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1.
Rev Assoc Med Bras (1992) ; 65(10): 1290-1294, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31721961

RESUMO

BACKGROUND: Scientific journals play a fundamental role in the field of health sciences, contributing not only to the dissemination of scientific results but also to the progress of medicine and the training of researchers. The visibility of scientific production in the health area is fundamental to the development of medicine. This study aimed to find the relationship between the editorial quality of a sample of Portuguese scientific health journals and their national and international visibility. METHODS: This is an analytical, transversal and, essentially, quantitative study, based on the analysis of the compliance with Latindex editorial quality criteria in a sample of 46 scientific health journals and ascertaining their national and international visibility. RESULTS: The research showed that the global average of compliance with the criteria by the sample of journals is 91%. The average visibility of the sample is 24%. The hypothesis that the editing criteria are related to the visibility of a sample of Portuguese health journals is confirmed. CONCLUSION: Despite the high rate of compliance with editorial quality criteria, the international visibility of the journals analyzed is still scarce. This reveals the need for the development of complementary competences.


Assuntos
Publicações Periódicas como Assunto/estatística & dados numéricos , Editoração/estatística & dados numéricos , Bibliometria , Estudos Transversais , Bases de Dados Bibliográficas/estatística & dados numéricos , Políticas Editoriais , Humanos , Publicações Periódicas como Assunto/normas , Portugal , Editoração/normas
2.
J Med Libr Assoc ; 107(3): 374-383, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31258443

RESUMO

Objective: This study updates Haaland's 1999 dental hygiene mapping study. By identifying core journals and estimating database coverage, it characterizes changes in dental hygiene research and aids librarians in collection development and user education. Method: Cited references from a three-year (2015-2017) sample of core dental hygiene journals were collected, categorized into five formats, and analyzed by format and publication year according to Bradford's Law of Scattering. CINAHL Complete, MEDLINE, and EMBASE were surveyed to determine the indexing coverage of cited journals. Results: The number of cited journal titles increased from 389 in 1999 to 1,675 in 2018. Core Zone 1 titles increased from 5 to 11. Journal article citations increased from 69.5% of all citations in 1999 to 78.4% in the present study, whereas book citations decreased from 18.1% to 5.1%. A newly added category, "Internet sources," accounted for 8.4% of citations. Overall, 68.6% of citations were 10 years or younger versus 71.4% in 1999. Most Zone 1 and Zone 2 journals were specific to dentistry or dental hygiene. Conclusion: Notable changes since 1999 were an increased volume of literature and a shift from print to online sources, reflecting improved accessibility of the literature and greater Internet use. From 1999 to 2018, citations to journal articles increased, books decreased, websites appeared, and government publications increased slightly. These findings indicate that dental hygiene research is growing and that indexing coverage for this field has improved dramatically in the past two decades.


Assuntos
Bibliometria , Bases de Dados Bibliográficas/estatística & dados numéricos , Higiene Bucal , Publicações Periódicas como Assunto/estatística & dados numéricos , Humanos
3.
BMC Med Educ ; 19(1): 255, 2019 Jul 09.
Artigo em Inglês | MEDLINE | ID: mdl-31288819

RESUMO

BACKGROUND: In 1997 the "Wessex Research Network (WReN) Spider" was developed and validated to assess the research experience of general practice based researchers. This bibliometric study traces the use and development of this instrument over 15 years. METHODS: We performed a bibliographic search to identify all the citations of the original article since 2002. RESULTS: Thirty one relevant papers were found. Publications were classified according to whether they used (N = 18) or cited (N = 13) the WReN Spider. The majority of these papers came from Australia (N = 18) and 10 papers focussed on the research training of Allied Health Professionals. The WReN Spider was used in 12 studies to assess baseline experience before a training intervention or to compare before and after training scores. The WReN Spider was often (N = 9) modified to additionally assess interest, confidence or interest in up-skilling in each of its 10 limbs. It was also often (N = 14) used in tandem with open ended questions to gain a more detailed understanding of people's research skills, or with additional questions focussing on the research context, culture and team. None of the papers confirmed the validation of the WReN Spider, although it was applied in contexts that differed from the one in which it was developed. CONCLUSIONS: The WReN Spider continues to be used to measure the research experience of health care practitioners, but it is frequently enhanced with other questions to look at the wider issues of research success, including collaborators, resource and environment.


