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Use of prophylactic mesh during initial stoma creation to prevent parastomal herniation: a systematic review and meta-analysis of randomised controlled trials.

Colorectal Dis 2021 Jul 31. Epub 2021 Jul 31.

Royal Devon & Exeter Hospital, Royal Devon & Exeter NHS Foundation Trust, Exeter, UK.

Background: Parastomal hernia (PSH) is a common complication following stoma creation. Previous reviews found mesh reinforcement during initial stoma creation beneficial in reducing PSH incidence. Since then, several multicentre randomised controlled trials (RCTs) produced widely ranging results rendering previous findings debatable. Read More

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Efficacy and safety of remdesivir in hospitalised COVID-19 patients: a systematic review and meta-analysis.

Infection 2021 Jul 31. Epub 2021 Jul 31.

School of Pharmacy and Pharmacology, University of Tasmania, Hobart, Australia.

Purpose: This review was aimed to synthesise the best available evidence on the effectiveness and safety of remdesivir in the treatment of moderate to severe COVID-19.

Method: Randomised controlled trials (RCTs) and observational studies reporting the effectiveness and safety of remdesivir were searched via databases and other sources from December 2019 to December 2020. Two independent reviewers performed literature screening, data extraction and assessment of risk bias. Read More

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J Nurs Manag 2021 Jul 31. Epub 2021 Jul 31.

Department of Sport Studies, Faculty of Educational Studies, Universiti Putra, Malaysia, Serdang, Selangor.

Objectives: This review aims to identify types of the existing fall prevention education and their effectiveness in promoting fall risk awareness, knowledge and preventive fall behaviour change among community-dwelling older people.

Background: Fall prevention education is a cost-effective and helpful tool for reducing fall occurrences.

Evaluation: This is a systematic review study using electronic searches via EBSCOHost® platform, ScienceDirect, Scopus and Google Scholar in March 2021. Read More

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Hands-Up program: protocol for a feasibility randomised controlled trial of a combined 6-week exercise and education intervention in adults aged 50-65 with a distal radius fracture.

BMJ Open 2021 Jul 30;11(7):e046122. Epub 2021 Jul 30.

St Joseph's Health Centre, London, Ontario, Canada.

Introduction: This pilot study will determine the feasibility of recruitment, retention and adherence for the online combined exercise and education programme (Hands-Up) compared with usual care.

Methods And Analysis: The proposed randomised controlled trial will be a pilot feasibility study with a 1:1 randomisation to the Hands-Up programme or usual physical therapy. The programme setting is an online home exercise and education program. Read More

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The history of labour induction: How did we get here?

James Owen Drife

Best Pract Res Clin Obstet Gynaecol 2021 Jul 16. Epub 2021 Jul 16.

Emeritus Professor of Obstetrics and Gynaecology, University of Leeds, Leeds, UK. Electronic address:

The mean duration of human pregnancy is 280 days but the range is wide, and "term" has been defined to range from 37 to 42 weeks. In the 18th and 19th centuries, labour induction was used mainly in cases of pelvic deformity, before the foetus grew too large to be delivered. Induction methods were unreliable until the 20th century, when pituitary extract, and then synthetic oxytocin and prostaglandins, became available. Read More

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The effect of timing of enteral nutrition support on feeding outcomes and dysphagia in patients with head and neck cancer undergoing radiotherapy or chemoradiotherapy: A systematic review.

Clin Nutr ESPEN 2021 Aug 3;44:96-104. Epub 2021 Jun 3.

School of Human Movement and Nutrition Sciences, University of Queensland, Queensland, Australia. Electronic address:

Background & Aims: Patients with head and neck cancer (HNC) often require enteral nutrition (EN). This systematic review reports the effect of EN timing in patients with HNC undergoing curative-intent and definitive or adjuvant radiotherapy or chemoradiotherapy on tube feeding duration, tube-related complications and dysphagia.

