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critical care systematic reviews

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https://www.readbyqxmd.com/read/28109052/the-use-of-methadone-to-facilitate-opioid-weaning-in-pediatric-critical-care-patients-a-systematic-review-of-the-literature-and-meta-analysis
#1
REVIEW
Leslie A Dervan, Beryl Yaghmai, Robert Scott Watson, Fredric M Wolf
BACKGROUND: Continuous opioid infusion therapy is commonly utilized in the pediatric intensive care setting to treat pain and facilitate tolerance of invasive therapies. Transitioning to methadone is one common strategy for weaning from continuous opioid infusions, but in practice this transition can be challenging, and many children still experience iatrogenic withdrawal. AIM: We reviewed the literature to evaluate the best available evidence to guide methadone therapy in this setting, and to summarize associated adverse events...
January 20, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28108472/relapsed-acute-promyelocytic-leukemia-lacks-classic-leukemic-promyelocyte-morphology-and-can-create-diagnostic-challenges
#2
Vanessa J Dayton, Robert W McKenna, Sophia L Yohe, Michelle M Dolan, Elizabeth Courville, Harold Alvarez, Michael A Linden
OBJECTIVES: Although current therapies for acute promyelocytic leukemia (APL), such as all-trans retinoic acid and arsenic trioxide, usually result in remission, some patients relapse. Early recognition of relapse is critical for prompt intervention. In this study, we systematically reviewed morphologic, immunophenotypic, and cytogenetic findings in paired diagnostic and relapsed APL cases and describe and quantify the changes in blast morphology at relapse. METHODS: By electronic database search, we identified eight paired diagnostic and relapsed APL cases for which peripheral blood or bone marrow smears were available for review...
January 20, 2017: American Journal of Clinical Pathology
https://www.readbyqxmd.com/read/28103931/developing-a-framework-to-guide-the-de-adoption-of-low-value-clinical-practices-in-acute-care-medicine-a-study-protocol
#3
Jeanna Parsons Leigh, Daniel J Niven, Jamie M Boyd, Henry T Stelfox
BACKGROUND: Healthcare systems have difficulty incorporating scientific evidence into clinical practice, especially when science suggests that existing clinical practices are of low-value (e.g. ineffective or harmful to patients). While a number of lists outlining low-value practices in acute care medicine currently exist, less is known about how best to initiate and sustain the removal of low-value clinical practices (i.e. de-adoption). This study will develop a comprehensive list of barriers and facilitators to the de-adoption of low-value clinical practices in acute care facilities to inform the development of a framework to guide the de-adoption process...
January 19, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28103849/-how-do-ethnic-minority-patients-experience-the-intercultural-care-encounter-in-hospitals-a-systematic-review-of-qualitative-research
#4
Liesbet Degrie, Chris Gastmans, Lieslot Mahieu, Bernadette Dierckx de Casterlé, Yvonne Denier
BACKGROUND: In our globalizing world, caregivers are increasingly being confronted with the challenges of providing intercultural healthcare, trying to find a dignified answer to the vulnerable situation of ethnic minority patients. Until now, international literature lacks insight in the intercultural care process as experienced by the ethnic minority patients themselves. We aim to fill this gap by analysing qualitative literature on the intercultural care encounter in the hospital setting, as experienced by ethnic minority patients...
January 19, 2017: BMC Medical Ethics
https://www.readbyqxmd.com/read/28103700/the-effects-of-mindfulness-based-interventions-for-health-and-social-care-undergraduate-students-a-systematic-review-of-the-literature
#5
Michelle O'Driscoll, Stephen Byrne, Aoife Mc Gillicuddy, Sharon Lambert, Laura J Sahm
Health and social care undergraduate students experience stress due to high workloads and pressure to perform. Consequences include depression and burnout. Mindfulness may be a suitable way to reduce stress in health and social care degree courses. The objective of this systematic review is to identify and critically appraise the literature on the effects of Mindfulness-Based Interventions for health and social care undergraduate students. PubMed, EMBASE, Psych Info, CINAHL, The Cochrane Library and Academic Search Complete were searched from inception to 21st November 2016...
