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Метка: Systematic

Новый сисобзор по травме! Migliorini 2019

Откуда инфа? См. запрос PubMed!
title = {Better outcomes with patellar resurfacing during primary total knee arthroplasty: a meta-analysis study},
issn = {1434-3916},
shorttitle = {Better outcomes with patellar resurfacing during primary total knee arthroplasty},
doi = {10.1007/s00402-019-03246-z},
abstract = {BACKGROUND: Total knee arthroplasty (TKA) is a feasible and cost-effective procedure. However, resurfacing of the patella sparks a heated debate. Anterior knee pain after TKA was supposed to be correlated to the patellofemoral joint, and the resurface of the patella was believed to be effective to avoid this complication.
AIM: A meta-analysis was performed to update current evidence concerning the outcomes of patellar resurfacing versus retaining for total knee arthroplasty. The first outcomes of interest were to compare the rate of anterior knee pain and revision surgeries.
MATERIAL AND METHODS: This study was conducted according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA). A comprehensive review of the literature was conducted accessing the main databases: Embase, Google Scholar, PubMed, Scopus. All the prospective clinical trials comparing the outcomes between patellar resurfacing versus retaining were included in this study. Only articles classified as level of evidence I to II were considered for inclusion. Only studies reporting a minimum 24 months follow-up were included. The following data were extracted: demographic baseline, anterior knee pain, reoperations, clinical scores (HSS, KSS and related subscales) and range of motion (ROM). Studies solely reporting quantitative data under the outcomes of interest were included.
RESULTS: In favor of the resurfacing group, we observed a statistically significant reduced rate of anterior knee pain (odd ratio 1.73) and reoperation (odd ratio 3.24). In the resurfacing group, a prevalence of anterior knee pain of 11.15\% was detected, whereas in the retaining group it amounted to 17.39\%. Furthermore, a greater KSS pain (+ 0.97\%), KSS clinical (+ 0.23\%), KSS functional (+ 2.44\%), KSS overall (+ 2.47\%) and HSS (+ 5.64\%) were reported. In the retaining group, we found a better range of motion (+ 3.09°).
CONCLUSION: Based on the main findings of this meta-analysis, patellar resurfaced TKA was demonstrated to have performed superior overall. Patellar resurfacing detected a lower rate of postoperative anterior knee pain and reoperation. Moreover, the resurfacing group showed greater value of the HSS, KSS and related subscales. In favor of the retaining group, a slightly better ROM was evidenced.
LEVEL OF EVIDENCE: Level II, meta-analysis of prospective clinical trials.},
language = {eng},
journal = {Archives of Orthopaedic and Trauma Surgery},
author = {Migliorini, Filippo and Eschweiler, Jörg and Niewiera, Marc and El Mansy, Yasser and Tingart, Markus and Rath, Björn},
month = jul,
year = {2019},
pmid = {31367842},
keywords = {Anterior knee pain, Patellar resurfacing, Patellar retaining, Prosthesis, Total knee arthroplasty}

Новый спинальный сисобзор! Turner 2019

Откуда инфа? См. запрос PubMed!
title = {Management of cervical spine epidural abscess: a systematic review},
volume = {6},
issn = {2049-9361},
shorttitle = {Management of cervical spine epidural abscess},
doi = {10.1177/2049936119863940},
abstract = {Background: Cervical spinal epidural abscess (CSEA) is a localized infection between the thecal sac and cervical spinal column which may result in neurological deficit and death if inadequately treated. Two treatment options exist: medical management and surgical intervention. Our objective was to analyze CSEA patient outcomes in order to determine the optimal method of treatment.
Methods: An electronic literature search for relevant case series and retrospective reviews was conducted through June 2016. Data abstraction and study quality assessment were performed by two independent reviewers. A lack of available data led to a post hoc decision not to perform meta-analysis of the results; study findings were synthesized qualitatively.
Results: 927 studies were identified, of which 11 were included. Four studies were ranked as good quality, and seven ranked as fair quality. In total, data from 173 patients were included. Mean age was 55 years; 61.3\% were male. Intravenous drug use was the most common risk factor for CSEA development. Staphylococcus aureus was the most commonly cultured pathogen. 140 patients underwent initial surgery, an additional 18 patients were surgically treated upon failure of medical management, and 15 patients were treated with antibiotics alone.
Conclusion: The rates of medical management failure described in our review were much higher than those reported in the literature for thoracolumbar spinal epidural abscess patients, suggesting that CSEA patients may be at a greater risk for poor outcomes following nonoperative treatment. Thus, early surgery appears most viable for optimizing CSEA patient outcomes. Further research is needed in order to corroborate these recommendations.},
language = {eng},
journal = {Therapeutic Advances in Infectious Disease},
author = {Turner, Anastasia and Zhao, Linlu and Gauthier, Paul and Chen, Suzan and Roffey, Darren M. and Wai, Eugene K.},
month = dec,
year = {2019},
pmid = {31367375},
pmcid = {PMC6643182},
keywords = {cervical spine, epidural abscess, surgery, treatment outcome},
pages = {2049936119863940}