Assuntos
Pesquisa Biomédica/instrumentação , Bases de Dados Bibliográficas/estatística & dados numéricos , Pessoal de Saúde , Pesquisa sobre Serviços de Saúde , Atenção Primária à Saúde , Pesquisadores , Pesquisa Biomédica/educação , Pessoal de Saúde/psicologia , Pesquisadores/psicologia
4.
Acupunct Med ; 37(4): 223-227, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31188014

RESUMO

INTRODUCTION: There has been a burgeoning of research evaluating acupuncture for various symptoms of cancer and the side-effects associated with its treatment. A systematic review was conducted to examine the quality of reporting in published studies of acupuncture in cancer according to the STRICTA (STandards for Reporting Interventions in Clinical Trials of Acupuncture) guidelines. METHODS: Systematic review of published research of acupuncture for symptoms of cancer and the side-effects associated with its treatment. Databases searched were: Medline, CINAHL, Cochrane (all databases), Scopus, and PubMed from their inception to December 2014. Clinical trials, pilot/feasibility studies, observational studies, and case studies were included. Only full journal papers published in English were included. The quality of reporting was evaluated using STRICTA guidelines. Each included paper was assessed by two independent reviewers, with disagreements adjudicated by a third reviewer. RESULTS: 88 papers were identified which met the inclusion criteria. The median number of STRICTA items reported in trials with a control or comparator arm (n=47) was 14 out of 17 (range 8 to 17, IQR 4). For studies without a control or comparator arm the median was 11 out of a possible 15 (range 5 to 15, IQR 3). Key weaknesses in reporting included details of other components of treatments, and details of the acupuncturist administering treatments. CONCLUSIONS: Despite the widespread use of the STRICTA guidelines in acupuncture research, adherence remains poor for a few specific items. Further research is required to explore the reasons why authors fail to report those items, and to develop strategies to improve the adherence to the guidelines.


Assuntos
Terapia por Acupuntura , Ensaios Clínicos como Assunto/normas , Neoplasias/terapia , Terapia por Acupuntura/efeitos adversos , Bases de Dados Bibliográficas/estatística & dados numéricos , Humanos , Editoração/normas
5.
Rev Assoc Med Bras (1992) ; 65(5): 682-690, 2019 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-31166446

RESUMO

BACKGROUND.: This study aimed to evaluate the scientific production of researchers in the field of Medicine who receive a productivity grant from the CNPq. METHODS: The curriculum Lattes of 542 researchers with active grants from 2012 to 2014 were included in the analysis. Grants categories/levels were stratified into three groups according to the CNPq database (1A-B, 1C-D, and 2). RESULTS.: There was a predominance of grants in category 2. During their academic career, Medicine researchers published 76512 articles, with a median of 119 articles per researcher (IQ, interquartile range, 77 to 174). Among the 76512 articles, 36584 (47.8%) were indexed in the Web of Science (WoS database). Researchers in Medicine were cited 643159 times in the WoS database, with a median of 754 citations (IQ, 356 to 1447). There were significant differences among the categories of grants concerning the number of citations in WoS (P <0.001). There was a significant difference in the number of times researchers were cited according to the specialty included in Medicine area. (P < 0.001). CONCLUSION.: Strategies to improve the scientific output qualitatively possibly can be enhanced by the knowledge of the profile of researchers in the field of Medicine.


Assuntos
Bibliometria , Pesquisa Biomédica/estatística & dados numéricos , Pesquisadores/estatística & dados numéricos , Apoio à Pesquisa como Assunto/estatística & dados numéricos , Brasil , Estudos Transversais , Bases de Dados Bibliográficas/estatística & dados numéricos , Organização do Financiamento , Órgãos Governamentais , Humanos , Publicações Periódicas como Assunto/estatística & dados numéricos , Distribuição por Sexo , Fatores de Tempo
6.
Gac Med Mex ; 155(3): 258-265, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31219467