Methods: Randomised controlled trials (RCTs) published between January 2015-April 2020 were obtained from Medline, CINAHL and Embase. Read More

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Safety and efficacy of tetrastarches in surgery and trauma: a systematic review and meta-analysis of randomised controlled trials.

Br J Anaesth 2021 Jul 28. Epub 2021 Jul 28.

Department of Anaesthesia and Perioperative Medicine, University of Cape Town, Cape Town, South Africa.

Background: Hydroxyethyl starch (HES) 130 is a frequently used fluid to replace intravascular losses during surgery or trauma. In the past years, several trials performed in critically ill patients have raised questions regarding the safety of this product. Our aim in this meta-analysis was to evaluate the safety and efficacy of 6% HES during surgery and in trauma. Read More

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Improving the investigative approach to polycythaemia vera: a critical assessment of current evidence and vision for the future.

Lancet Haematol 2021 Aug;8(8):e605-e612

Division of Hematology and Medical Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA. Electronic address:

Polycythaemia vera is a challenging disease to study given its low prevalence and prolonged time-to-event for important clinical endpoints such as thrombosis, progression, and mortality. Although researchers in this space often rise to meet these challenges, there is considerable room for improvement in the analysis of retrospective data, the development of risk-stratification tools, and the design of randomised controlled trials. In this Viewpoint, we review the evidence behind the contemporary approach to risk stratification and treatment of polycythaemia vera. Read More

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Neoadjuvant chemotherapy before surgery versus surgery followed by chemotherapy for initial treatment in advanced ovarian epithelial cancer.

Cochrane Database Syst Rev 2021 Jul 30;7:CD005343. Epub 2021 Jul 30.

Department of Gynaecological Oncology, Musgrove Park Hospital, Taunton, UK.

Background: Epithelial ovarian cancer presents at an advanced stage in the majority of women. These women require a combination of surgery and chemotherapy for optimal treatment. Conventional treatment has been to perform surgery first and then give chemotherapy. Read More

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Efficacy and safety of high flow nasal oxygen for children with bronchiolitis: systematic review and meta-analysis.

BMJ Open Respir Res 2021 Jul;8(1)

Children's Hospital for Wales, University of Wales Hospital, Cardiff, Cardiff, UK

Background: To assess the published evidence to establish the efficacy and safety of high flow oxygen cannula (HFNC) as respiratory support for children up to 24 months of age with bronchiolitis within acute hospital settings.

Methods: We searched eight databases up to March 2021. Studies including children up to 24 months of age with a diagnosis of bronchiolitis recruited to an randomised controlled trial were considered in the full meta-analysis. Read More

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Risk of Major Amputation Following Application of Paclitaxel Coated Balloons in the Lower Limb Arteries: A Systematic Review and Meta-Analysis of Randomised Controlled Trials.

Eur J Vasc Endovasc Surg 2021 Jul 26. Epub 2021 Jul 26.

Patras University Hospital, Rion, Greece.

Objective: There have been concerns about the long term safety of paclitaxel coated devices in the lower limbs. A formal systematic review and meta-analysis of randomised controlled trials (RCTs) was performed to examine the long term risk of major amputation using paclitaxel coated balloons in peripheral arterial disease (PAD).

Method: This systematic review was registered with PROSPERO (ID 227761). Read More

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Systematic review and meta-analysis of fluid therapy protocols in acute pancreatitis: type, rate and route.

HPB (Oxford) 2021 Jul 8. Epub 2021 Jul 8.

HPB Unit, Department of General and Digestive Surgery, Hospital Universitario La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP), Universidad Autónoma de Madrid (UAM), Madrid, Spain.

Background: Adequate fluid resuscitation is paramount in the management of acute pancreatitis (AP). The aim of this study is to assess benefits and harms of fluid therapy protocols in patients with AP.