Новый сисобзор! Orhurhu 2019

Откуда инфа? См. запрос PubMed!
 title = {Systematic {Review} of {Radiofrequency} {Ablation} for {Management} of {Knee} {Pain}},
 volume = {23},
  issn = {1534-3081},
 doi = {10.1007/s11916-019-0792-y},
  abstract = {PURPOSE OF REVIEW: Chronic pain of the lower extremity remains challenging to manage. Radiofrequency ablation procedure applies heat to nerve fibers with the goal of mitigating chronic pain conditions of the knee. However, the clinical efficacy has not yet been adequately established. The goal of this review paper is to report the use of radiofrequency ablations in the treatment of osteoarthritis of the knee.
RECENT FINDINGS: PubMed and the Cochrane Controlled Trials Register were searched (final search 28 February 2018) using the MeSH terms "radiofrequency ablation," "neurolysis," "radiofrequency therapy," "pain syndrome," "analgesia," and "pain" in the English literature. Bibliographies of the published papers were screened for relevance to lower extremity radiofrequency ablation therapies. The quality of selected publications was assessed using the Cochrane risk of bias instrument. Of the 923 papers screened, 317 were further investigated for relevance. Our final search methodology yielded 19 studies that investigated the use of radiofrequency ablation at the knee. Of these 19 studies, there were four randomized control trials, two non-randomized control trials, three prospective studies, two retrospective studies, one case-control study, one technical report, and seven case reports. In summary, the data available suggests radiofrequency ablation as a promising and efficacious with all 19 studies revealing significant short- and long-term pain reductions in patients with knee pain.},
  language = {eng},
   number = {8},
   journal = {Current Pain and Headache Reports},
  author = {Orhurhu, Vwaire and Urits, Ivan and Grandhi, Ravi and Abd-Elsayed, Alaa},
 month = jul,
    year = {2019},
  pmid = {31286282},
  keywords = {Knee pain, Neurolysis, Pain therapy, RFA, Radiofrequency ablation, Radiofrequency therapy},
 pages = {55}

Новый сисобзор! Semlitsch 2019

Откуда инфа? См. запрос PubMed!
title = {Management of overweight and obesity in primary care-{A} systematic overview of international evidence-based guidelines},
issn = {1467-789X},
doi = {10.1111/obr.12889},
abstract = {Overweight and obesity are increasing worldwide. In general practice, different approaches exist to treat people with weight problems. To provide the foundation for the development of a structured clinical pathway for overweight and obesity management in primary care, we performed a systematic overview of international evidence-based guidelines. We searched in PubMed and major guideline databases for all guidelines published in World Health Organization (WHO) "Stratum A" nations that dealt with adults with overweight or obesity. Nineteen guidelines including 711 relevant recommendations were identified. Most of them concluded that a multidisciplinary team should treat overweight and obesity as a chronic disease. Body mass index (BMI) should be used as a routine measure for diagnosis, and weight-related complications should be taken into account. A multifactorial, comprehensive lifestyle programme that includes reduced calorie intake, increased physical activity, and measures to support behavioural change for at least 6 to 12 months is recommended. After weight reduction, long-term measures for weight maintenance are necessary. Bariatric surgery can be offered to people with a BMI greater than or equal to 35 kg/m2 when all non-surgical interventions have failed. In conclusion, there was considerable agreement in international, evidence-based guidelines on how multidisciplinary management of overweight and obesity in primary care should be performed.},
language = {eng},
journal = {Obesity Reviews: An Official Journal of the International Association for the Study of Obesity},
author = {Semlitsch, Thomas and Stigler, Florian L. and Jeitler, Klaus and Horvath, Karl and Siebenhofer, Andrea},
month = jul,
year = {2019},
pmid = {31286668},
keywords = {adults, obesity, overweight, systematic overview}