RESUMO

Introduction: CONACYT's Mexican Science and Technology Journals Classification System (SCRMCYT) includes the area of medicine and health sciences (M&HS). Objective: A bibliometric analysis of M&HS journals listed in SCRMCYT in 2018 was performed. Method: Twelve characteristics related to indexation in the Web of Science Core Collection (WoSCC), Scopus, and PubMed databases were analyzed. Indexed journals were analyzed on whether they had recent indexed publications (2017 and 2018). Indexed journals' 50 most-cited articles in WoSCC and Scopus were analyzed. Results: Of the 35 M&HS journals included in the 2018 SCRMCYT list, 31 (89 %) were indexed in Scopus (22 with indexed publications in 2017; 18 in 2018), 17 (49 %) in PubMed (10 with indexed publications in 2017 and 2018), and 12 (34 %) in WoSCC (12 with indexed publications in 2017; 8 in 2018). The 50 most-cited articles had been published only in 4 journals indexed in WoSCC and 5 in Scopus; 60 % were review articles. Conclusions: Approximately half the 2018 SCRMCYT M&HS journals lack publications indexed in 2018; this suggests that national and international relevance of these journals can be improved.


Assuntos
Bases de Dados Bibliográficas/estatística & dados numéricos , Publicações Periódicas como Assunto/estatística & dados numéricos , Bibliometria , Humanos , México , Ciência , Tecnologia
7.
Rev Lat Am Enfermagem ; 27: e3126, 2019 Mar 10.
Artigo em Inglês, Português, Espanhol | MEDLINE | ID: mdl-30916227

RESUMO

OBJECTIVE: to analyze and synthesize knowledge about the effect of acupuncture on chemotherapy-induced peripheral neuropathy symptoms in adults with cancer. METHOD: the method used was a Systematic Review. Potential articles were identified by searching in the PubMed of National Library of Medicine, Cumulative Index to Nursing and Allied Health Literature, Embase, Cochrane Central and Scopus. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses strategy, 607 articles were identified. After removing the duplicates, all titles and abstracts were reviewed, and seven articles were selected for full review. After the full review, five studies were selected for inclusion. RESULTS: of the five articles included, four were cohort studies and one was a quasi-experimental study. All articles showed that acupuncture was associated with an improvement in the peripheral neuropathy, but the type of protocol, use of medications, time of treatment, and different outcome measures made it difficult to compare the studies. CONCLUSION: the use of acupuncture appears to be associated with an improvement in the symptoms of chemotherapy-induced peripheral neuropathy and has no side effects. In order to improve the evidence about benefits associated with acupuncture, more experimental studies using both subjective and objective measures are needed.


Assuntos
Terapia por Acupuntura , Doenças do Sistema Nervoso Periférico/terapia , Pontos de Acupuntura , Adulto , Antineoplásicos/efeitos adversos , Bases de Dados Bibliográficas/estatística & dados numéricos , Medicina Baseada em Evidências , Humanos , Neoplasias/tratamento farmacológico , Doenças do Sistema Nervoso Periférico/induzido quimicamente , Qualidade de Vida , Inquéritos e Questionários , Resultado do Tratamento
8.
Seizure ; 66: 53-60, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30802843

RESUMO

PURPOSE: To evaluate the predictors of seizure reduction outcome after vagus nerve stimulation (VNS) in patients with drug-resistant epilepsy (DRE). METHODS: A meta-analysis was performed using relevant research from databases such as PubMed, Embase, Cochrane Online Library, and Clinicaltrials.gov. Studies were selected according to predefined inclusion and exclusion criteria. The quality of studies was evaluated by using the Newcastle-Ottawa Scale (NOS) scale. All data was pooled by STATA 12.0 software for meta-analysis. RESULTS: The review considered 1281 articles, and 16 articles with NOS score ≥6 were included in the analysis. The meta-analysis showed that at 6 m, 1, 2, 3, 4, 6 and 12 years after implantation, 33.99, 43.42, 46.50, 63.31, 52.71, 54.64, 70.37 and 82.90% of patients exhibited >50% reduction of seizure frequency after VNS. The duration of epilepsy showed a significant difference between the good responders and poor responders (p = 0.038), whereas age at VNS implantation (p = 0.305), age at seizure onset (p = 0.530), seizure type (p = 0.11), etiology (p = 0.187), and history of previous epilepsy surgery (p = 0.075) were not predictors of seizure reduction outcome after VNS. Several features about the electroencephalogram (EEG) feature and heart rhythm complexity (HRV) have not been analyzed by a sufficient number of studies. CONCLUSIONS: DRE patients with shorter duration of epilepsy may be better candidates for VNS rather than those who are younger at onset and implantation. Several EEG or HRV features may have predictive value but more research is needed.


