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1.
Clin Neurol Neurosurg ; 213: 107134, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-35078087

RESUMO

OBJECTIVE: This study intends to systematically evaluate the efficacy and safety of donepezil for improving cognitive function in patients with mild cognitive impairment (MCI), and to provide evidence-based foundation for donepezil in MCI treatment. METHODS: We searched in PubMed, Embase, Cochrane Library, Clinical trials.gov, Web of Science, CQVIP, and CNKI databases, and then we summarized the interventional and observational studies on the use of donepezil for improving the cognitive function of MCI patients. The literature was collected according to the inclusion criteria for data extraction. We evaluated the quality of the selected literature and used Stata 15.0 for meta-analysis. RESULTS: A total of 12 randomized controlled trials (RCTs) and 5 non-randomized concurrent controlled trials (CCTs) were included, and a total of 2847 patients were included. In terms of efficacy, meta-analysis showed that donepezil could significantly improve the MMSE (SMD: 0.85, 95%CI: 0.40-1.31) and MoCA (SMD: 1.88, 95%CI: 0.32-3.45) scores of MCI patients. Donepezil could not significantly reduce ADAS-cog score, nor could it significantly delay disease progression. The quality of the evidence was low overall. In terms of safety, donepezil could significantly increase the risk of adverse reactions such as nausea, vomiting, diarrhea in patients with MCI. CONCLUSION: Donepezil can improve the cognitive function of MCI patients to a certain extent. However, there is no trend of significantly delaying the progression of the disease, and it is easy to lead to the occurrence of adverse reactions.


Assuntos
Disfunção Cognitiva , Nootrópicos , Cognição , Disfunção Cognitiva/tratamento farmacológico , Bases de Dados Factuais , Donepezila/efeitos adversos , Humanos , Nootrópicos/uso terapêutico , Ensaios Clínicos Controlados Aleatórios como Assunto
2.
J Am Coll Surg ; 234(6): 1137-1146, 2022 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-35703812

RESUMO

BACKGROUND: Emerging literature suggests that measures of social vulnerability should be incorporated into surgical risk calculators. The Social Vulnerability Index (SVI) is a measure designed by the CDC that encompasses 15 socioeconomic and demographic variables at the census tract level. We examined whether adding the SVI into a parsimonious surgical risk calculator would improve model performance. STUDY DESIGN: The eight-variable Surgical Risk Preoperative Assessment System (SURPAS), developed using the entire American College of Surgeons (ACS) NSQIP database, was applied to local ACS-NSQIP data from 2012 to 2018 to predict 12 postoperative outcomes. Patient addresses were geocoded and used to estimate the SVI, which was then added to the model as a ninth predictor variable. Brier scores and c-indices were compared for the models with and without the SVI. RESULTS: The analysis included 31,222 patients from five hospitals. Brier scores were identical for eight outcomes and improved by only one to two points in the fourth decimal place for four outcomes with addition of the SVI. Similarly, c-indices were not significantly different (p values ranged from 0.15 to 0.96). Of note, the SVI was associated with most of the eight SURPAS predictor variables, suggesting that SURPAS may already indirectly capture this important risk factor. CONCLUSION: The eight-variable SURPAS prediction model was not significantly improved by adding the SVI, showing that this parsimonious tool functions well without including a measure of social vulnerability.


Assuntos
Complicações Pós-Operatórias , Vulnerabilidade Social , Bases de Dados Factuais , Humanos , Estudos Retrospectivos , Medição de Risco , Fatores de Risco
3.
J Neural Transm (Vienna) ; 129(7): 835-846, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35672518

