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1.
Curr Alzheimer Res ; 2021 Nov 26.
Artigo em Inglês | MEDLINE | ID: mdl-34825872

RESUMO

BACKGROUND: Patients with dementia have an increased risk of developing epilepsy, es- pecially in patients with vascular dementia and Alzheimer's disease. In selecting the optimal an- ti-epileptic drug (AED), the possible side effects such as drowsiness and worsening of cognitive function should be taken into consideration, together with co-morbidities and type of epilepsy. OBJECTIVE: The current systematic review investigates the efficacy, tolerability, and changes in cog- nitive function after administration of AED in patients with dementia and epilepsy. METHODS: We searched six databases, including MEDLINE and CENTRAL, checked reference lists, contacted experts, and searched Google Scholar to identify studies reporting randomized trials. Studies identified were independently screened, data extracted, and quality appraised by two researchers. A narrative synthesis was used to report findings. RESULTS: We included one study with 95 patients with Alzheimer's disease randomized to either lev- etiracetam, lamotrigine, or phenobarbital. No significant differences were found for efficacy, but patients receiving levetiracetam showed an improvement in mini-mental state examination scores and had fewer adverse events. CONCLUSION: High-quality evidence in the form of randomized controlled trials to guide clinicians in choosing an AED in patients with dementia and concomitant epilepsy remains scarce. However, levetiracetam has previously been shown to possibly improve cognition in patients with both mild cognitive impairment and Alzheimer's disease, is better tolerated in the elderly population, and has no clinically relevant interaction with either cholinesterase inhibitors or NMDA receptor antagon- ists.

2.
Res Synth Methods ; 2021 Sep 08.
Artigo em Inglês | MEDLINE | ID: mdl-34494371

RESUMO

Systematic reviews of medical devices have generally adopted the same methodology for the conduct of their reviews as reviews of other clinical interventions, in particular, medicines. It has been suggested that these methods may need to be developed to account for the challenges of reviewing the evidence for medical devices when compared to reviews of medicines. The purpose of this research note is to focus on the methods of searching for medical devices. Our aim is to set out guidance on 'how to search' for medical devices. This includes: Defining what you are searching for; How to design a search strategy; Searching bibliographic databases; Searching beyond bibliographic databases; and Search reporting. The research note is written by three experienced searchers/researchers with experience of critically appraising Medical Technologies Evaluation Programme (MTEP) submissions, undertaking systematic searches and/or reviews of medical devices, or developing guidance for searching for studies for systematic reviews of the effectiveness of interventions, including medical devices. The research note includes a worked example of a search for a fictitious medical device.

3.
Front Chem ; 9: 707797, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34381760

RESUMO

In order to use a Hemoglobin Based Oxygen Carrier as an oxygen therapeutic or blood substitute, it is necessary to increase the size of the hemoglobin molecule to prevent rapid renal clearance. A common method uses maleimide PEGylation of sulfhydryls created by the reaction of 2-iminothiolane at surface lysines. However, this creates highly heterogenous mixtures of molecules. We recently engineered a hemoglobin with a single novel, reactive cysteine residue on the surface of the alpha subunit creating a single PEGylation site (ßCys93Ala/αAla19Cys). This enabled homogenous PEGylation by maleimide-PEG with >80% efficiency and no discernible effect on protein function. However, maleimide-PEG adducts are subject to deconjugation via retro-Michael reactions and cross-conjugation to endogenous thiol species in vivo. We therefore compared our maleimide-PEG adduct with one created using a mono-sulfone-PEG less susceptible to deconjugation. Mono-sulfone-PEG underwent reaction at αAla19Cys hemoglobin with > 80% efficiency, although some side reactions were observed at higher PEG:hemoglobin ratios; the adduct bound oxygen with similar affinity and cooperativity as wild type hemoglobin. When directly compared to maleimide-PEG, the mono-sulfone-PEG adduct was significantly more stable when incubated at 37°C for seven days in the presence of 1 mM reduced glutathione. Hemoglobin treated with mono-sulfone-PEG retained > 90% of its conjugation, whereas for maleimide-PEG < 70% of the maleimide-PEG conjugate remained intact. Although maleimide-PEGylation is certainly stable enough for acute therapeutic use as an oxygen therapeutic, for pharmaceuticals intended for longer vascular retention (weeks-months), reagents such as mono-sulfone-PEG may be more appropriate.