Новый сисобзор! Price 2019

Откуда инфа? См. запрос PubMed!
    title = {The {Arthroplasty} {Candidacy} {Help} {Engine} tool to select candidates for hip and knee replacement surgery: development and economic modelling},
    volume = {23},
    issn = {2046-4924},
    shorttitle = {The {Arthroplasty} {Candidacy} {Help} {Engine} tool to select candidates for hip and knee replacement surgery},
    doi = {10.3310/hta23320},
    abstract = {BACKGROUND: There is no good evidence to support the use of patient-reported outcome measures (PROMs) in setting preoperative thresholds for referral for hip and knee replacement surgery. Despite this, the practice is widespread in the NHS.
OBJECTIVES/RESEARCH QUESTIONS: Can clinical outcome tools be used to set thresholds for hip or knee replacement? What is the relationship between the choice of threshold and the cost-effectiveness of surgery?
METHODS: A systematic review identified PROMs used to assess patients undergoing hip/knee replacement. Their measurement properties were compared and supplemented by analysis of existing data sets. For each candidate score, we calculated the absolute threshold (a preoperative level above which there is no potential for improvement) and relative thresholds (preoperative levels above which individuals are less likely to improve than others). Owing to their measurement properties and the availability of data from their current widespread use in the NHS, the Oxford Knee Score (OKS) and Oxford Hip Score (OHS) were selected as the most appropriate scores to use in developing the Arthroplasty Candidacy Help Engine (ACHE) tool. The change in score and the probability of an improvement were then calculated and modelled using preoperative and postoperative OKS/OHSs and PROM scores, thereby creating the ACHE tool. Markov models were used to assess the cost-effectiveness of total hip/knee arthroplasty in the NHS for different preoperative values of OKS/OHSs over a 10-year period. The threshold values were used to model how the ACHE tool may change the number of referrals in a single UK musculoskeletal hub. A user group was established that included patients, members of the public and health-care representatives, to provide stakeholder feedback throughout the research process.
RESULTS: From a shortlist of four scores, the OHS and OKS were selected for the ACHE tool based on their measurement properties, calculated preoperative thresholds and cost-effectiveness data. The absolute threshold was 40 for the OHS and 41 for the OKS using the preferred improvement criterion. A range of relative thresholds were calculated based on the relationship between a patient's preoperative score and their probability of improving after surgery. For example, a preoperative OHS of 35 or an OKS of 30 translates to a 75\% probability of achieving a good outcome from surgical intervention. The economic evaluation demonstrated that hip and knee arthroplasty cost of {\textless} £20,000 per quality-adjusted life-year for patients with any preoperative score below the absolute thresholds (40 for the OHS and 41 for the OKS). Arthroplasty was most cost-effective for patients with lower preoperative scores.
LIMITATIONS: The ACHE tool supports but does not replace the shared decision-making process required before an individual decides whether or not to undergo surgery.
CONCLUSION: The OHS and OKS can be used in the ACHE tool to assess an individual patient's suitability for hip/knee replacement surgery. The system enables evidence-based and informed threshold setting in accordance with local resources and policies. At a population level, both hip and knee arthroplasty are highly cost-effective right up to the absolute threshold for intervention. Our stakeholder user group felt that the ACHE tool was a useful evidence-based clinical tool to aid referrals and that it should be trialled in NHS clinical practice to establish its feasibility.
FUTURE WORK: Future work could include (1) a real-world study of the ACHE tool to determine its acceptability to patients and general practitioners and (2) a study of the role of the ACHE tool in supporting referral decisions.
FUNDING: The National Institute for Health Research Health Technology Assessment programme.},
    language = {eng},
    number = {32},
    journal = {Health Technology Assessment (Winchester, England)},
    author = {Price, Andrew and Smith, James and Dakin, Helen and Kang, Sujin and Eibich, Peter and Cook, Jonathan and Gray, Alastair and Harris, Kristina and Middleton, Robert and Gibbons, Elizabeth and Benedetto, Elena and Smith, Stephanie and Dawson, Jill and Fitzpatrick, Raymond and Sayers, Adrian and Miller, Laura and Marques, Elsa and Gooberman-Hill, Rachael and Blom, Ashley and Judge, Andrew and Arden, Nigel and Murray, David and Glyn-Jones, Sion and Barker, Karen and Carr, Andrew and Beard, David},
    month = jun,
    year = {2019},
    pmid = {31287051},
    pages = {1--216}