Assuntos
Epilepsia Resistente a Medicamentos/terapia , Resultado do Tratamento , Estimulação do Nervo Vago/métodos , Adolescente , Adulto , Idade de Início , Criança , Pré-Escolar , Bases de Dados Bibliográficas/estatística & dados numéricos , Eletroencefalografia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Adulto Jovem
9.
Leg Med (Tokyo) ; 37: 67-75, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30716583

RESUMO

PURPOSE: The objective of this study was to illustrate the global research productivity and tendency of forensic anthropology in recent ten years (2008-2017) by bibliometric analysis. METHODS: "Forensic anthropology" was used as the Medical Subject Headings term and topic in PubMed and Web of Science Core Collection. RESULTS: As 5130 articles retrieved, two independent investigators evaluated all of them respectively. After restricting the published year, excluding duplicated and irrelevant articles, 1663 articles were available. The total of 219 countries and regions contributed to this research and the United States was the most productive country. There were 201 peer-reviewed journals including all of articles and two of them were identified as core journals according to Bradford's law. Eight of the top 10 productive authors were from developed countries. The top 10 cited articles were published by authors from developed countries with half in the United States. Sex estimation and age estimation were the most popular topics. CONCLUSIONS: With the basic and recognized methodology administered in this study, it provided a relative broad view to evaluate the scientific research capacity of forensic anthropology and reveal the worldwide tendency in this field.


Assuntos
Bases de Dados Bibliográficas/estatística & dados numéricos , Bases de Dados Bibliográficas/tendências , Antropologia Forense/estatística & dados numéricos , Antropologia Forense/tendências , Pesquisa/estatística & dados numéricos , Pesquisa/tendências , Determinação da Idade pelo Esqueleto/métodos , Determinação da Idade pelo Esqueleto/estatística & dados numéricos , Países Desenvolvidos/estatística & dados numéricos , Feminino , Humanos , Masculino , Análise para Determinação do Sexo/métodos , Análise para Determinação do Sexo/estatística & dados numéricos , Fatores de Tempo , Estados Unidos/epidemiologia
10.
Mult Scler Relat Disord ; 30: 129-135, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30771579

RESUMO

Current multiple sclerosis (MS) therapeutic options have significantly increased treatment algorithm complexity. This urges physicians to take into account multiple factors in the decision-making process and make an even more thorough analysis of the risk-benefit balance. We carried out a descriptive review aiming to assess some factors that endanger the proper MS treatment fulfillment, focusing mainly on Latin American countries. Firstly, it is paramount to warrant the correct, fair and timely treatment access. We found that disease modifying drugs (DMDs) access is highly variable among different countries and even different regions within a country. In this sense less than 35% of MS patients in Latin American have access to treatment. Secondly, adherence depends on some characteristics such as the way of administration, treatment length and side effects, among others. Finally, chronic immune suppression has become a common consequence of most DMDs. Hence, the different mechanisms of action and their safety profile should be taken carefully into consideration when choosing a specific drug. These three areas of interest related to a single medication, adherence, access to it and mechanism of action, are of utmost importance when trying to achieve effectiveness instead of just efficacy.


Assuntos
Fatores Imunológicos/uso terapêutico , Esclerose Múltipla/terapia , Bases de Dados Bibliográficas/estatística & dados numéricos , Gerenciamento Clínico , Humanos , Esclerose Múltipla/epidemiologia , Esclerose Múltipla/psicologia , Cooperação do Paciente
11.
Seizure ; 65: 80-88, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30639977

RESUMO

PURPOSE: Sexual functioning is an important factor influencing quality of life. Mounting evidence suggests that both male and female patients with epilepsy (PWE) have an increased risk of developing sexual dysfunction (SD). The aim of this meta-analysis was to quantify the association between epilepsy and the risk of SD. METHODS: PubMed, Embase, and Cochrane Library database were systematically searched to identify the pertinent studies focusing on the association between epilepsy and SD. Relative risk (RR) for SD with 95% confidence interval (CI) was calculated. The overall quality of the evidence was generated by applying the GRADE-profiler. This meta-analysis was registered on the PROSPERO (ID: CRD42018103572, http://www.crd.york.ac.uk/PROSPERO). RESULTS: Nine studies (3 cross-sectional, 5 case-control, and 1 cohort) were included in this meta-analysis, for a total of 1556 subjects and 599 cases of epilepsy. Synthetic results demonstrated that epilepsy was associated with an increased risk of female SD (6 studies, pooled RR = 2.69, 95%CI: 1.48-4.89, P = 0.001; heterogeneity: I2 = 88.9%, P < 0.001) as well as male SD (3 studies, pooled RR = 4.85, 95%CI: 2.01-11.7, P < 0.001; heterogeneity: I2 = 74.2%, P = 0.021). The GRADE-profiler showed that the rate of events of SD on average in the PWE and the controls were 383/659 (58.1%) and 168/1017 (16.5%), respectively. The quality of evidence across outcomes was MODERATE. CONCLUSIONS: Epilepsy is significantly associated with an increased risk of SD in both sexes. These findings suggest that both clinicians and patients should recognize that epilepsy has a potential hazardous effect on sexual functioning.