4.
Sci Total Environ ; 789: 147857, 2021 May 24.
Artigo em Inglês | MEDLINE | ID: mdl-34323835

RESUMO

The feasibility and added value of an ecosystem services approach in retrospective environmental risk assessment were evaluated using a site-specific case study in a lowland UK river. The studied water body failed to achieve good ecological status temporarily in 2018, due in part to the exceedance of the environmental quality standard (annual average EQS) for zinc. Potential ecosystem service delivery was quantified for locally prioritised ecosystem services: regulation of chemical condition; maintaining nursery populations and habitats; recreational fishing; nature watching. Quantification was based on observed and expected taxa or functional groups within WFD biological quality elements, including macrophytes, benthic macroinvertebrates and fish, and on published functional trait data for constituent taxa. Benthic macroinvertebrate taxa were identified and enumerated before, during and after zinc EQS exceedance, enabling a generic retrospective risk assessment for this biological quality element, which was found to have good ecosystem service potential. An additional targeted risk assessment for zinc was based on laboratory-based species sensitivity distributions normalised using biotic-ligand modelling to account for site-specific, bioavailability-corrected zinc exposure. Risk to ecosystem services for diatoms (microalgae) was found to be high, while risks for benthic macroinvertebrates and fish were found to be low. The status of potential ecosystem service delivery (ESD) by fish was equivalent to high ecological status defined under the WFD, while ESD was higher for benthic macroinvertebrates than defined by WFD methods. The illustrated ecosystem services approach uses readily available data and adds significantly to the taxonomic approach currently used under the WFD by using functional traits to evaluate services that are prioritised as being important in water bodies. The main shortcomings of the illustrated approach were lack of: representation of bacteria and fungi; WFD predicted species lists for diatoms and macrophytes; site-specific functional trait data required for defining actual (rather than potential) ecosystem service delivery.

6.
BMC Psychiatry ; 21(1): 315, 2021 06 23.
Artigo em Inglês | MEDLINE | ID: mdl-34162340

RESUMO

BACKGROUND: Peer support is being integrated within mental health services to further the development of a recovery approach. However, the most effective models and formats of intervention delivery are unknown. We conducted this systematic review and meta-analysis to determine the effectiveness of peer support for improving outcomes for people with lived experience of mental health conditions, when delivered as group interventions. METHODS: Studies reporting randomised controlled trials of group peer support interventions for people experiencing mental health conditions were identified by searching MEDLINE, PsycINFO, Embase and Cochrane CENTRAL, from inception until July 12th 2019 and undertaking supplementary searches. Included studies were assessed for risk of bias and meta-analyses were conducted if three or more trials provided usable data. RESULTS: Eight trials met eligibility criteria, providing data from 2131 participants. Six trials had either high or unclear risk of bias. Interventions were categorised as mutual support groups, or peer support groups, sub-categorised as anti-stigma or self-management interventions. Meta-analyses were only possible for peer support groups and five outcomes. We found evidence that group peer support may make small improvements to overall recovery but not hope or empowerment individually, or to clinical symptoms. Evidence for effectiveness for outcomes which could not be meta-analysed was mixed. CONCLUSIONS: Findings from the few eligible trials suggest group peer support interventions may be specifically effective for supporting personal recovery and have a limited impact on other outcomes, though there were some risks of bias to study findings. Interventions were heterogeneous and most social outcomes were absent in the literature, highlighting further limitations to the current evidence-base. There is insufficient evidence available from trials of group peer support torecommend the routine implementation of these interventions across mainstream mental health services at present. More high-quality trials of peer-developed, group peer support interventions are needed in order tomake firm conclusions about intervention effectiveness.