January 19, 2017: Psychology, Health & Medicine
https://www.readbyqxmd.com/read/28100176/effect-of-training-and-structured-medication-review-on-medication-appropriateness-in-nursing-home-residents-and-on-cooperation-between-health-care-professionals-the-intherakt-study-protocol
#6
Angelika Mahlknecht, Nadja Nestler, Ulrike Bauer, Nadine Schüßler, Jochen Schuler, Sebastian Scharer, Ralf Becker, Isabel Waltering, Georg Hempel, Oliver Schwalbe, Maria Flamm, Jürgen Osterbrink
BACKGROUND: Pharmacotherapy in residents of nursing homes is critical due to the special vulnerability of this population. Medical care and interprofessional communication in nursing homes are often uncoordinated. As a consequence, polypharmacy and inappropriate medication use are common and may lead to hospitalizations and health hazards. The aim of this study is to optimize communication between the involved professional groups by specific training and by establishing a structured medication review process, and to improve medication appropriateness and patient-relevant health outcomes for residents of nursing homes...
January 18, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28099642/sedation-protocols-versus-daily-sedation-interruption-a-systematic-review-and-meta-analysis
#7
Antonio Paulo Nassar, Marcelo Park
Objective: The aim of this study was to systematically review studies that compared a mild target sedation protocol with daily sedation interruption and to perform a meta-analysis with the data presented in these studies. Methods: We searched Medline, Scopus and Web of Science databases to identify randomized clinical trials comparing sedation protocols with daily sedation interruption in critically ill patients requiring mechanical ventilation. The primary outcome was mortality in the intensive care unit...
October 2016: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/28099233/primary-outcome-measures-in-pediatric-septic-shock-trials-a-systematic-review
#8
Kusum Menon, James Dayre McNally, Jerry J Zimmerman, Michael S D Agus, Katie O'Hearn, R Scott Watson, Hector R Wong, Mark Duffett, David Wypij, Karen Choong
OBJECTIVE: To evaluate all published pediatric randomized controlled trials of patients with septic shock from any cause to examine the outcome measures used, the strengths and limitations of these measurements and whether the trial outcomes met feasibility criteria. DATA SOURCES: We used a previously published database of pediatric critical care randomized controlled trials (PICUtrials.net) derived from searches of MEDLINE, EMBASE, LILACS, and CENTRAL. STUDY SELECTION: We included randomized controlled trials of interventions to children admitted to a PICU with septic or dengue hemorrhagic shock which were published in English...
January 17, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28098628/the-abcdef-bundle-science-and-philosophy-of-how-icu-liberation-serves-patients-and-families
#9
E Wesley Ely
Over the past 20 years, critical care has matured in a myriad of ways resulting in dramatically higher survival rates for our sickest patients. For millions of new survivors comes de novo suffering and disability called "the postintensive care syndrome." Patients with postintensive care syndrome are robbed of their normal cognitive, emotional, and physical capacity and cannot resume their previous life. The ICU Liberation Collaborative is a real-world quality improvement initiative being implemented across 76 ICUs designed to engage strategically the ABCDEF bundle through team- and evidence-based care...
February 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28095335/guilt-shame-and-expressed-emotion-in-carers-of-people-with-long-term-mental-health-difficulties-a-systematic-review
#10
Mary Gemma Cherry, Peter James Taylor, Stephen Lloyd Brown, Jake Wilfred Rigby, William Sellwood
Expressed emotion (EE) is a global index of familial emotional climate, whose primary components are emotional over-involvement (EOI) and critical comments (CC)/hostility. There is a strong theoretical rationale for hypothesising that carers' guilt and shame may be differentially associated with their EOI and CC/hostility respectively. This systematic review investigates the magnitude of these theorised associations in carers of people with long-term mental health difficulties. Electronic searches (conducted in May 2016 across Medline, CINAHL, Embase, PsycINFO and ProQuest) were supplemented with iterative hand searches...