Assuntos
Epilepsia/complicações , Caracteres Sexuais , Disfunções Sexuais Fisiológicas/etiologia , Bases de Dados Bibliográficas/estatística & dados numéricos , Epilepsia/epidemiologia , Feminino , Humanos , Masculino , Disfunções Sexuais Fisiológicas/epidemiologia
12.
Neurol Res ; 41(4): 319-325, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30644790

RESUMO

OBJECTIVE: Many studies have analyzed the association between the catechol-O-methyltransferase (COMT) Val158Met polymorphism and Parkinson's disease (PD), which yield inconsistent results. This meta-analysis was designed to determine the possible association between the COMT Val158Met polymorphism and the risk of PD in different populations. METHODS: The PubMed, Springer Link, Ovid, Chinese Wanfang Data Knowledge Service Platform, Chinese National Knowledge Infrastructure and Chinese Biology Medicine databases were used for literature searching up to May 2018. The association between the COMT Val158Met polymorphism and the risk of PD was evaluated by calculating the pooled odds ratio (OR) and 95% confidence intervals (CIs). RESULTS: A total of 27 studies including 10,239 PD patients and 15,538 controls were screened out. In the overall population, COMT Val158Met polymorphism was not significantly associated with the risk of PD. In the subgroup analysis stratified by ethnicity, a significant association between COMT Val158Met polymorphism and PD risk was detected in Japan (LL vs. HH: OR = 1.48, 95% CI = 1.04-2.11; LL vs. HH+HL: OR = 1.54, 95% CI = 1.10-2.15) and India (LL+HL vs. HH: OR = 1.48, 95% CI = 1.14-1.91). CONCLUSION: This study indicated a significantly closer association between COMT Val158Met polymorphism and PD in the Japanese and Indian populations compared with other ethnicities. Ethnicity seems to play an important role in the genetic association of PD.


Assuntos
Catecol O-Metiltransferase/genética , Predisposição Genética para Doença , Saúde Global , Doença de Parkinson/etnologia , Doença de Parkinson/genética , Polimorfismo de Nucleotídeo Único , Bases de Dados Bibliográficas/estatística & dados numéricos , Feminino , Humanos , Masculino , Metionina/genética , Doença de Parkinson/epidemiologia , Doença de Parkinson/etiologia , Valina/genética
13.
Seizure ; 65: 55-61, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30612076

RESUMO

PURPOSE: To analyse the factors predicting uncontrolled seizures in epilepsy with auditory features (EAF). METHODS: We analysed individual data from EAF patients who were previously reported. Two authors independently reviewed the titles and abstracts identified and extracted data from each eligible study using a standardized form. The outcome measure was uncontrolled seizures. The odds ratio (OR) and 95% confidence interval (CI) were used. RESULTS: A total of 27 studies including 181 patients with familial and sporadic EAF met our inclusion criteria. None of the clinical factors appeared to affect seizure outcomes significantly except that treatment with carbamazepine was a protective factor against uncontrolled seizures (OR = 0.399, 95% CI: 0.195-0.820, p = 0.012), and polytherapy was associated with uncontrolled seizures. Treatment with carbamazepine was also a protective factor against uncontrolled seizures for families with LGI1 mutations (OR = 0.248, 95% CI: 0.085-0.724, p = 0.011). Carbamazepine might have a better efficacy in patients with frequent seizures (p = 0.041). Low-dose carbamazepine might completely control seizures in some EAF patients, although other effective doses of antiepileptic drugs might not. Patients without carbamazepine treatment were more likely to use new antiepileptic drugs, which might be due to the higher rate of uncontrolled seizures. CONCLUSIONS: Carbamazepine treatment is a protective factor against uncontrolled seizures for EAF. However, this evidence is not strong enough to state that carbamazepine is the first choice drug for EAF.