Assuntos
Transtornos Mentais , Serviços de Saúde Mental , Aconselhamento , Humanos , Transtornos Mentais/terapia , Saúde Mental , Grupo Associado
7.
PLoS One ; 16(4): e0248316, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33914750

RESUMO

BACKGROUND: There is a recognised need to develop clear service models and pathways to provide high quality care in the community for people with complex emotional needs, who may have been given a "personality disorder" diagnosis. Services should be informed by the views of people with these experiences. AIMS: To identify and synthesise qualitative studies on service user experiences of community mental health care for Complex Emotional Needs. METHODS: We searched six bibliographic databases for papers published since 2003. We included peer reviewed studies reporting data on service user experiences and views about good care from community-based mental health services for adults with CEN, including generic mental health services and specialist "personality disorder" services. Studies using any qualitative method were included and thematic synthesis used to identify over-arching themes. RESULTS: Forty-seven papers were included. Main themes were: 1) The need for a long-term perspective on treatment journeys; 2) The need for individualised and holistic care; 3) Large variations in accessibility and quality of mental health services; 4) The centrality of therapeutic relationships; 5) Impacts of 'personality disorder' diagnosis. Themes tended to recur across studies from different countries and years. DISCUSSION: Recurrent major themes included wanting support that is individualised and holistic, provides continuity over long journeys towards recovery, and that is delivered by empathetic and well-informed clinicians who are hopeful but realistic about the prospects of treatment. Care that met these simple and clearly stated priorities tended to be restricted to often limited periods of treatment by specialist "personality disorder" services: generic and primary care services were often reported as far from adequate. There is an urgent need to co-design and test strategies for improving long-term support and treatment care for people with "personality disorders" throughout the mental health care system.


Assuntos
Serviços Comunitários de Saúde Mental , Gerenciamento Clínico , Emoções , Acesso aos Serviços de Saúde , Saúde Holística , Humanos , Transtornos Mentais/terapia , Transtornos da Personalidade/terapia , Medicina de Precisão , Pesquisa Qualitativa , Qualidade da Assistência à Saúde
8.
Res Synth Methods ; 12(4): 557-570, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33713573

RESUMO

There is limited guidance on how to web-search in systematic reviews and concern relates to the reproducibility of searches using search engines such as Google. The aim of this paper is to address one potential source of variation in Google searches: does the geographical location of a researcher affect Google search returns? Using a virtual private network, we ran the same web-search for the medical technology Dasatinib in 12 different countries. Two researchers independently extracted the search returns by country organised by page rank. We compared: C1. any difference in the items returned by Google searches between countries and C2. any difference in the page rank of items returned between countries. Searches were undertaken on Monday September 28th 2020. From 12 countries, 43 items were identified. For C1: 19 items were common to all 12 countries. Twenty-four items were missed by searches in some countries. This means that there were differences in search returns between countries. For C2: a randomised trial reported by Raddich et al was the first search return for all countries. All other items, common to all countries, varied in their page-rank. We find that geographic location would appear to influence Google search returns based on the findings of this case study. The findings suggest that recording the location of the researcher undertaking web-searching may now be an important factor to report alongside detail on steps taken to minimise personalisation of web-searches covered by recent guidance. This finding also has implications for stopping-rules.


Assuntos
Ferramenta de Busca , Reprodutibilidade dos Testes , Revisões Sistemáticas como Assunto
9.
Res Synth Methods ; 12(3): 384-393, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33555126

RESUMO

Clinical trials registers form an important part of the search for studies in systematic reviews of intervention effectiveness but the search interfaces and functionality of registers can be challenging to search systematically and resource intensive to search well. We report a technical review of the search interfaces of three leading trials register resources: ClinicalTrials.gov, the EU Clinical Trials Register and the WHO International Clinical Trials Registers Platform. The technical review used a validated checklist to identify areas where the search interfaces of these trials register resources performed well, where performance was adequate, where performance was poor, and to identify differences between search interfaces. The review found low overall scores for each of the interfaces (ClinicalTrials.gov 55/165, the EU Clinical Trials Register 25/165, the WHO International Clinical Trials Registers Platform 32/165). This finding suggests a need for joined-up dialogue between the producers of the registers and researchers who search them via these interfaces. We also set out a series of four proposed changes which might improve the search interfaces. Trials registers are an invaluable resource in systematic reviews of intervention effectiveness. With the continued growth in systematic reviews, and initiatives such as 'AllTrials', there is an anticipated need for these resources. We conclude that small changes to the search interfaces, and improved dialogue with providers, might improve the future search functionality of these valuable resources.