RESUMO

Since the initial description of Essential Tremor (ET), the entity of ET with rest tremor has proven to be a controversial concept. Some authors argued it could be a late manifestation of ET, others suggested it could be a variant of ET, yet others suggested it could represent a transitional state between ET and Parkinson's disease. The novel tremor classification has proposed the construct of ET-plus to differentiate patients with rest tremor from pure ET. However, there is no clarity of what ET-plus rest tremor represents. With the aim of shedding light on this controversial entity, we have, therefore, systematically reviewed all clinical, electrophysiological, imaging and anatomopathological studies indexed in the Medline database published both before and after the new tremor classification and involving patients with ET-plus rest tremor. Forty-four studies involving 4028 patients were included in this review and analyzed in detail by means of descriptive statistics. The results of the current review suggest that ET-plus rest tremor is a heterogenous group of conditions: thus, rest tremor might represent a late feature of ET, might reflect a different disorder with higher age at onset and lower dependance on genetic susceptibility than ET, might suggest the development of Parkinson's disease or might indicate a misdiagnosis of ET. The reviewed lines of evidence refuse recent claims arguing against the construct of ET-plus, which should be viewed as a syndrome with different possible underpinnings, and highlights methodological issues to be solved in future research.


Assuntos
Tremor Essencial , Doença de Parkinson , Bases de Dados Factuais , Tremor Essencial/diagnóstico , Tremor Essencial/patologia , Predisposição Genética para Doença , Humanos , Doença de Parkinson/diagnóstico , Tremor/diagnóstico
4.
Anal Chem ; 94(24): 8561-8569, 2022 Jun 21.
Artigo em Inglês | MEDLINE | ID: mdl-35670335

RESUMO

Liquid chromatography-high-resolution mass spectrometry (LC-HRMS) is the most popular platform for untargeted metabolomics studies, but compound annotation is a challenge. In this work, we developed a new LC-HRMS data-targeted extraction method called MetEx for metabolite annotation. MetEx contains the retention time (tR), MS1, and MS2 information of 30 620 metabolites from freely available spectral databases, including MoNA and KEGG. The tR values of 95.4% of the compounds in our database were calculated by the GNN-RT model. The MS2 spectra of 39.4% compounds were also predicted using CFM-ID. MetEx was initially examined on a mixture of 634 standards, considering chemical coverage and accurate metabolite assignment, and later applied to human plasma (NIST SRM 1950), human urine, HepG2 cells, mouse liver tissue, and mouse feces. MetEx correctly assigned 252 out of 253 standards detected in our instruments. The platform also provided 8.0-44.2% more compounds in the biological samples compared to XCMS, MS-DIAL, and MZmine 2. MetEx is implemented and visualized in R and freely available at http://www.metaboex.cn/MetEx.


Assuntos
Metabolômica , Plasma , Animais , Cromatografia Líquida/métodos , Bases de Dados Factuais , Espectrometria de Massas/métodos , Metabolômica/métodos , Metotrexato , Camundongos
5.
Anal Chem ; 94(24): 8674-8682, 2022 Jun 21.
Artigo em Inglês | MEDLINE | ID: mdl-35672005

RESUMO

Highly quantitative metabolomics studies of complex biological mixtures are facilitated by the resolution enhancement afforded by 2D NMR spectra such as 2D 13C-1H HSQC spectra. Here, we describe a new public web server, COLMARq, for the semi-automated analysis of sets of 2D HSQC spectra of cohorts of samples. The workflow of COLMARq includes automated peak picking using the deep neural network DEEP Picker, quantitative cross-peak volume extraction by numerical fitting using Voigt Fitter, the matching of corresponding cross-peaks across cohorts of spectra, peak volume normalization between different spectra, database query for metabolite identification, and basic univariate and multivariate statistical analyses of the results. COLMARq allows the analysis of cross-peaks that belong to both known and unknown metabolites. After a user has uploaded cohorts of 2D 13C-1H HSQC and optionally 2D 1H-1H TOCSY spectra in their preferred format, all subsequent steps on the web server can be performed fully automatically, allowing manual editing if needed and the sessions can be saved for later use. The accuracy, versatility, and interactive nature of COLMARq enables quantitative metabolomics analysis, including biomarker identification, of a broad range of complex biological mixtures as is illustrated for cohorts of samples from bacterial cultures of Pseudomonas aeruginosa in both its biofilm and planktonic states.