Assuntos
Anticonvulsivantes/uso terapêutico , Vias Auditivas/fisiopatologia , Carbamazepina/uso terapêutico , Epilepsia/complicações , Epilepsia/tratamento farmacológico , Convulsões/diagnóstico , Convulsões/etiologia , Adulto , Bases de Dados Bibliográficas/estatística & dados numéricos , Relação Dose-Resposta a Droga , Epilepsia/diagnóstico , Epilepsia/genética , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Mutação/genética , Proteínas/genética , Adulto Jovem
14.
J Neurol ; 266(5): 1051-1058, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30027321

RESUMO

BACKGROUND: Patients who suffer a transient ischemic attack (TIA) have a high short-term risk of developing ischemic stroke, notably within the first 48 h. Timely diagnosis and urgent preventive treatment substantially reduce this risk. We conducted a systemic review to quantify patient delay in patients with (suspected) TIA, and assess determinants related to such delay. METHODS: A systematic review using MEDLINE and EMBASE databases up to March 2017 to identify studies reporting the time from onset of TIA symptoms to seeking medical help. RESULTS: We identified nine studies providing data on patient delay, published between 2006 and 2016, with 7/9 studies originating from the United Kingdom (UK). In total 1103 time-defined TIA patients (no remaining symptoms > 24 h), and 896 patients with a minor stroke (i.e., mild remaining symptoms > 24 h) were included (49.1% men, mean age 72.2 years). Patient's delay of more than 24 h was reported in 33.1-44.4% of TIA patients, with comparable proportions for minor stroke patients. Delays were on average shorter in patients interviewed at the emergency department than among patients seen at TIA outpatient clinics. Univariably associated with a shorter delay were (1) a longer duration of symptoms, (2) motor symptoms, (3) a higher ABCD2 score, and (4) correct patient's recognition as possible ischemic cerebrovascular event. CONCLUSIONS: More than a third of patients experiencing a TIA delays medical attention for more than a day, thus critically extending the initiation of stroke preventive treatment. There still seems to be insufficient awareness among lay people that symptoms suggestive of TIA should be considered as an emergency. Additional data and multivariable analyses are needed to define main determinants of patient delay.


Assuntos
Ataque Isquêmico Transitório/terapia , Acidente Vascular Cerebral/prevenção & controle , Tempo para o Tratamento , Bases de Dados Bibliográficas/estatística & dados numéricos , Humanos , Ataque Isquêmico Transitório/complicações , Acidente Vascular Cerebral/etiologia , Fatores de Tempo
15.
Top Stroke Rehabil ; 26(1): 73-79, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30222075

RESUMO

BACKGROUND: Stroke is a leading cause of disability in the adult population, impairing upper limb (UL) movements affecting activities of daily living. Muscle weakness has been associated to disabilities in this population, but much attention is given to central nervous system alterations and less to skeletal muscles. OBJECTIVE: The objective of this review is to carry out a systematic literature review to identify structural muscle alterations in the UL of poststroke individuals. METHOD: The search was performed in December, 2017. MEDLINE, PubMed, SCOPUS, CINAHL, and Science Direct were used as electronic databases. There was no restriction regarding language and publication dates. Studies conducted on poststroke subjects and results on UL skeletal muscle alterations identified by imaging tests were included. RESULTS: Seven studies were included. The sample size and the variables varied among the studies. All the studies compared the paretic UL with the nonparetic UL and one of the studies also compared healthy subjects. Ultrasonography was the most used measurement tool to assess muscle adaptation. CONCLUSIONS: This review demonstrated little evidence with poor to fair quality on the structural muscle adaptations in the poststroke subjects, showing muscle atrophy, a higher stiffness, and amount of fibrous and fat tissue without alterations in lean tissue of distal muscles of the paretic UL compared to the nonparetic limb. However, the nonparetic side also presented alterations, which makes it an inappropriate comparison. Thus, well-designed studies addressing this issue are required.