Assuntos
Ensaios Clínicos como Assunto , Sistema de Registros
11.
Environ Sci Pollut Res Int ; 28(2): 1789-1800, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32852714

RESUMO

National Environmental Quality Standards (EQS) for zinc used for the assessment of ecological status in freshwaters have been shown to vary by over two orders of magnitude across 25 European countries. Such variability is unlikely to reflect consistent ecological protection or environmental relevance. Recent European technical guidance on EQS derivation gives an opportunity to derive protective metrics for zinc that are relevant to national water chemistry conditions. To derive a zinc EQS relevant to national water chemistry conditions and account for bioavailability, the new technical guidance requires high-quality spatial and temporal monitoring data. These data must be of water samples with concurrent measures of pH, dissolved organic carbon (DOC) and calcium, the parameters that most influence zinc bioavailability in freshwaters. A national bioavailability-based zinc EQS for France has been derived from Biotic Ligand Model calculations undertaken for freshwaters samples from 4645 sites (22,000 samples with concurrent measures of pH, DOC, calcium) in 96 regions. An EQS of 11.3 µg Zn L-1 was derived based on sensitive waters from the Bretagne region typically of circumneutral pH and relatively low DOC and low dissolved calcium. The least sensitive waters to zinc exposures in France are found in the Hauts-De-France, higher pH values than those in Bretagne, similar dissolved organic carbon and higher dissolved calcium. An indicative assessment of compliance showed that across France, 2% of the sites would exceed this bioavailability-based EQS.


Assuntos
Poluentes Químicos da Água , Zinco , Disponibilidade Biológica , Monitoramento Ambiental , Europa (Continente) , França , Padrões de Referência , Poluentes Químicos da Água/análise
12.
J Pediatr Urol ; 16(5): 525, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-33176976
14.
JAMA ; 323(22): 2268-2280, 2020 06 09.
Artigo em Inglês | MEDLINE | ID: mdl-32515814