Assuntos
Imageamento por Ressonância Magnética , Metabolômica , Misturas Complexas , Bases de Dados Factuais , Humanos , Espectroscopia de Ressonância Magnética/métodos , Metabolômica/métodos , Fluxo de Trabalho
6.
Curr Opin Neurol ; 35(3): 271-277, 2022 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-35674068

RESUMO

PURPOSE OF REVIEW: Although substantial progress has been made in understanding the natural history of multiple sclerosis (MS) and the development of new therapies, many questions concerning disease behavior and therapeutics remain to be answered. Data generated from real-world observational studies, based on large MS registries and databases and analyzed with advanced statistical methods, are offering the scientific community answers to some of these questions that are otherwise difficult or impossible to address. This review focuses on observational studies published in the last 2 years designed to compare the effectiveness of escalation vs. induction treatment strategies, to assess the effectiveness of treatment in pediatric-onset and late-onset MS, and to identify the clinical phenotype of secondary progressive (SP)MS. RECENT FINDINGS: The main findings originating from real-world studies suggest that MS patients who will qualify for high-efficacy disease-modifying therapies (DMTs) should be offered these as early as possible to prevent irreversible accumulation of neurological disability. Especially pediatric patients derive substantial benefits from early treatment. In patients with late-onset MS, sustained exposure to DMTs may result in more favorable outcomes. Data-driven definitions are more accurate in defining transition to SPMS than diagnosis based solely on neurologists' judgment. SUMMARY: Patients, physicians, industry, and policy-makers have all benefited from real-world evidence based on registry data, in answering questions of diagnostics, choice of treatment, and timing of treatment decisions.


Assuntos
Esclerose Múltipla Crônica Progressiva , Esclerose Múltipla Recidivante-Remitente , Esclerose Múltipla , Criança , Bases de Dados Factuais , Humanos , Esclerose Múltipla/diagnóstico , Esclerose Múltipla/epidemiologia , Esclerose Múltipla/terapia , Esclerose Múltipla Crônica Progressiva/terapia , Esclerose Múltipla Recidivante-Remitente/diagnóstico , Sistema de Registros
7.
Artigo em Inglês | MEDLINE | ID: mdl-35657835

RESUMO

Deep learning (DL) methods have been widely used in the field of seizure prediction from electroencephalogram (EEG) in recent years. However, DL methods usually have numerous multiplication operations resulting in high computational complexity. In addtion, most of the current approaches in this field focus on designing models with special architectures to learn representations, ignoring the use of intrinsic patterns in the data. In this study, we propose a simple and effective end-to-end adder network and supervised contrastive learning (AddNet-SCL). The method uses addition instead of the massive multiplication in the convolution process to reduce the computational cost. Besides, contrastive learning is employed to effectively use label information, points of the same class are clustered together in the projection space, and points of different class are pushed apart at the same time. Moreover, the proposed model is trained by combining the supervised contrastive loss from the projection layer and the cross-entropy loss from the classification layer. Since the adder networks uses the l1 -norm distance as the similarity measure between the input feature and the filters, the gradient function of the network changes, an adaptive learning rate strategy is employed to ensure the convergence of AddNet-CL. Experimental results show that the proposed method achieves 94.9% sensitivity, an area under curve (AUC) of 94.2%, and a false positive rate of (FPR) 0.077/h on 19 patients in the CHB-MIT database and 89.1% sensitivity, an AUC of 83.1%, and an FPR of 0.120/h in the Kaggle database. Competitive results show that this method has broad prospects in clinical practice.


