive, hypoglycaemic, anti-inflammatory, anticonvulsant, antibacterial, uterolytic, antimotility, spasmolytic and anticholinergic effects. The common side effects of African Potato are nausea and vomiting, which subside over time. In vitro, African Potato demonstrated inhibitory effects on CYP1A2, 2C9, 2D6, 3A4, 3A5, CYP19-metabolism and induction of P-glycoprotein. In vivo, it did not alter the pharmacokinetics of efavirenz or lopinavir/ritonavir.
CONCLUSION
African Potato is mainly used as an immunostimulant. The exact mechanisms of action for all the pharmacological actions are unknown. More research is required to substantiate claims regarding beneficial effects. There are many research gaps that require investigation including pharmacokinetic interactions with conventional drugs, especially those used in HIV/AIDS.
Topics: Africa; Catechols; Humans; Hypoxis; Medicine, African Traditional; Plant Extracts; Plants, Medicinal
PubMed: 32527245
DOI: 10.1186/s12906-020-02956-x -
Vaccine May 2020The prevalence of co-infection of hepatitis B virus (HBV) and human immunodeficiency virus (HIV) is high and increases risk of hepatitis B chronicity and mortality.... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
The prevalence of co-infection of hepatitis B virus (HBV) and human immunodeficiency virus (HIV) is high and increases risk of hepatitis B chronicity and mortality. Despite guidelines for HIV-infected patients to be immunized against HBV, the immunogenicity of the HBV vaccination in HIV-infected patients is lower than that in the HIV-seronegative population.
METHOD
In this study, we performed a systematic review of the literature and meta-analysis of randomized clinical trials to investigate the response rate to an increased dose of HBV vaccination in HIV-infected patients. A fixed-effects model, with heterogeneity and sensitivity analyses, was used. We identified nine studies involving 970 HIV-positive vaccine recipients.
RESULTS
The study results were divided into two groups, depending on the time when antibody against hepatitis surface antigen was measured. Results showed a significant increase in response rates among patients who received a double dose of the vaccine versus the standard dose in both subgroups; the pooled odds ratio (OR) was 1.76 (95% confidence interval [CI]: 1.36-2.29) and 2.28 (95% CI: 1.73-3.01) for the rate that was measured 4-6 weeks and >12 months after completion of vaccination, respectively. The total OR was 1.99 (95% CI: 1.64-2.41). No heterogeneity was found.
DISCUSSION
Our meta-analysis shows that a double dose of the HBV vaccine may significantly improve the immune response in HIV-infected patients. Higher immunogenicity was observed, when it was measured 4-6 weeks and >12 months after completion of the vaccination.
Topics: Coinfection; Dose-Response Relationship, Immunologic; HIV Infections; Hepatitis B; Hepatitis B Antibodies; Hepatitis B Vaccines; Humans; Immunity; Immunogenicity, Vaccine
PubMed: 32334887
DOI: 10.1016/j.vaccine.2020.04.022 -
Respiratory Research Apr 2020Subphenotypes were recently reported within clinical acute respiratory distress syndrome (ARDS), with distinct outcomes and therapeutic responses. Experimental models... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Subphenotypes were recently reported within clinical acute respiratory distress syndrome (ARDS), with distinct outcomes and therapeutic responses. Experimental models have long been used to mimic features of ARDS pathophysiology, but the presence of distinct subphenotypes among preclinical ARDS remains unknown. This review will investigate whether: 1) subphenotypes can be identified among preclinical ARDS models; 2) such subphenotypes can identify some responsive traits.
METHODS
We will include comparative preclinical (in vivo and ex vivo) ARDS studies published between 2009 and 2019 in which pre-specified therapies were assessed (interleukin (IL)-10, IL-2, stem cells, beta-agonists, corticosteroids, fibroblast growth factors, modulators of the receptor for advanced glycation end-products pathway, anticoagulants, and halogenated agents) and outcomes compared to a control condition. The primary outcome will be a composite of the four key features of preclinical ARDS as per the American Thoracic Society consensus conference (histologic evidence of lung injury, altered alveolar-capillary barrier, lung inflammatory response, and physiological dysfunction). Secondary outcomes will include the single components of the primary composite outcome, net alveolar fluid clearance, and death. MEDLINE, Embase, and Cochrane databases will be searched electronically and data from eligible studies will be extracted, pooled, and analyzed using random-effects models. Individual study reporting will be assessed according to the Animal Research: Reporting of In Vivo Experiments guidelines. Meta-regressions will be performed to identify subphenotypes prior to comparing outcomes across subphenotypes and treatment effects.