RESUMO

Importance: Smoking is a major risk factor for chronic obstructive pulmonary disease (COPD), yet much of COPD risk remains unexplained. Objective: To determine whether dysanapsis, a mismatch of airway tree caliber to lung size, assessed by computed tomography (CT), is associated with incident COPD among older adults and lung function decline in COPD. Design, Setting, and Participants: A retrospective cohort study of 2 community-based samples: the Multi-Ethnic Study of Atherosclerosis (MESA) Lung Study, which involved 2531 participants (6 US sites, 2010-2018) and the Canadian Cohort of Obstructive Lung Disease (CanCOLD), which involved 1272 participants (9 Canadian sites, 2010-2018), and a case-control study of COPD: the Subpopulations and Intermediate Outcome Measures in COPD Study (SPIROMICS), which involved 2726 participants (12 US sites, 2011-2016). Exposures: Dysanapsis was quantified on CT as the geometric mean of airway lumen diameters measured at 19 standard anatomic locations divided by the cube root of lung volume (airway to lung ratio). Main Outcomes and Measures: Primary outcome was COPD defined by postbronchodilator ratio of forced expired volume in the first second to vital capacity (FEV1:FVC) less than 0.70 with respiratory symptoms. Secondary outcome was longitudinal lung function. All analyses were adjusted for demographics and standard COPD risk factors (primary and secondhand tobacco smoke exposures, occupational and environmental pollutants, and asthma). Results: In the MESA Lung sample (mean [SD] age, 69 years [9 years]; 1334 women [52.7%]), 237 of 2531 participants (9.4%) had prevalent COPD, the mean (SD) airway to lung ratio was 0.033 (0.004), and the mean (SD) FEV1 decline was -33 mL/y (31 mL/y). Of 2294 MESA Lung participants without prevalent COPD, 98 (4.3%) had incident COPD at a median of 6.2 years. Compared with participants in the highest quartile of airway to lung ratio, those in the lowest had a significantly higher COPD incidence (9.8 vs 1.2 cases per 1000 person-years; rate ratio [RR], 8.12; 95% CI, 3.81 to 17.27; rate difference, 8.6 cases per 1000 person-years; 95% CI, 7.1 to 9.2; P < .001) but no significant difference in FEV1 decline (-31 vs -33 mL/y; difference, 2 mL/y; 95% CI, -2 to 5; P = .30). Among CanCOLD participants (mean [SD] age, 67 years [10 years]; 564 women [44.3%]), 113 of 752 (15.0%) had incident COPD at a median of 3.1 years and the mean (SD) FEV1 decline was -36 mL/y (75 mL/y). The COPD incidence in the lowest airway to lung quartile was significantly higher than in the highest quartile (80.6 vs 24.2 cases per 1000 person-years; RR, 3.33; 95% CI, 1.89 to 5.85; rate difference, 56.4 cases per 1000 person-years; 95% CI, 38.0 to 66.8; P<.001), but the FEV1 decline did not differ significantly (-34 vs -36 mL/y; difference, 1 mL/y; 95% CI, -15 to 16; P=.97). Among 1206 SPIROMICS participants (mean [SD] age, 65 years [8 years]; 542 women [44.9%]) with COPD who were followed up for a median 2.1 years, those in the lowest airway to lung ratio quartile had a mean FEV1 decline of -37 mL/y (15 mL/y), which did not differ significantly from the decline in MESA Lung participants (P = .98), whereas those in highest quartile had significantly faster decline than participants in MESA Lung (-55 mL/y [16 mL/y ]; difference, -17 mL/y; 95% CI, -32 to -3; P = .004). Conclusions and Relevance: Among older adults, dysanapsis was significantly associated with COPD, with lower airway tree caliber relative to lung size associated with greater COPD risk. Dysanapsis appears to be a risk factor associated with COPD.


Assuntos
Volume Expiratório Forçado , Pulmão/patologia , Doença Pulmonar Obstrutiva Crônica/patologia , Capacidade Vital , Idoso , Feminino , Humanos , Pulmão/anatomia & histologia , Pulmão/diagnóstico por imagem , Pulmão/fisiopatologia , Masculino , Doença Pulmonar Obstrutiva Crônica/fisiopatologia , Estudos Retrospectivos , Fatores de Risco , Fumar/efeitos adversos , Espirometria , Tomografia Computadorizada por Raios X
15.
Res Synth Methods ; 11(5): 627-640, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32495989

RESUMO

This study aimed to address the question: what does "effectiveness" mean to researchers in the context of literature searching for systematic reviews? We conducted a thematic analysis of responses to an e-mail survey. Eighty-nine study authors, whose studies met inclusion in a recent review (2018), were contacted via e-mail and asked three questions; one directly asking the question: in literature searching, what does effective (or effectiveness in) literature searching mean to you? Thirty-eight (46%) responses were received from diverse professional groups, including: literature searchers, systematic reviewers, clinicians and researchers. A shared understanding of what effectiveness means was not identified. Instead, five themes were developed from data: (a) effectiveness is described as a metric; (b) effectiveness is a balance between metrics; (c) effectiveness can be categorized by search purpose; (d) effectiveness is an outcome; and, (e) effectiveness is an experimental concept. We propose that these themes constitute a preliminary typology of understandings. No single definition of effectiveness was identified. The proposed typology suggests that different researchers have differing understandings of effectiveness. This could lead to uncertainty as to the aim and the purpose of literature searches and confusion about the outcomes. The typology offers a potential route for further exploration.