Assuntos
Eletroencefalografia , Convulsões , Bases de Dados Factuais , Eletroencefalografia/métodos , Humanos , Convulsões/diagnóstico
8.
Stud Health Technol Inform ; 290: 3-6, 2022 Jun 06.
Artigo em Inglês | MEDLINE | ID: mdl-35672959

RESUMO

Clinical researchers hold high expectations for the utility of health data sourced from hospital information systems. In Japan, the standardized structured medical information eXchange version 2 (SS-MIX2) storage is a common resource for obtaining clinical data from different medical databases. However, little is known about the coverage of the data types derived from the SS-MIX2 storage. In this regard, we calculated the proportions of a dataset that could be extracted via SS-MIX2 for various clinical study categories listed in various articles published in the New England Journal of Medicine. In the 95 articles reviewed, the proportions varied from 13.3% ± 13.3% (mean ± SD) for dementia to 61.8% ± 13.7% for diabetes. For cardiology, the proportion of data accessed in a unique format (SEAMAT) increased significantly. We further noted that there was room for improvement in the coverage of SS-MIX2 data.


Assuntos
Cardiologia , Troca de Informação em Saúde , Sistemas de Informação Hospitalar , Bases de Dados Factuais , Japão
9.
PLoS One ; 17(6): e0269648, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35675367

RESUMO

Despite remarkable progress in digital linguistics, extensive databases of geographical language distributions are missing. This hampers both studies on language spatiality and public outreach of language diversity. We present best practices for creating and sharing digital spatial language data by collecting and harmonizing Uralic language distributions as case study. Language distribution studies have utilized various methodologies, and the results are often available as printed maps or written descriptions. In order to analyze language spatiality, the information must be digitized into geospatial data, which contains location, time and other parameters. When compiled and harmonized, this data can be used to study changes in languages' distribution, and combined with, for example, population and environmental data. We also utilized the knowledge of language experts to adjust previous and new information of language distributions into state-of-the-art maps. The extensive database, including the distribution datasets and detailed map visualizations of the Uralic languages are introduced alongside this article, and they are freely available.


Assuntos
Bases de Dados Factuais , Idioma , Gerenciamento de Dados , Disseminação de Informação , Mapas como Assunto
10.
Sci Data ; 9(1): 263, 2022 06 02.
Artigo em Inglês | MEDLINE | ID: mdl-35654801

RESUMO

In recent years, due to the complementary action of drug combinations over mono-therapy, the multiple-drugs for multiple-targets paradigm has received increased attention to treat bacterial infections and complex diseases. Although new drug combinations screening has benefited from experimental tests like automated high throughput screening, it is limited due to the large number of possible drug combinations. The task of drug combination screening can be streamlined through computational methods and models. Such models require up-to-date databases; however, existing databases are static and consist of the data collected at the time of their creation. This paper introduces the Continuous Drug Combination Database (CDCDB), a continuously updated drug combination database. The CDCDB includes over 40,795 drug combinations, of which 17,107 are unique combinations consisting of more than 4,129 individual drugs, curated from ClinicalTrials.gov, the FDA Orange Book®, and patents. To create CDCDB, we use various methods, including natural language processing techniques, to improve the process of drug combination discovery, ensuring that our database can be used for drug synergy prediction. Website: https://icc.ise.bgu.ac.il/medical_ai/CDCDB/ .


Assuntos
Bases de Dados Factuais , Combinação de Medicamentos , Descoberta de Drogas , Ensaios de Triagem em Larga Escala
11.
Sci Data ; 9(1): 265, 2022 06 02.
Artigo em Inglês | MEDLINE | ID: mdl-35654905

RESUMO

Trait databases have become important resources for large-scale comparative studies in ecology and evolution. Here we introduce the AnimalTraits database, a curated database of body mass, metabolic rate and brain size, in standardised units, for terrestrial animals. The database has broad taxonomic breadth, including tetrapods, arthropods, molluscs and annelids from almost 2000 species and 1000 genera. All data recorded in the database are sourced from their original empirical publication, and the original metrics and measurements are included with each record. This allows for subsequent data transformations as required. We have included rich metadata to allow users to filter the dataset. The additional R scripts we provide will assist researchers with aggregating standardised observations into species-level trait values. Our goals are to provide this resource without restrictions, to keep the AnimalTraits database current, and to grow the number of relevant traits in the future.


