Trip Database Research Articles

Barriers to access dental care services among adult population: A systematic review

Objective: This systematic review was done with the aim of assessing the barriers faced in utilizing dental care services by general population in age group between 20 and 60 years in India as these findings would provide evidence for making appropriate decisions in our National Oral Health Policy which could further improve access to dental care services for people across India. This was a systematic review. Materials and Methods: For this review, PubMed, TRIP database, Cochrane, and Google Scholar were the electronic databases searched based on the PICO. Preferred Reporting Items for Systematic Reviews and Meta- Analyses guidelines were followed for the final inclusion of articles. Results: The search generated a total of 91 articles from four different electronic bases: PubMed, TRIP database, Cochrane, and Google Scholar. Based on the inclusion criteria, 14 articles made it to the final analysis. All 14 studies reported a lack of time and nonavailability of dentists as major barriers in accessing dental care services. Conclusion: The cross-sectional studies of this review were assessed for quality using a modified Newcastle- Ottawa Scale, proposed by Egger et al. in 2003. Even though the available literature forms a lower standard of evidence, further evaluation of barriers using a standardized questionnaire is recommended using better-designed studies to substantiate the unequal access to health-care facilities to Indian Population.

Prevention of Bortezomib-Induced Polyneuropathy in Multiple Myeloma Patients

Bortezomib (Velcade®) is a proteasome pathway inhibitor that has improved multiple myeloma (MM) overall survival. Bortezomib-induced peripheral neuropathy (BIPN) is a frequent adverse event, requiring delay, dose reduction or cessation of therapy. Although most of the symptoms resolve after discontinuation or dose-reduction, almost 25% develop chronic symptoms, affecting quality of life and limiting the therapeutic choices. There is limited evidence regarding the strategies to prevent bortezomib-induced polyneuropathy (BIPN). We conducted a review of the published data to summarize the available information regarding BIPN prevention strategies. Our search included literature published in the Cochrane Library databases, Medline/PubMed, SciELO, Google Scholar, and Trip Database in the last ten years, including observational analytic studies, experimental studies, systematic reviews, and metanalysis, which reported the efficacy of interventions to prevent BIPN. Eight studies have been included. The subcutaneous administration of bortezomib has shown a protective effect of all grades of BIPN (OR=0.40, 95% CI 0.27 to 0.59, p<0.001) and grade 3 to 4 (OR = 0.45, 95% CI 0.25 to 0.82, P<0.05), as evidenced in a metanalysis. Cumulative dose of bortezomib > 30 mg/m2 is significantly associated with a higher risk of BIPN. Other therapies as Acetyl-l-carnitine (ALC), dexamethasone in partnered dosing (day of/after bortezomib), high-dose intravenous mecobalamin (HDIME), and the combination of docosahexaenoic acid, α-lipoic acid, vitamin C 60 mg, and vitamin E have been assessed but their efficacy for BIPN prevention has not been confirmed. We conclude that the subcutaneous route of administration of bortezomib effectively prevents BIPN while other strategies lack robust evidence to be recommended.

Analysis of the range of antifungal drugs for systemic use and evidence-based clinical efficacy and safety of fluconazole

Today, according to the WHO, every fifth inhabitant of the Earth is infected with fungi, and every tenth has pronounced clinical manifestations of fungal diseases. The incidence of mycotic foot infections among the population both in Ukraine and in various European countries varies from 20 to 70 %.Aim. To analyze the assortment of antifungal drugs for systemic use at the pharmaceutical market of Ukraine within 2016-2018 and the evidence base for efficacy and safety of the antifungal drug – fluconazole.Materials and methods. The analysis of the assortment of antifungal drugs was performed within 2016-2018 according to the “Pharmstandard” information and search system “Morion” of company. The analysis of clinical efficacy and safety of fluconazole was carried out according to the evidence-based medicine databases, such as Cochrane Library, Trip Database, PubMed, Nice.Results. Antifungal drugs for systemic use were presented at the pharmaceutical market within 2016-2018 in a sufficient assortment (103-111 TN drugs) based on 7 INN. However, most INN drugs were presented by 1-4 TN and had a narrow price range per package. Only fluconazole preparations had a significant amount of TH at the market (79-89 TN drugs) with a wide range of prices per package (from 8.63 to 1407.29 UAH). In 10 systematic reviews analyzed the results of clinical efficacy and safety of fluconazole for the prevention and treatment of fungal infections in children and adults were presented. Fluconazole has the proven pronounced clinical efficacy and is recommended by the American and European Communities of Infectious Diseases as a first-line therapy for candida infections.Conclusions. The analysis of systematic reviews and meta-analyses prove the safety and efficacy of fluconazole when used in children and adults for the prevention and treatment of fungal infections.