Methods: MEDLINE, Embase, Science Citation Index and clinical trial registries were searched for randomised clinical trials published before May 2020, assessing types of fluids, routes and rates of administration. Read More

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Effect of educational progressive web application on patient's oral and denture knowledge and hygiene: A randomised controlled trial.

Health Informatics J 2021 Jul-Sep;27(3):14604582211035821

Universiti Kebangsaan Malaysia, Malaysia.

This study aimed to evaluate the effect of a novel progressive web application (PWA) on the patient's oral and denture knowledge and hygiene. Fifty-two removable partial denture wearers were randomised to receive education using the PWA, or verbal instructions accompanied by demonstration of hygienic procedures. Changes in the participants' knowledge score, plaque index, gingival index and denture plaque was evaluated during a follow-up period of 3 months. Read More

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A systematic review of outcome reporting for interventions to treat people with diabetic foot ulceration.

Diabet Med 2021 Jul 29:e14664. Epub 2021 Jul 29.

Centre for Surgical Research, University of Bristol, UK.

Background: Diabetic foot ulceration (DFU) is a challenging clinical problem that affects up to a quarter of patients with diabetes in their lifetime. An agreed set of outcomes for assessing treatments or interventions for DFU has not previously been considered. The aim of this study was to identify outcomes that are reported in clinical studies assessing a treatment or intervention for DFU, to inform the development of a core outcome set (COS). Read More

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Reducing mosquito-borne disease transmission to humans: A systematic review of cluster randomised controlled studies that assess interventions other than non-targeted insecticide.

PLoS Negl Trop Dis 2021 Jul 29;15(7):e0009601. Epub 2021 Jul 29.

The Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, Australia.

Background: Mosquito control interventions are widely used to reduce mosquito-borne diseases. It is unclear what combination of interventions are most effective in reducing human disease. A novel intervention study for Buruli ulcer targeting mosquito vectors was proposed for a Buruli ulcer-endemic area of Victoria, Australia. Read More

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Automated conversational agents for post-intervention follow-up: a systematic review.

BJS Open 2021 Jul;5(4)

Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK.

Background: Advances in natural language processing and other machine learning techniques have led to the development of automated agents (chatbots) that mimic human conversation. These systems have mainly been used in commercial settings, and within medicine, for symptom checking and psychotherapy. The aim of this systematic review was to determine the acceptability and implementation success of chatbots in the follow-up of patients who have undergone a physical healthcare intervention. Read More

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Transjugular intrahepatic porto-systemic shunts in the setting of portal vein thrombosis: a review.

J Dig Dis 2021 Jul 29. Epub 2021 Jul 29.

Interventional Radiology Service, Department of Radiology, Northern Health, Melbourne, Victoria, Australia.

Aim: The presence of portal venous thrombosis (PVT) has previously been considered a contraindication to the insertion of transjugular intrahepatic porto-systemic shunts (TIPSS). However, patients with PVT may be symptomatic with complications of portal hypertension, and may thus benefit from TIPSS to reduce portal venous pressure. There is increasing literature discussing the techniques and outcomes of TIPSS in PVT. Read More

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A Meta-Analysis of Safety of Different Regimens of Remdesivir in COVID-19 Patients.

Curr Drug Saf 2021 Jul 27. Epub 2021 Jul 27.

Department of Clinical Pharmacology, Seth GS Medical College & KEM Hospital, Parel-400 012, Mumbai, Maharashtra, India.

Remdesivir is an adenosine analogue drug that targets RNA dependent RNA polymerase enzyme and inhibits the viral replication. As on 22nd of October 2020, US FDA fully approved drug Remdesivir for the treatment of COVID-19 patients who requires hospitalisation. Many clinical studies reported the derangement in hepatic and renal function tests which is alarming considering the health conditions of the COVID-19 patients. Read More

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Bariatric Surgery as a Viable Treatment for Idiopathic Intracranial Hypertension: a Case Series and Review of Literature.

Obes Surg 2021 Jul 28. Epub 2021 Jul 28.