Assuntos
Metabolismo Basal , Peso Corporal , Encéfalo , Bases de Dados Factuais , Animais , Ecologia , Tamanho do Órgão , Fenótipo
12.
Sci Data ; 9(1): 266, 2022 06 03.
Artigo em Inglês | MEDLINE | ID: mdl-35661743

RESUMO

This document introduces the PHYTMO database, which contains data from physical therapies recorded with inertial sensors, including information from an optical reference system. PHYTMO includes the recording of 30 volunteers, aged between 20 and 70 years old. A total amount of 6 exercises and 3 gait variations were recorded. The volunteers performed two series with a minimum of 8 repetitions in each one. PHYTMO includes magneto-inertial data, together with a highly accurate location and orientation in the 3D space provided by the optical system. The files were stored in CSV format to ensure its usability. The aim of this dataset is the availability of data for two main purposes: the analysis of techniques for the identification and evaluation of exercises using inertial sensors and the validation of inertial sensor-based algorithms for human motion monitoring. Furthermore, the database stores enough data to apply Machine Learning-based algorithms. The participants' age range is large enough to establish age-based metrics for the exercises evaluation or the study of differences in motions between different groups.


Assuntos
Exercício Físico , Modalidades de Fisioterapia , Dispositivos Eletrônicos Vestíveis , Adulto , Idoso , Algoritmos , Bases de Dados Factuais , Marcha , Humanos , Pessoa de Meia-Idade , Adulto Jovem
13.
J Mol Biol ; 434(11): 167528, 2022 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-35662462

RESUMO

Experimental biologists are often left alone with the task to download, process, and analyze big datasets in order to perform correlation or other simpler analyses. To address these issues, we introduce EviCor, a handy toolbox for exploration of data from large public resources such as The Cancer Genome Atlas and The Cancer Cell Line Encyclopedia, complemented with follow-up information on same samples, which couples omics datasets with drug response profiles (https://www.evicor.org/). The data was processed for easy retrieval from the server-side database and includes pre-computed drug-feature correlation tables. Using information from multiple independent sources, the task-oriented web interface presents relations between phenotype, single-molecule, and pathway variables with graphical, statistical, and network analysis tools. Building custom multivariate models is enabled via user-friendly web interface and programmatic access via RESTinterface. Project code is available at https://github.com/aveviort/HyperSet.


Assuntos
Antineoplásicos , Uso da Internet , Software , Antineoplásicos/farmacologia , Linhagem Celular Tumoral , Bases de Dados Factuais , Humanos
14.
J Mol Biol ; 434(11): 167603, 2022 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-35662469

RESUMO

Knowing which proteins interact with each other is essential information for understanding how most biological processes at the cellular and organismal level operate and how their perturbation can cause disease. Continuous technical and methodological advances over the last two decades have led to many genome-wide systematically-generated protein-protein interaction (PPI) maps. To help store, visualize, analyze and disseminate these specialized experimental datasets via the web, we developed the freely-available Open-source Protein Interaction Platform (openPIP) as a customizable web portal designed to host experimental PPI maps. Such a portal is often required to accompany a paper describing the experimental data set, in addition to depositing the data in a standard repository. No coding skills are required to set up and customize the database and web portal. OpenPIP has been used to build the databases and web portals of two major protein interactome maps, the Human and Yeast Reference Protein Interactome maps (HuRI and YeRI, respectively). OpenPIP is freely available as a ready-to-use Docker container for hosting and sharing PPI data with the scientific community at http://openpip.baderlab.org/ and the source code can be downloaded from https://github.com/BaderLab/openPIP/.