Assuntos
Adaptação Fisiológica/fisiologia , Músculo Esquelético/fisiopatologia , Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral/patologia , Extremidade Superior/inervação , Bases de Dados Bibliográficas/estatística & dados numéricos , Humanos , Acidente Vascular Cerebral/fisiopatologia , Extremidade Superior/fisiopatologia
16.
World Neurosurg ; 121: e882-e891, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30315969

RESUMO

BACKGROUND: Hypnosis is a technique that could aid awake surgery protocols. The aim of the present study is to describe the results of a preliminary experience of a cohort of patients operated on with an original protocol of hypnosis-aided awake surgery (HAS). METHODS: All patients were operated on with the aid of HAS and their data were retrospectively reviewed. A thorough literature review was conducted to compare the results of HAS with the standard awake surgery protocol regarding 1) the incidence of intraoperative pain; 2) the overall incidence of complications; 3) the length of time in which the patients were suitable for intraoperative neuropsychological testing; and 4) the incidence of gross total resection. The comparison presented a notably high statistical impact (1-ß = 0.90-0.93 for α = 0.05; effect size, 0.5). RESULTS: The final cohort comprised 6 patients from our institution and 43 records retrieved in the relevant literature underwent HAS for intrinsic brain tumor treatment. This cohort was compared with cohorts of patients who were considered eligible through a literature review. HAS showed a statistically significant superiority in the first 3 outcome variables, whereas the incidence of gross total resection favored the standard awake approaches. CONCLUSIONS: According to the results, hypnosis-aided resection of intrinsic brain tumor located in eloquent areas is safe and effective, although dissociation phenomena deserve further investigation to be completely understood.


Assuntos
Neoplasias Encefálicas/psicologia , Neoplasias Encefálicas/cirurgia , Craniotomia/métodos , Hipnose/métodos , Vigília/fisiologia , Adulto , Idoso , Bases de Dados Bibliográficas/estatística & dados numéricos , Feminino , Humanos , Avaliação de Estado de Karnofsky , Imagem por Ressonância Magnética , Masculino , Monitorização Intraoperatória , Estudos Retrospectivos , Estatísticas não Paramétricas , Adulto Jovem
17.
World Neurosurg ; 121: e898-e907, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30315978

RESUMO

BACKGROUND: The retroclival region is among the rarest locations for an arachnoid cyst (AC), with only a few reported cases. No accepted classification system is available for these rare cysts. Such a classification system would solve the nomenclature problem and could result in easier and more systematic management. We reviewed and analyzed data from databases and reported studies of retroclival ACs (RACs) and have proposed a classification system. METHODS: A retrospective review of RACs was conducted in Marmara and Adiyaman University Hospitals, Turkey. Cysts in the prepontine and/or premedullary cisterns that spared the chiasmatic cistern were included. Additionally, the reported data were searched for relevant studies on cysts. The findings were analyzed to establish a clear nomenclature and classification system, and the clinical presentations, treatment strategies, and surgical approaches were reviewed. RESULTS: We identified 1 adult and 1 pediatric patient, and only the adult had undergone surgery. Additional data searches yielded 14 patients with RACs. The cysts were classified as type 1 if they had extended superiorly beyond the borders of the diencephalic leaf of the Liliequist membrane. If they had not extended, they were classified as type 2. Finally, type 2 cysts that had extended to the anterior spinal cistern were classified as type 3. CONCLUSIONS: RACs can be more easily and systematically managed using a simple clinical classification system. Together with the previously proposed suprasellar AC classification, our proposed RAC classification should be adequate to classify all ACs in the ventral midline cistern, which could solve the nomenclature problem.


Assuntos
Cistos Aracnóideos/classificação , Cistos Aracnóideos/cirurgia , Neurocirurgia/métodos , Adulto , Cistos Aracnóideos/diagnóstico por imagem , Criança , Bases de Dados Bibliográficas/estatística & dados numéricos , Feminino , Humanos , Imagem por Ressonância Magnética , Estudos Retrospectivos , Turquia
18.
Neuropsychol Rehabil ; 29(5): 657-671, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28421863

RESUMO

Prospective memory is the ability to remember to do something in the future and it is essential to every-day functional independence. Traumatic brain injury is associated with frequent and persistent prospective memory deficits. This study presents a review and meta-analysis investigating the effects of task parameters on prospective memory performance of individuals with TBI. Individual studies using continuous behavioural measures of prospective memory with a sample of adults with TBI and matched controls were included. Consistent with previous research, a random effects meta-analysis indicated that TBI groups demonstrated lower prospective memory performance than control groups (d = 1.10, SE = 0.12, 95% CI = 0.86-1.34). In addition, we found that type of prospective memory cue, saliency of cues, and complexity of the ongoing task significantly moderated the difference in prospective memory performance between TBI and control groups. These findings suggest that prospective memory task parameters should be considered in the assessment of prospective memory in individuals with cognitive impairment. In addition, considering the influence of these task parameters would be useful to develop effective compensatory strategies to reduce prospective memory failures.