January 5, 2017: Psychiatry Research
https://www.readbyqxmd.com/read/28092220/using-teledentistry-in-clinical-practice-an-enabler-to-improve-access-to-oral-health-care-a-qualitative-systematic-review
#11
Michelle Irving, Rosemary Stewart, Heiko Spallek, Anthony Blinkhorn
Background Access to dental care is important for overall health, but can remain problematic for those in rural or isolated locations. It can be difficult to encourage clinicians to choose or continue a rural health career. Teledentistry is showing some promise as a strategy to support rural, isolated and new health care workers. This study aims to explore the quantitative and qualitative framework associated with teledentistry in an effort to uncover the interaction of multiple influences on its delivery and sustainability...
January 1, 2017: Journal of Telemedicine and Telecare
https://www.readbyqxmd.com/read/28089599/impact-of-oral-chlorhexidine-on-bloodstream-infection-in-critically-ill-patients-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#12
REVIEW
Luciano Silvestri, William I Weir, Dario Gregori, Nia Taylor, Durk F Zandstra, Joris J M van Saene, Hendrick K F van Saene
OBJECTIVES: Oropharyngeal overgrowth of microorganisms in the critically ill is a risk factor for lower respiratory tract infection and subsequent invasion of the bloodstream. Oral chlorhexidine has been used to prevent pneumonia, but its effect on bloodstream infection never has been assessed in meta-analyses. The authors explored the effect of oral chlorhexidine on the incidence of bloodstream infection, the causative microorganism, and on all-cause mortality in critically ill patients...
November 2, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28081032/a-systematic-review-of-the-factors-influencing-ethnic-minority-women-s-cervical-cancer-screening-behavior-from-intrapersonal-to-policy-level
#13
Dorothy N S Chan, Winnie K W So
BACKGROUND: Cervical cancer can be prevented by effective screening using Papanicolaou tests, but the utilization rate is lower among ethnic minorities than in the general population. Understanding the factors influencing minorities' use of such screening can aid the design of an appropriate intervention to increase their uptake rate. OBJECTIVE: The aims of this study were to examine the factors that influence ethnic minority women in using cervical cancer screening and the similarities and differences in associated factors across different groups and to explore the interrelationships between the factors identified...
January 9, 2017: Cancer Nursing
https://www.readbyqxmd.com/read/28078082/core-components-for-effective-infection-prevention-and-control-programmes-new-who-evidence-based-recommendations
#14
Julie Storr, Anthony Twyman, Walter Zingg, Nizam Damani, Claire Kilpatrick, Jacqui Reilly, Lesley Price, Matthias Egger, M Lindsay Grayson, Edward Kelley, Benedetta Allegranzi
Health care-associated infections (HAI) are a major public health problem with a significant impact on morbidity, mortality and quality of life. They represent also an important economic burden to health systems worldwide. However, a large proportion of HAI are preventable through effective infection prevention and control (IPC) measures. Improvements in IPC at the national and facility level are critical for the successful containment of antimicrobial resistance and the prevention of HAI, including outbreaks of highly transmissible diseases through high quality care within the context of universal health coverage...
2017: Antimicrobial Resistance and Infection Control
https://www.readbyqxmd.com/read/28069989/incomplete-diagnostic-follow-up-after-a-positive-colorectal-cancer-screening-test-a-systematic-review
#15
A R H Dalton
BACKGROUND: Colorectal cancer (CRC) screening using faecal occult blood or faecal immunological testing (FOBT/FIT) involves completion of a screening test-then if required a follow-up diagnostic test. METHODS: A systematic review, of EMBASE, MEDLINE, the Cochrane Library and Google Scholar, of studies up to 2016. Studies explored characteristics behind, reasons for and interventions to reduce incomplete diagnostic testing after a positive FOBT/FIT in CRC screening...