Assuntos
Uso da Internet , Mapas de Interação de Proteínas , Software , Bases de Dados Factuais , Genoma Humano , Humanos
15.
J Am Coll Surg ; 235(1): 78-85, 2022 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-35703965

RESUMO

BACKGROUND: Patient morbidity and mortality decrease when injured patients meeting CDC Field Triage Criteria (FTC) are transported by emergency medical services (EMS) directly to designated trauma centers (TCs). This study aimed to identify potential disparities in the transport of critically injured patients to TCs by EMS. STUDY DESIGN: We identified all patients in the National EMS Information System (NEMSIS) database in the National Association of EMS State Officials East region from January 1, 2018, to December 31, 2019, with a final prehospital acuity of critical or emergent by EMS. The cohort was stratified into patients transported to TCs or non-TCs. Analyses consisted of descriptive epidemiology, comparisons, and multivariable logistic regression analysis to measure the association of demographic features, vital signs, and CDC FTC designation by EMS with transport to a TC. RESULTS: A total of 670,264 patients were identified as sustaining an injury, of which 94,250 (14%) were critically injured. Of those 94,250 critically injured, 56.0% (52,747) were transported to TCs. Among all critically injured women (n = 41,522), 50.4% were transported to TCs compared with 60.4% of critically injured men (n = 52,728, p < 0.001). In a multivariable logistic regression model, critically injured women were 19% less likely to be taken to a TC compared with critically injured men (OR 0.81, 95% CI 0.71-0.93, p = 0.003). CONCLUSIONS: Critically injured female patients are less likely to be transported to TCs when compared with their male counterparts. Performance improvement processes that assess EMS compliance with field triage guidelines should explicitly evaluate for sex-based disparities. Further studies are warranted.


Assuntos
Serviços Médicos de Emergência , Ferimentos e Lesões , Estudos de Coortes , Bases de Dados Factuais , Feminino , Humanos , Masculino , Estudos Retrospectivos , Centros de Traumatologia , Triagem , Ferimentos e Lesões/terapia
16.
P R Health Sci J ; 41(2): 56-62, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35704522

RESUMO

OBJECTIVE: To study the utilization of emergency room (ER) services for health complaints of the musculoskeletal (MSK) system in older men and women. METHODS: Data from all medical encounters at the ER of a teaching hospital for calendar years 2016-2020 were extracted from an electronic database. MSK encounters were defined as those with ICD 10-CM M and S codes in the primary diagnosis field of the database. Frequency distributions were calculated by year, sex, and age group for MSK and all encounters. The most frequent codes used by sex and age groups were assessed. RESULTS: The number of unique patients with medical encounters at the ER during the five-year period was 94,346. There was a total of 220,153 encounters (median:1 encounter per patient; interquartile range:1-3). A 33.2% reduction in the number of encounters occurred in 2020 compared to 2019. The total number of unique patients in the 60 yr. and older group was 24,412 (25.9% of all unique patients). The total number of encounters in the group 60 yr. and older was 56,294 (25.6% of all encounters). Women accounted for 31,488 (56%) encounters in this age group. A total of 12,744 encounters (22.6%) in older adults involved the MSK system and this proportion decreased with increasing age. The most common MSK conditions included low back pain, pain in joints, and femoral fractures. CONCLUSION: Older adults with MSK health conditions represent a substantial portion of ER patients. Many MSK health conditions could be evaluated and treated in other health care settings.


Assuntos
Doenças Musculoesqueléticas , Idoso , Bases de Dados Factuais , Serviço Hospitalar de Emergência , Feminino , Humanos , Masculino , Doenças Musculoesqueléticas/diagnóstico , Doenças Musculoesqueléticas/epidemiologia , Dor
17.
PLoS One ; 17(6): e0268633, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35704601