Assuntos
Lesões Encefálicas Traumáticas/complicações , Transtornos da Memória/etiologia , Memória Episódica , Adulto , Estudos de Casos e Controles , Bases de Dados Bibliográficas/estatística & dados numéricos , Humanos
19.
World Neurosurg ; 123: 443-452.e8, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30500587

RESUMO

INTRODUCTION: Optimal surgical strategy for patients with tremor remains uncertain. We conducted a systematic review and meta-analysis evaluating randomized controlled trials of deep brain stimulation (DBS) and lesion surgery (LS) in the treatment of tremor. METHODS: We searched PubMed, Embase, and the Cochrane database to include randomized clinical trials with either LS, deep brain stimulation, or controls. The outcomes were the change in tremor score, quality of life, cognitive function, and neuropsychiatric function. We used standardized mean differences (SMDs) to pool the outcomes. RESULTS: Fifteen trials, including 1508 patients, met eligibility criteria. We observed no significant difference in change of tremor scale (SMD -0.07, 95% confidence interval [CI]: -0.38 to 0.24), quality of life (SMD -0.21, 95% CI: -0.69 to 0.27), cognitive function (SMD 0.06, 95% CI: -0.27 to 0.39), or neuropsychiatric function (SMD -0.15, 95% CI: -0.49 to 0.19) between LS and stimulation surgery. We observed heterogeneity across studies during indirect comparison of quality of life. We identified a possible effect modifier: improvement in quality of life correlated with duration of disease (P = 0.035). We found that focused-ultrasound LS was associated with a 0.70 SMD increase (P = 0.014) in quality of life versus DBS in an exploratory subgroup analysis by separating 2 studies with focused-ultrasound LS from other LS studies. CONCLUSIONS: Although the main analysis showed that LS and DBS were equally effective in the treatment of patients with tremor, an exploratory subgroup analysis indicated an improvement in quality of life with noninvasive focused-ultrasound surgery.


Assuntos
Estimulação Encefálica Profunda/métodos , Procedimentos Neurocirúrgicos/métodos , Resultado do Tratamento , Tremor/terapia , Bases de Dados Bibliográficas/estatística & dados numéricos , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto
20.
World Neurosurg ; 123: 409-417.e7, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30391768

RESUMO

BACKGROUND: Applying vancomycin into the surgical site has been well-described in spinal neurosurgery, with extensive institutional experience and systematic reviews describing its effectiveness in reducing surgical site infections (SSIs). Its use in nonspinal neurosurgical procedures is a logical extension of those findings; however, recent studies have described varying degrees of success. We have summarized the effect of local vancomycin application on SSIs in nonspinal neurosurgical procedures and describe the quality of the supporting evidence. METHODS: MEDLINE, Embase, and Google Scholar were searched through June 2018. Information on study design, demographic data, exposure, and outcomes was extracted. The estimates were combined using random-effects models. RESULTS: Our search retrieved 9 studies for quantitative analysis. They assessed vancomycin use in craniotomy, cranioplasty, deep brain stimulator-related procedures, and ventriculoperitoneal shunt surgery. Most of the studies had serious methodological shortcomings that introduced confounding. We found an overall beneficial effect on SSI incidence (odds ratio, 0.25; 95% confidence interval, 0.12-0.52), which was seen across all subspecialties, except for cranioplasty. The use of vancomycin did not result in the emergence of resistant infections or in a significant increase in the proportion of infections caused by gram-negative organisms. CONCLUSIONS: Vancomycin use in nonspinal neurosurgery is not supported by high-quality evidence, limiting the strength of the conclusions that can be drawn on the topic. Nonetheless, we found an overall favorable effect on SSIs (except in the context of cranioplasty), which should be reproduced in a randomized controlled fashion.


Assuntos
Antibacterianos/uso terapêutico , Procedimentos Neurocirúrgicos/efeitos adversos , Infecção da Ferida Cirúrgica/tratamento farmacológico , Infecção da Ferida Cirúrgica/etiologia , Vancomicina/uso terapêutico , Bases de Dados Bibliográficas/estatística & dados numéricos , Humanos
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