The impact of availability and identity of the caregiver on the post-stroke patient

Background After having a stroke, most patients are helped by a caregiver with activities that they cannot perform by themselves. The caregiver presence and actions are an important variable that may affect rehabilitation in many ways. The aim of this review study was to evaluate the impact of caregiver presence (or absence) and identity (spouse, family, or foreign domestic worker) on therapeutic exercise performance, depression symptoms, patient–spouse relations and total functional outcomes of stroke patients. Assessing these effects may help health care professionals and families to prioritise/choose the caregiver for their patient/family member. Methods A narrative literature review was conducted, focusing on one-direction effects (caregiver on patient effects) on the topics of interest mentioned, in a post-stroke population. PubMed, CINAHL, PEDro, Trip database, and Google Scholar were searched, and included studies of most designs and research qualities. The search strategy had not been specified before commencing the review. Each study was analysed individually with the purpose of synthesising the available evidence to achieve a greater understanding of this topic. Results A total of 17 relevant papers were included: six randomised controlled trials, six observational studies, two systematic reviews, two survey-based studies, and one case series. Trials were consistent with the positive effect that caregivers have on therapeutic exercise performance. Studies have shown a positive effect of caregivers on the patient's depressive symptoms, but only at the chronic phase after stroke. A spouse caregiver seems to more positively affect the patient–spouse relations in the acute phase of rehabilitation, while foreign domestic workers can improve these relations at more chronic phases. The presence of a caregiver is shown to decrease functional outcomes within institutionalised rehabilitation centres, while it is necessary and positively affects functionality at more chronic phases within community settings. Conclusions The advantages and disadvantages of employing a caregiver depend in many cases on the rehabilitation phase. The caregiver might be beneficial or harmful to the patient's functional progress, depressive symptoms and marital relationship depending on the rehabilitation phase. More studies are needed to assess the caregiver effects on post-stroke patients' rehabilitation and quality of life.

Scoping review about the recommendations for home isolation in the COVID-19 pandemic

ObjetivoLa pandemia de COVID-19 ha afectado a países de todos los continentes, donde se ha aplicado de forma sistemática medidas de confinamiento y aislamiento. El objetivo es sintetizar la evidencia disponible sobre el manejo del aislamiento domiciliario por infección por COVID-19.MétodoSe ha realizado una scoping review consultando mediante lenguaje controlado Trip Database, PUBMED, CINAHL, COCHRANE y Elsevier, sin ningún tipo de límites. De todos los documentos localizados se extrajo información sobre la fecha de publicación, país de publicación, tipo de estudio, valoración del nivel de evidencia y grado de recomendación y resultados de interés para responder a la pregunta de investigación. Se ha realizado una lectura crítica de los documentos seleccionados, pero sin utilizarla como criterio de exclusión sino informativo.ResultadosSe localizaron 163 registros y se han seleccionado 14. Las recomendaciones se han agrupado en 10 temas alrededor de todo el manejo cotidiano de un cuidado en domicilio.ConclusionesSe objetiva la escasez de evidencias consistentes sobre el aislamiento ante la infección de la COVID-19. La mayoría de los documentos son revisiones realizadas tras el consenso de expertos a nivel internacional.