Assuntos
Publicações , Pesquisa Qualitativa , Projetos de Pesquisa , Pesquisadores , Ferramenta de Busca , Revisões Sistemáticas como Assunto , Coleta de Dados/métodos , Humanos , Reprodutibilidade dos Testes , Inquéritos e Questionários , Resultado do Tratamento
16.
Biomater Sci ; 8(14): 3896-3906, 2020 Jul 21.
Artigo em Inglês | MEDLINE | ID: mdl-32539053

RESUMO

In order to infuse hemoglobin into the vasculature as an oxygen therapeutic or blood substitute, it is necessary to increase the size of the molecule to enhance vascular retention. This aim can be achieved by PEGylation. However, using non-specific conjugation methods creates heterogenous mixtures and alters protein function. Site-specific PEGylation at the naturally reactive thiol on human hemoglobin (ßCys93) alters hemoglobin oxygen binding affinity and increases its autooxidation rate. In order to avoid this issue, new reactive thiol residues were therefore engineered at sites distant to the heme group and the α/ß dimer/dimer interface. The two mutants were ßCys93Ala/αAla19Cys and ßCys93Ala/ßAla13Cys. Gel electrophoresis, size exclusion chromatography and mass spectrometry revealed efficient PEGylation at both αAla19Cys and ßAla13Cys, with over 80% of the thiols PEGylated in the case of αAla19Cys. For both mutants there was no significant effect on the oxygen affinity or the cooperativity of oxygen binding. PEGylation at αAla19Cys had the additional benefit of decreasing the rates of autoxidation and heme release, properties that have been considered contributory factors to the adverse clinical side effects exhibited by previous hemoglobin based oxygen carriers. PEGylation at αAla19Cys may therefore be a useful component of future clinical products.


Assuntos
Hemoglobinas , Polietilenoglicóis , Cromatografia em Gel , Heme , Humanos , Oxigênio
17.
Syst Rev ; 9(1): 115, 2020 05 26.
Artigo em Inglês | MEDLINE | ID: mdl-32456670

RESUMO

BACKGROUND: This work aimed to identify studies of interventions seeking to address mental health inequalities, studies assessing the economic impact of such interventions and factors which act as barriers and those that can facilitate interventions to address inequalities in mental health care. METHODS: A systematic mapping method was chosen. Studies were included if they: (1) focused on a population with: (a) mental health disorders, (b) protected or other characteristics putting them at risk of experiencing mental health inequalities; (2) addressed an intervention focused on addressing mental health inequalities; and (3) met criteria for one or more of three research questions: (i) primary research studies (any study design) or systematic reviews reporting effectiveness findings for an intervention or interventions, (ii) studies reporting economic evaluation findings, (iii) primary research studies (any study design) or systematic reviews identifying or describing, potential barriers or facilitators to interventions. A bibliographic search of MEDLINE, HMIC, ASSIA, Social Policy & Practice, Sociological Abstracts, Social Services Abstracts and PsycINFO spanned January 2008 to December 2018. Study selection was performed according to inclusion criteria. Data were extracted and tabulated to map studies and summarise published research on mental health inequalities. A visual representation of the mapping review (a mapping diagram) is included. RESULTS: Overall, 128 studies met inclusion criteria: 115 primary studies and 13 systematic reviews. Of those, 94 looked at interventions, 6 at cost-effectiveness and 36 at barriers and facilitators. An existing taxonomy of disparities interventions was used and modified to categorise interventions by type and strategy. Most of the identified interventions focused on addressing socioeconomic factors, race disparities and age-related issues. The most frequently used intervention strategy was providing psychological support. Barriers and associated facilitators were categorised into groups including (not limited to) access to care, communication issues and financial constraints. CONCLUSIONS: The mapping review was useful in assessing the spread of literature and identifying highly researched areas versus prominent gaps. The findings are useful for clinicians, commissioners and service providers seeking to understand strategies to support the advancement of mental health equality for different populations and could be used to inform further research and support local decision-making. SYSTEMATIC REVIEW REGISTRATION: Not applicable.