January 9, 2017: Journal of Public Health
https://www.readbyqxmd.com/read/28069561/cancer-survivors-experience-with-telehealth-a-systematic-review-and-thematic-synthesis
#16
REVIEW
Anna Cox, Grace Lucas, Afrodita Marcu, Marianne Piano, Wendy Grosvenor, Freda Mold, Roma Maguire, Emma Ream
BACKGROUND: Net survival rates of cancer are increasing worldwide, placing a strain on health service provision. There is a drive to transfer the care of cancer survivors-individuals living with and beyond cancer-to the community and encourage them to play an active role in their own care. Telehealth, the use of technology in remote exchange of data and communication between patients and health care professionals (HCPs), is an important contributor to this evolving model of care. Telehealth interventions are "complex," and understanding patient experiences of them is important in evaluating their impact...
January 9, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28068459/does-pharmacogenomic-testing-improve-clinical-outcomes-for-major-depressive-disorder-a-systematic-review-of-clinical-trials-and-cost-effectiveness-studies
#17
Joshua D Rosenblat, Yena Lee, Roger S McIntyre
OBJECTIVE: Pharmacogenomic testing has become scalable and available to the general public. Pharmacogenomics has shown promise for predicting antidepressant response and tolerability in the treatment of major depressive disorder (MDD). In theory, pharmacogenomics can improve clinical outcomes by guiding antidepressant selection and dosing. The current systematic review examines the extant literature to determine the impact of pharmacogenomic testing on clinical outcomes in MDD and assesses its cost-effectiveness...
January 3, 2017: Journal of Clinical Psychiatry
https://www.readbyqxmd.com/read/28068239/stereotactic-body-radiation-therapy-for-locally-advanced-pancreatic-cancer-a-systematic-review-and-pooled-analysis-of-19-trials
#18
REVIEW
Fausto Petrelli, Tiziana Comito, Antonio Ghidini, Valter Torri, Marta Scorsetti, Sandro Barni
PURPOSE: Although surgery is the standard of care for resectable pancreatic cancer (PC), standard-dose chemoradiation therapy and chemotherapy alone are suitable for patients with unresectable disease. Stereotactic body radiation therapy (SBRT) is an alternative, focused local therapy that delivers high radiation doses within a few fractions to the cancer, sparing the surrounding critical tissue. We performed a systematic review and pooled analysis of published trials to evaluate the efficacy and safety of this emerging treatment modality...
February 1, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28065197/aligning-guidelines-and-medical-practice-literature-review-on-pediatric-palliative-care-guidelines
#19
Eva De Clercq, Michael Rost, Nadia Pacurari, Bernice S Elger, Tenzin Wangmo
OBJECTIVE: Palliative care for children is becoming an important subspecialty of healthcare. Although concurrent administration of curative and palliative care is recommended, timely referral to pediatric palliative care (PPC) services remains problematic. This literature review aims to identify barriers and recommendations for proper implementation of palliative care for children through the looking glass of PPC guidelines. METHOD: To identify studies on PPC guidelines, five databases were searched systematically between 1960 and 2015: Scopus, PubMed, PsycINFO, the Web of Science, and CINAHL...
January 9, 2017: Palliative & Supportive Care
https://www.readbyqxmd.com/read/28064354/can-systematic-reviews-contribute-to-regulatory-decisions
#20
REVIEW
Corrado Barbui, Antonio Addis, Laura Amato, Giuseppe Traversa, Silvio Garattini
INTRODUCTION: The new call on independent research on drugs issued in October 2016 by the Italian Medicines Agency (AIFA) explicitly reported that proposals based on systematic reviews were not admissible, and no justification or explanation for this choice was given. Prompted by this policy decision, here, we briefly discuss the potential usefulness of systematic reviews in responding to regulatory needs. First, systematic reviews, by collecting, analysing and critically appraising all relevant studies on a specific topic, may be used by different stakeholders as a basis for making clinical and policy recommendations, including regulatory recommendations...
January 7, 2017: European Journal of Clinical Pharmacology
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