RESUMO

BACKGROUND: Strong scientific evidence affirms that climate change is now a public health emergency. Increasingly, climate litigation brought against governments and corporations utilizes international human rights, environmental and climate laws and policies to seek accountability for climate-destructive and health-harming actions. The health impacts of climate change make litigation an important means of pursuing justice and strategically challenging legal systems. Yet there is scant documentation in the literature of the role that public health has played in climate litigation and the legal weight public health narratives are given in such contexts. Therefore, we assessed to what extent courts of law have used public health harm in legal adjudication and sought to provide practical recommendations to address barriers to positioning legal arguments in public health-centric frames. METHODS: We reviewed legal databases to identify all publicly reported, documented, cases of climate litigation filed in any country or jurisdiction between 1990 and September 2020. For the 1641 cases identified, we quantified the frequency of cases where health concerns were explicitly or implicitly raised. FINDINGS: Case numbers are trending upwards, notably in high income countries. Resolution remains pending in over half of cases as the majority were initiated in the past three years. Cases were primarily based in climate and human rights law and brought by a wide range of groups and individuals predominantly against governments. About half of the decided cases found in favour for the plaintiffs. Based on this, we selected the 65 cases that were directly linked to public health. We found economic forces and pricing of health risks play a key role, as courts are challenged by litigants to adjudicate on the responsibility for health impacts. CONCLUSIONS: While courts of law are receptive to public health science, significant legal reform is needed to enhance leveraging of public health evidence in legal judgements of climate litigation cases. The integration of a public health mandate into a new eco-centric legal paradigm will optimize its potential to promote human well-being-the core objective underpinning both international law, human rights, and public health. Existing legal doctrines and practices can be enhanced to increase the weight of public health arguments in climate legal action and consequently ensure legal rulings in climate litigation prioritize, protect and promote public health.


Assuntos
Direitos Humanos , Saúde Pública , Mudança Climática , Bases de Dados Factuais , Humanos , Problemas Sociais
18.
BJS Open ; 6(3)2022 May 02.
Artigo em Inglês | MEDLINE | ID: mdl-35668711

RESUMO

BACKGROUND: Healthcare requires patient feedback to improve outcomes and experience. This study undertook a systematic review of the depth, variability, and digital suitability of current patient-reported outcome measures (PROMs) in patients undergoing laparoscopic cholecystectomy. METHODS: A PROSPERO-registered (registration number CRD42021261707) systematic review was undertaken for all relevant English language articles using PubMed version of MEDLINE, Scopus, and Web of Science electronic databases in June 2021. The search used Boolean operators and wildcards and included the keywords: laparoscopic cholecystectomy AND patient outcome OR patient-reported outcome OR patient-reported outcome measure OR PRO OR PROM. Medical Subjects Heading terms were used to search PubMed and Scopus. Articles published from 1 January 2011 to 2 June 2021 were included. RESULTS: A total of 4960 individual articles were reviewed in this study, of which 44 were found to evaluate PROMs in patients undergoing laparoscopic cholecystectomy and underwent methodological index for non-randomized studies (MINORS) grading. Twenty-one articles spanning 19 countries and four continents met all inclusion criteria and were included in the qualitative data synthesis. There was significant heterogeneity in PROMs identified with eight different comprehensive PROM tools used in the 21 studies. There was wide variation in the time points at which PROMs were recorded. Fourteen of 21 studies recorded PROMs before and after surgery, and 7 of 21 recorded PROMs only after surgery. Follow-up intervals ranged from 3 days to 2 years after surgery. CONCLUSIONS: This study identified that while post-laparoscopic cholecystectomy PROMs are infrequently measured currently, tools are widely available to achieve this in clinical practice. PROMs may not capture all the outcomes but should be incorporated into future cholecystectomy outcome research. The EQ-5D™ (EuroQoL Group, Rotterdam, the Netherlands) provides a simple platform for the modern digital era.