Worcestershire Acute Hospitals NHS Trust, Charles Hastings Way, Worcester, Worcestershire, WR5 1DD, UK.

Purpose: Idiopathic intracranial hypertension is a significant cause of preventable blindness. Patients suffer from debilitating headaches, pulsatile tinnitus, nausea, vomiting, photophobia and radicular pain. At this rate, treatment cost will increase to 462. Read More

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Liver Transplantation for Non-Resectable Liver Metastases from Colorectal Cancer: A Systematic Review and Meta-Analysis.

World J Surg 2021 Jul 28. Epub 2021 Jul 28.

Department of Hepato-Pancreato-Biliary Surgery, Manchester Royal Infirmary, Manchester University NHS Foundation Trust, Oxford Road, Manchester, M13 9WL, UK.

Backgrounds: Colorectal liver metastases were historically considered a contraindication to liver transplantation, but dismal outcomes for those with metastatic colorectal cancer and advancements in liver transplantation (LT) have led to a renewed interest in the topic. We aim to compare the current evidence for liver transplantation for non-resectable colorectal liver metastases (NRCLM) with the current standard treatment of palliative chemotherapy.

Methods: A systematic review and meta-analysis of proportions was conducted following screening of MEDLINE, EMBASE, SCOPUS and CENTRAL for studies reporting liver transplantation for colorectal liver metastases. Read More

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Opioid-sparing effects of medical cannabis or cannabinoids for chronic pain: a systematic review and meta-analysis of randomised and observational studies.

BMJ Open 2021 Jul 28;11(7):e047717. Epub 2021 Jul 28.

Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada

Objective: To assess the efficacy and harms of adding medical cannabis to prescription opioids among people living with chronic pain.

Design: Systematic review.

Data Sources: CENTRAL, EMBASE and MEDLINE. Read More

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PediAppRREST: effectiveness of an interactive cognitive support tablet app in reducing deviations from guidelines in the management of paediatric cardiac arrest: protocol for a simulation-based randomised controlled trial.

BMJ Open 2021 Jul 28;11(7):e047208. Epub 2021 Jul 28.

Division of Pediatric Emergency Medicine, Department of Women's and Children's Health, University of Padua, Padua, Italy

Introduction: Paediatric cardiac arrest (PCA), despite its low incidence, has a high mortality. Its management is complex and deviations from guideline recommendations occur frequently. We developed a new interactive tablet app, named PediAppRREST, to support the management of PCA. Read More

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Are interventions to improve cardiovascular disease risk factors in premenopausal women effective? A systematic review and meta-analysis.

BMJ Open 2021 Jul 28;11(7):e042103. Epub 2021 Jul 28.

Deakin Health Economics, Deakin University Faculty of Health, Burwood, Victoria, Australia.

Objectives: Non-traditional risk factors place young women at increased risk of cardiovascular disease (CVD) over their lifetime. The current study undertakes a systematic review and meta-analysis of randomised controlled trials (RCTs) that examined the effectiveness of primary prevention interventions for CVD in premenopausal women.

Methods: An electronic literature search was performed in key databases in July 2018 and updated in May 2020. Read More

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Behavioural interventions for CVD risk reduction for blue-collar workers: a systematic review.

J Epidemiol Community Health 2021 Jul 28. Epub 2021 Jul 28.

Department of Preventive Medicine, Rush University Medical Center, Chicago, Illinois, USA.

Objectives: Individuals working in blue-collar occupations experience high rates of cardiovascular disease (CVD). The purpose of this systematic review is to describe the characteristics and efficacy of behavioural interventions that have targeted CVD risk factors in this high-risk group.

Methods: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we searched seven databases to find interventions focused on changing the following: blood pressure, cholesterol, diet, physical activity, smoking or weight. Read More

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Characteristics and effects of integrated nutrition and stimulation interventions to improve the nutritional status and development of children under 5 years of age: a systematic review and meta-analysis.