DISCUSSION
This study will inform on the presence and underlying pathophysiological features of subphenotypes among preclinical models of ARDS and should help to determine whether sufficient evidence exists to perform preclinical trials of subphenotype-targeted therapies, prior to potential clinical translation.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO (ID: CRD42019157236).
Topics: Adrenergic beta-Agonists; Animals; Disease Models, Animal; Humans; Phenotype; Positive-Pressure Respiration; Randomized Controlled Trials as Topic; Respiratory Distress Syndrome; Treatment Outcome
PubMed: 32264897
DOI: 10.1186/s12931-020-01337-9 -
Journal of Community Psychology Jul 2020On the basis of the systematic literature review, we investigate the characteristics of community-based Youth Participatory Action Research (YPAR) programs with a focus...
On the basis of the systematic literature review, we investigate the characteristics of community-based Youth Participatory Action Research (YPAR) programs with a focus on health and well-being and their recommendations for future programs. The study was based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses diagram. Most included a case study design, mixed or qualitative methodology, interview as data collection, and YPAR youth in data reporting. The sample differs between studies, and most of the work took place in the United States. The stages (raise awareness, capacitation, design, motivation, implementation, evaluation, dissemination, and replication) are evident as a fundamental strategy in these programs.
Topics: Adolescent; Adult; Community-Based Participatory Research; Female; Health Services Research; Humans; Leadership; Male; Qualitative Research; Young Adult
PubMed: 31985839
DOI: 10.1002/jcop.22320 -
Sleep Medicine Mar 2020Nightmares are a highly prevalent and distressing feature of post-traumatic stress disorder (PTSD). Previous studies have reached mixed conclusions regarding the effects... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Nightmares are a highly prevalent and distressing feature of post-traumatic stress disorder (PTSD). Previous studies have reached mixed conclusions regarding the effects of prazosin on nightmares, sleep quality, and overall PTSD symptoms in patients with PTSD.
METHODS
MEDLINE, EMBASE, all EBM databases, PsycIFNO, and CINAHL were systematically searched from inception date to October 2018 for randomized clinical trials that included reporting of nightmares, sleep quality or overall PTSD symptoms. The analysis included data from eight trials involving 286 PTSD patients in the prazosin group and 289 PTSD patients in the placebo group.
RESULTS
In our meta-analysis, prazosin resulted in a statistically significant improvement in nightmares (standardized mean difference (SMD) = -1.13, 95% confidence interval (CI) = -1.91 to -0.36), but was not more beneficial than placebo for overall PTSD symptoms (SMD = -0.45, 95% CI = -0.95 to 0.05) and sleep quality (SMD = -0.44, 95% CI = -1.44 to 0.55). In terms of acceptability, there was no significant difference between the prazosin group and the placebo group with respect to discontinuation for all causes (odds ratio (OR) = 1.00, 95% CI = 0.62-1.62). In conclusion, the use of prazosin was associated with an improvement of nightmare symptoms.
CONCLUSION
Our findings indicate that additional studies are needed before considering downgrading the use of prazosin in the treatment of nightmares in patients with PTSD.
Topics: Antihypertensive Agents; Dreams; Humans; Prazosin; Randomized Controlled Trials as Topic; Sleep Wake Disorders; Stress Disorders, Post-Traumatic
PubMed: 31972510
DOI: 10.1016/j.sleep.2019.06.010 -
PloS One 2019Child maltreatment can have serious effects on development and physical, social and emotional wellbeing. Any long-lasting relational effects can impede the capacity to... (Meta-Analysis)
Meta-Analysis
Healing The Past By Nurturing The Future: A qualitative systematic review and meta-synthesis of pregnancy, birth and early postpartum experiences and views of parents with a history of childhood maltreatment.