Assuntos
Transtornos Mentais , Saúde Mental , Análise Custo-Benefício , Humanos , Transtornos Mentais/terapia , Projetos de Pesquisa , Fatores Socioeconômicos
18.
J Clin Epidemiol ; 123: 39-48, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32229252

RESUMO

OBJECTIVES: The objective of this study was to compare the effectiveness and efficiency of methods used to identify and export conference abstracts into a bibliographic management tool. STUDY DESIGN AND SETTING: This is a case study. The effectiveness and efficiency of methods to identify and export conference abstracts presented at the American Society of Hematology (ASH) conference 2016-2018 for a systematic review were evaluated. A reference standard handsearch of conference proceedings was compared with: 1) contacting Blood (the journal that report ASH proceedings); 2) keyword searching; 3) searching Embase; 4) searching MEDLINE via EndNote; and 5) searching CPCI-S. Effectiveness was determined by the number of abstracts identified compared with the reference standard, whereas efficiency was a comparison between the resources required to identify and export conference abstracts compared with the reference standard. RESULTS: Six hundred and four potentially eligible and 15 confirmed eligible conference abstracts (abstracts included in the review) were identified by the handsearch. Comparator 2 was the only method to identify all abstracts and it was more efficient than the reference standard. Comparators 1 and 3-5 missed a number of eligible abstracts. CONCLUSION: This study raises potentially concerning questions about searching for conferences' abstracts by methods other than directly searching the original conference proceedings. Efficiency of exporting would be improved if journals permitted bulk downloads.


Assuntos
Indexação e Redação de Resumos/estatística & dados numéricos , Congressos como Assunto/estatística & dados numéricos , Bases de Dados Bibliográficas/estatística & dados numéricos , Hematologia , Armazenamento e Recuperação da Informação/métodos , Projetos de Pesquisa , Humanos , Revisões Sistemáticas como Assunto
19.
J Paediatr Child Health ; 56(4): 636-641, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31821679

RESUMO

AIM: This study describes an Australian cohort of paediatric Buruli ulcer (BU) patients and compares them with adult BU patients. METHODS: Analysis of a prospective cohort of all BU cases managed at Barwon Health, Victoria, from 1 January 1998 to 31 May 2018 was performed. Children were defined as ≤15 years of age. RESULTS: A total of 565 patients were included: 52 (9.2%) children, 289 (51.2%) adults aged 16-64 years and 224 (39.6%) adults aged ≥65 years. Among children, half were female and the median age was 8.0 years (interquartile range 4.8-12.3 years). Six (11.5%) cases were diagnosed from 2001 to 2006, 14 (26.9%) from 2007 to 2012 and 32 (61.5%) from 2013 to 2018. Compared to adults, children had a significantly higher proportion of non-ulcerative lesions (32.7%, P < 0.001) and a higher proportion of severe lesions (26.9%, P < 0.01). The median duration of symptoms prior to diagnosis was shorter for children compared with adults aged 16-64 years (42 vs. 56 days, P = 0.04). Children were significantly less likely to experience antibiotic complications (6.1%) compared with adults (20.6%, P < 0.001), but had a significantly higher rate of paradoxical reactions (38.8%) compared with adults aged 16-64 (19.2%) (P < 0.001). Paradoxical reactions in children occurred significantly earlier than in adults (median 17 vs. 56 days, P < 0.01). Cure rates were similarly high for children compared to adults treated with antibiotics alone or with antibiotics and surgery. CONCLUSIONS: Paediatric BU cases in Australia are increasing and represent an important but stable proportion of Australian BU cohorts. Compared with adults, there are significant differences in clinical presentation and treatment outcomes.


Assuntos
Úlcera de Buruli , Mycobacterium ulcerans , Adolescente , Adulto , Idoso , Antibacterianos/uso terapêutico , Úlcera de Buruli/diagnóstico , Úlcera de Buruli/tratamento farmacológico , Úlcera de Buruli/epidemiologia , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Vitória/epidemiologia , Adulto Jovem
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