BMJ Glob Health 2021 Jul;6(7)

School of Health Sciences, Western Sydney University, Penrith South, New South Wales, Australia.

Introduction: Around 250 million children in low-income and middle-income countries are at risk of not fulfilling their developmental potential. There is a need to update syntheses investigating the effects of combined nutrition and stimulation interventions on children's growth and development and identify intervention characteristics associated with positive effects.

Methods: We did a systematic review to: (1) understand the effects of integrated nutrition and stimulation interventions versus (i) usual care and (ii) standalone nutrition or stimulation interventions, on the growth and development of children under five; (2) explore intervention characteristics (delivery strategies, behaviour change techniques, intensity and personnel) associated with positive effects. Read More

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Contemporary Review on Craniectomy and Cranioplasty; Part 1: Decompressive Craniectomy.

J Craniofac Surg 2021 Jul 27. Epub 2021 Jul 27.

Applied Medical Sciences Department, Luminus Technical University College, Amman, Jordan Consultant Clinical Scientist (Reconstructive Science), London, UK.

Abstract: This paper aims to review clinical benefits of decompressive craniectomy (DC) in both adult and paediatric populations; its indications and factors contributing to its postoperative success. The Glasgow Outcome Scale and the Modified Rankin Scale are the most commonly used scales to assess the long-term outcome in patients post DC. In adult traumatic brain injury patients, 2 randomized clinical trials were carried out; DECRA (Decompressive Craniectomy in Diffuse Traumatic Brain Injury) and RESCUEicp (Randomised Evaluation of Surgery with Craniectomy for Uncontrollable Elevation of inter cranial pressure) employing collectively 555 patients. Read More

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Efficacy of erythritol powder air-polishing in active and supportive periodontal therapy: A systematic review and meta-analysis.

Int J Dent Hyg 2021 Jul 28. Epub 2021 Jul 28.

Department of Periodontics, College of Dentistry, University of Sulaimani, Sulaymaniyah, Iraq.

Objective: This systematic review aimed to analyse the available evidence to answer two focused questions about the efficacy of erythritol powder air-polishing (EPAP) (i) as an adjunctive during active periodontal therapy (APT) and (ii) as an alternative to hand/ultrasonic instrumentation during supportive periodontal therapy (SPT). Additionally, microbiological outcomes and patient's comfort/perceptions were assessed as secondary outcomes.

Methods: PubMed, Cochrane, and Medline were searched for relevant articles published before February 2021 following PRISMA guidelines. Read More

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Transition to psychosis in randomised clinical trials of individuals at clinical high risk of psychosis compared to observational cohorts: a systematic review and meta-analysis.

Eur Psychiatry 2021 Jul 28:1-22. Epub 2021 Jul 28.

Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.

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Neurophysiological changes of brain and spinal cord in individuals with patellofemoral pain: a systematic review and meta-analysis protocol.

BMJ Open 2021 Jul 26;11(7):e049882. Epub 2021 Jul 26.

Department of Physical Therapy, University of Nevada, Las Vegas, Las Vegas, Nevada, USA

Introduction: Reduced neuromuscular control due to altered neurophysiological functions of the central nervous system has been suggested to cause movement deficits in individuals with patellofemoral pain (PFP). However, the underlying neurophysiological measures of brain and spinal cord in this population remain to be poorly understood. The purpose of this systematic review is to evaluate the evidence for altered cortical and spinal cord functions in individuals with PFP. Read More

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Can health information through mobile phones close the divide in health behaviours among the marginalised? An equity analysis of Kilkari in Madhya Pradesh, India.

BMJ Glob Health 2021 Jul;6(Suppl 5)

Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA.

Kilkari is one of the largest maternal mobile messaging programmes in the world. It makes weekly prerecorded calls to new and expectant mothers and their families from the fourth month of pregnancy until 1-year post partum. The programme delivers reproductive, maternal, neonatal and child health information directly to subscribers' phones. Read More

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