Новый сисобзор! Taudorf 2019

Откуда инфа? См. запрос PubMed!
    title = {Cutaneous candidiasis - {An} evidence-based review of topical and systemic treatments to inform clinical practice},
    issn = {1468-3083},
    doi = {10.1111/jdv.15782},
    abstract = {Cutaneous candidiasis is a common skin disease and several treatments have been investigated within the last fifty years. Yet, systematic reviews are lacking, and evidence- based topical as well as systemic treatment strategies remain unclear. Thus, the aim of this review was to summarize efficacy and adverse effects of topical and oral therapies for cutaneous candidiasis in all age groups. Two individual researchers searched Pubmed and Embase for "cutaneous candidiasis" and "cutaneous candidiasis treatment", "intertrigo", "diaper dermatitis" and "cheilitis". Searches were limited to "English language, "clinical trials" and "Human subjects" and prospective clinical trials published in abstracts or articles were included. In total, 149 studies were identified, of which 44 were eligible, comprising 41 studies of 19 topical therapies and four studies of three systemic therapies for cutaneous candidiasis. Topical therapies were investigated in infants, children, adolescents, adults and elderly, while studies of systemic therapies were limited to adolescents and adults. Clotrimazole, nystatin and miconazole were the most studied topical drugs and demonstrated similar efficacy with complete cure rates of 73 - 100\%. Single-drug therapy was as effective as combinations of anti-fungal, anti-bacterial and topical corticosteroid. Four studies investigated systemic therapy, and oral fluconazole demonstrated similar efficacy to oral ketoconazole and topical clotrimazole. Limitations to this review was mainly that heterogenicity of studies hindered meta-analyses. In conclusions, clotrimazole, nystatin and miconazole were the most studied topical drugs and demonstrated equal good efficacy and mild adverse effects similar to combinations of anti-fungal, anti-bacterial, and topical corticosteroids. Oral fluconazole was as effective as topical clotrimazole and is the only commercially available evidence-based option for systemic treatment of cutaneous candidiasis. This article is protected by copyright. All rights reserved.},
    language = {eng},
    journal = {Journal of the European Academy of Dermatology and Venereology: JEADV},
    author = {Taudorf, E. H. and Jemec, G. B. E. and Hay, R. J. and Saunte, D. M. L.},
    month = jul,
    year = {2019},
    pmid = {31287594},
    keywords = {
, cheilitis, cutaneous candidiasis, cutaneous candidiasis treatment, diaper dermatitis, intertrigo}