BACKGROUND
Child maltreatment can have serious effects on development and physical, social and emotional wellbeing. Any long-lasting relational effects can impede the capacity to nurture children, potentially leading to 'intergenerational trauma'. Conversely, the transition to parenthood during pregnancy, birth and the early postpartum period offers a unique life-course opportunity for healing. This systematic review aims to understand the pregnancy, birth and early postpartum experiences of parents who reported maltreatment in their own childhood.
METHODS
A protocol, based on the ENTREQ statement, was registered with PROSPERO. We searched Medline, PsycINFO, CINAHL, EMBASE, NHS Evidence and key Web of Science databases from date of inception to June 2018 to identify qualitative studies exploring perinatal experiences of parents who were maltreated in their own childhood. Two reviewers independently screened articles for inclusion and extracted data. Data were synthesised using grounded theory and thematic analysis approaches.
FINDINGS
The search yielded 18329 articles, 568 full text articles were reviewed, and 50 studies (60 articles) met inclusion criteria for this review. Due to the large number of studies across the whole perinatal period (pregnancy to two years postpartum), this paper reports findings for experiences during pregnancy, birth and early postpartum (27 studies). Parents described positive experiences and strategies to help them achieve their hopes and dreams of providing safe, loving and nurturing care for their children. However, many parents experienced serious challenges. Seven core analytic themes encapsulated these diverse and dynamic experiences: New beginnings; Changing roles and identities; Feeling connected; Compassionate care; Empowerment; Creating safety; and Reweaving a future.
CONCLUSIONS
Pregnancy birth and the early postpartum period is a unique life-course healing opportunity for parents with a history of maltreatment. Understanding parent's experiences and views of perinatal care and early parenting is critical for informing the development of acceptable and effective support strategies.
Topics: Adult Survivors of Child Abuse; Female; Humans; Parenting; Parents; Parturition; Postpartum Period; Pregnancy; Pregnant Women
PubMed: 31834894
DOI: 10.1371/journal.pone.0225441 -
The British Journal of Radiology Feb 2020The recent increase in publications on radiomic analysis as means to produce diagnostic and predictive biomarkers in head and neck cancers (HNCC) reveal complicated and...
Radiomic analysis for response assessment in advanced head and neck cancers, a distant dream or an inevitable reality? A systematic review of the current level of evidence.
OBJECTIVE
The recent increase in publications on radiomic analysis as means to produce diagnostic and predictive biomarkers in head and neck cancers (HNCC) reveal complicated and often conflicting results. The objective of this paper is to systematically review the published data, and evaluate the current level of evidence accumulated that would determine clinical application.
METHODS
Articles in the English language available on the Ovid-MEDLINE and Embase databases were used for the literature search. :Studies which evaluated the role of radiomics as a predictive or prognostic tool for response assessment in HNCC were included in this review.Study appraisal and synthesis methods: The authors set-out to perform a meta-analysis, however given the small number of studies retrieved that presented adequate data, combined with excessive methodological heterogeneity, we could only perform a structured descriptive systematic review summarizing the key findings. Independent extraction of articles was performed by two authors using predefined data fields and any disagreement was resolved by consensus.
RESULTS
Though most papers concluded that radiomics is an effective predictive and prognostic biomarker in the management of HNCC, significant heterogeneity exists in the study methodology and statistical modelling; thus precluding accurate mathematical comparison or the ability to make clear recommendations going forwards. Moreover, most studies have not been validated and the reproducibility of their results will be a challenge.
CONCLUSION
Until robust external validation studies on the reproducibility and accuracy of radiomic analysis methods on HNCC are carried out, the current level of evidence remains low, with the authors advising caution against hasty implementation of these tools in the multidisciplinary clinic.
ADVANCES IN KNOWLEDGE
This review is the first attempt to critically analyze the merits and demerits of currently published literature on tumour heterogeneity studies in HNCC, and identifies specific loop holes that need to be addressed by research groups, for a meaningful clinical translation of this potential biomarker.
Topics: Head and Neck Neoplasms; Humans; Magnetic Resonance Imaging; Positron Emission Tomography Computed Tomography; Prognosis; Tomography, X-Ray Computed
PubMed: 31682155
DOI: 10.1259/bjr.20190496