Assuntos
Colecistectomia Laparoscópica , Colecistectomia , Bases de Dados Factuais , Atenção à Saúde , Humanos , Medidas de Resultados Relatados pelo Paciente
19.
BMJ Open ; 12(6): e058708, 2022 Jun 07.
Artigo em Inglês | MEDLINE | ID: mdl-35672062

RESUMO

INTRODUCTION: Dry eye is a leading cause of ocular morbidity and economic and societal burden for patients and healthcare systems. There are several treatment options available for dry eye and high-quality systematic reviews synthesise the evidence for their effectiveness and potential harms. METHODS AND ANALYSIS: We will search the Cochrane Eyes and Vision US satellite (CEV@US) database of eyes and vision systematic reviews for systematic reviews on interventions for dry eye. CEV@US conducted an initial search of PubMed and Embase to populate the CEV@US database of eyes and vision systematic reviews in 2007, which was updated most recently in August 2021. We will search the database for systematic reviews published since 1 January 2016 because systematic reviews more than 5 years are unlikely to be up to date. We will consider Cochrane and non-Cochrane systematic reviews eligible for inclusion. Two authors will independently screen articles. We will include studies that evaluate interventions for dry eye and/or meibomian gland dysfunction with no restriction on types of participants or review language. We will select reliable systematic reviews (ie, those meeting pre-established methodological criteria) for inclusion, assessed by one investigator and verified by a second investigator. We will extract ratings of the certainty of evidence from within each review. We will report the degree of overlap for systematic reviews that answer similar questions and include overlapping primary studies. We will present results of the overview in alignment with guidelines in the Cochrane Handbook of Systematic Reviews of Interventions (Online Chapter 5: Overviews of Reviews), the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement, and an overview of reviews quality and transparency checklist. The anticipated start and completion dates for this overview are 1 May 2021 and 30 April 2022, respectively. ETHICS AND DISSEMINATION: This overview will not require the approval of an Ethics Committee because it will use published studies. We will publish results in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER: CRD42021279880.


Assuntos
Síndromes do Olho Seco , Bases de Dados Factuais , Síndromes do Olho Seco/etiologia , Síndromes do Olho Seco/terapia , Humanos , Projetos de Pesquisa
20.
BMC Pregnancy Childbirth ; 22(1): 471, 2022 Jun 07.
Artigo em Inglês | MEDLINE | ID: mdl-35672663

RESUMO

BACKGROUND: The use of caesarean section has steadily increased, with Latin America being the region with the highest rates. Multiple factors account for that increase and the Robson classification is appropriate to compare determinants at the clinical level for caesarean section rates over time. The purpose of this study is to describe the evolution of caesarean section rates by Robson groups in Uruguay from 2008 to 2018 using a country level database. METHODS: We included the records of all women giving birth in Uruguay (pregnancies ≥22 weeks and weights ≥500 g) with valid data in the mode of childbirth recorded in the Perinatal Information System database between 2008 and 2018. Caesarean section rates were calculated by Robson groups for each of the years included, disaggregated by care sector (public/private) and by geographical area (Capital City/Non-Capital), with time trends and their significance analyzed using linear regression models. RESULTS: Of the total 485,263 births included in this research, the overall caesarean section rate was 43,1%. In 2018, among the groups at lower risk of caesarean section (1 to 4), the highest rates were seen in women in group 2B (98,8%), followed by those in group 4B (97,9%). A significant increase in the number of caesarean sections was seen in groups 2B (97,9 to 98,8%), 3 (8,36 to 11,1%) and 4 (A (22,7 to 26,9%) and B (95,4 to 97,9%) Significant growth was also observed in groups 5 (74,3 to 78,1%), 8 (90,6 to 95,5%), and 10 (39,1 to 46,7%). The private sector had higher rates of caesarean section for all groups throughout the period, except for women in group 9. The private sector in Montevideo presented the highest rates in the groups with the lowest risk of caesarean section (1, 2A, 3 and 4A), followed by the private sector outside of the capital. CONCLUSION: Uruguay is no exception to the increasing caesarean section trend, even in groups of women who have lower risk of requiring caesarean section. The implementation of interventions aimed at reducing caesarean section in the groups with lower obstetric risk in Uruguay is warranted.


Assuntos
Cesárea , Parto Obstétrico , Bases de Dados Factuais , Feminino , Humanos , Parto , Gravidez , Uruguai/epidemiologia
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