Новый сисобзор! Zhao 2019

Откуда инфа? См. запрос PubMed!
    title = {The {Effect} of {Diuretics} on {Patients} with {Heart} {Failure}: {A} {Network} {Meta}-{Analysis}: {Diuretics} {Effect} on {Heart} {Failure} {Patients}},
    volume = {22},
    issn = {1482-1826},
    shorttitle = {The {Effect} of {Diuretics} on {Patients} with {Heart} {Failure}},
    doi = {10.18433/jpps30146},
    abstract = {PURPOSE: We aimed to comprehensively evaluate the curative effect of torasemide, tolvaptan, furosemide and azosemide on patients with heart failure.
METHODS: Relevant studies were retrieved by searching the electronic databases until May 2018. Quality assessment and data extraction of selected studies were evaluated by two reviewers. Heterogeneity across studies was assessed utilizing the I2 statistic and Q- test, and appropriate effect model was selected to calculate the pooled effect size. Network meta-analysis was conducted and the convergence degree of model was evaluated.
RESULTS: A total of 12 studies were enrolled in this study. Significant heterogeneity was not identified across the studies. Significantly greater differences were found in left ventricular ejection fraction (LVEF) for furosemide VS. azosemide, in brain natriuretic peptide (BNP) for furosemide VS. azosemide and furosemide VS. torasemide, and in adverse effects for furosemide VS. torasemide through Meta-analysis of direct comparison. In addition, network meta-analysis results suggested there were no significant differences in adverse effects, mortality, BNP and LVEF among these groups. However, the relatively low mortality and small improvement of BNP and LVEF were found in HF patients treated with torasemide.
CONCLUSION: Torasemide might be an optimal treatment for HF patients considering its comprehensive curative effect.},
    language = {eng},
    number = {1},
    journal = {Journal of Pharmacy \& Pharmaceutical Sciences: A Publication of the Canadian Society for Pharmaceutical Sciences, Societe Canadienne Des Sciences Pharmaceutiques},
    author = {Zhao, Xingsheng and Ren, Yu and Li, Hui and Liu, Xi},
    year = {2019},
    pmid = {31287791},
    pages = {270--280}

Новый сисобзор! Kizaki 2019

Откуда инфа? См. запрос PubMed!
title = {Arthroscopic versus {Open} {Osteochondral} {Autograft} {Transplantation} ({Mosaicplasty}) for {Cartilage} {Damage} of the {Knee}: {A} {Systematic} {Review}},
issn = {1938-2480},
shorttitle = {Arthroscopic versus {Open} {Osteochondral} {Autograft} {Transplantation} ({Mosaicplasty}) for {Cartilage} {Damage} of the {Knee}},
doi = {10.1055/s-0039-1692999},
abstract = {Osteochondral autograft transplantation (OAT) is a surgical option for repairing cartilage damage in knees, and can be performed using open or arthroscopic procedures. The aim of this review was to report clinical outcomes, postoperative complications, defect location, and defect size between open and arthroscopic OATs. Three electronic databases (EMBASE, PUBMED, and MEDLINE) were searched for relevant articles. In regard to eligibility criteria, knee articular damage cases solely treated with OAT were included and cases concomitant with ligament reconstruction, limb realignment, and meniscus repair were excluded. The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and descriptive statistics are presented. A total of 24 studies were included with a total sample of 1,139 patients (532 in open OAT vs. 607 in arthroscopic OAT). Defect size in open OAT was three times larger than that of arthroscopic OAT (2.96 ± 0.76 vs. 0.97 ± 0.48 cm2). In terms of defect location, the medial femoral condyle (MFC) was the most common (75.4\%), followed by the lateral femoral condyle (LFC; 12.1\%), patella (6.7\%), and trochlea (5.7\%). All of these defect locations were treated with open OAT, whereas arthroscopic OAT treatments were restricted to the MFC and LFC. The clinical outcomes were overall favorable with the modified Hospital for Special Surgery knee scores being 89.6 ± 8.0 (36.1-month follow-up) versus 90.4 ± 6.0 (89.5-month follow-up) and the Lysholm scores being 81.6 ± 8.9 (44.2-month follow-up) and 83.3 ± 7.4 (12.0-month follow-up) between open and arthroscopic OATs, respectively. Fifty-three postoperative complications were observed (39/279 vs. 14/594) and the most common complication was hemarthrosis (13/39 in open, vs. 1/14 in arthroscopic OAT). The overall clinical outcomes were favorable in open and arthroscopic OATs, whereas open OAT allowed for treatment of lesions approximately three times greater in dimension than in arthroscopic OAT. Also, defect location was restricted to MFC and LFC in arthroscopic OAT. The most common complication was hemarthrosis.},
language = {eng},
journal = {The Journal of Knee Surgery},
author = {Kizaki, Kazuha and El-Khechen, Hussein Ali and Yamashita, Fumiharu and Duong, Andrew and Simunovic, Nicole and Musahl, Volker and Ayeni, Olufemi R.},
month = jul,
year = {2019},
pmid = {31288271}