5-Aminolevulinic acid for recurrent malignant gliomas: A systematic review

ObjectivesNowadays, several techniques have been developed in order to guide neurosurgeons during intended maximal safe resection of high-grade gliomas (HGG). Fluorescence-guided microsurgery using 5-aminolevulinic acid (5-ALA) is one of these. A large amount of studies have been performed evaluating benefits in newly diagnosed HGG. However, little is known about the safety, accuracy and efficacy in recurrent HGG.The primary objective of this thesis is to examine the value of 5-ALA in patients with recurrent HGG concerning diagnostic accuracy, extent of resection (EOR), safety and survival compared to white-light resection. As a secondary objective, we compared these results with current literature concerning 5-ALA in newly diagnosed HGG. Patients and methodsWe performed a systematic review and included eighteen articles obtained from MEDLINE, EMBASE, Web of Science and TRIP database. Search terms include “glioma” and “aminolevulinic acid”. Additional studies were identified through checking the reference lists. This study is in conformity with the PRISMA and BMJ guidelines. Results5-ALA shows similar results regarding diagnostic accuracy in recurrent HGG compared to newly diagnosed HGG, although specificity and negative predictive value seem lower. It shows complementary value in identifying tumor boundaries compared to MRI-neuronavigation. Diagnostic accuracy is not influenced by previous chemo- or radiotherapy. New neurological deficits proved to be similar and were in general mainly temporary. However, adverse events overall were more common. Therefore, indications for repeat surgery should be followed strictly. 5-ALA might increase overall survival in recurrent gliomas, but has no clear impact on progression-free survival. Conclusion5-ALA should be regarded as a useful and safe intraoperative tool in recurrent glioma surgery.

Faecal immunochemical test to triage patients with abdominal symptoms for suspected colorectal cancer in primary care: review of international use and guidelines.

Recently, faecal immunochemical tests (FITs) have been introduced for investigation of primary care patients with low-risk symptoms of colorectal cancer (CRC), but recommendations vary across the world. This systematic review of clinical practice guidelines aimed to determine how FITs are used in symptomatic primary care patients and the underpinning evidence for these guidelines. MEDLINE, Embase and TRIP databases were systematically searched, from 1 November 2008 to 1 November 2018 for guidelines on the assessment of patients with symptoms suggestive of CRC. Known guideline databases, websites and references of related literature were searched. The following questions were addressed: (i) which countries use FIT for symptomatic primary care patients; (ii) in which populations is FIT used; (iii) what is the cut-off level used for haemoglobin in the faeces (FIT) and (iv) on what evidence are FIT recommendations based. The search yielded 2433 publications; 25 covered initial diagnostic assessment of patients with symptoms of CRC in 15 countries (Asia, n = 1; Europe, n = 13; Oceania, n = 4; North America, n = 5; and South America, n = 2). In three countries (Australia, Spain and the UK), FIT was recommended for patients with abdominal symptoms, unexplained weight loss, change in bowel habit or anaemia despite a low level of evidence in the symptomatic primary care patient population. Few countries recommend FITs in symptomatic patients in primary care either because of limited evidence or because symptomatic patients are directly referred to secondary care without triage. These results demonstrate a clear need for research on FIT in the symptomatic primary care population.

A systematic mixed studies review of health behaviour change interventions in colorectal cancer survivors.

To explore available health behaviour change interventions in improving key health behaviours in colorectal cancer survivors and patient perspectives about these interventions. A systematic mixed studies review was conducted. Databases searched included Ovid Medline, Ovid Embase, EBSCO PsychoInfo and EBSCO CINAHL. A grey literature search was also completed using Google Scholar and the TRIP database. Identified studies were published between 2003 - 2018. A parallel-results convergent synthesis design using narrative syntheses was used. Data analysis was conducted following a process of constant comparison. Quality appraisal was conducted using recognized tools appropriate to different study designs. Sixteen unique studies were identified from an initial search of 354 records. There was a pattern of successful physical activity and dietary change associated with behaviour change interventions of varying intensity, modality and length, but sparse description of intervention content was common. Participants preferred clear explanations of health behaviour importance and for interventions to be administered in sessions either with, or led by, other patients. The available evidence tentatively suggests that behaviour change interventions can improve the health behaviours of colorectal cancer survivors. However, more research focused on identifying key intervention elements is needed. Patients indicated clear preferences for specific intervention content and delivery, but further research is needed to allow for the appropriate incorporation of patient preferences into the design of such interventions. This review highlights the potential for interventions to improve health behaviours evidenced to influence short and long-term health outcomes in colorectal cancer survivors. However, the examination of the impact of these interventions and patient perspectives indicated a paucity of research. This is an important finding in demonstrating additional research is necessary to improve the support available to a growing group of patients with complex health needs.

Efficacy of single and repeated administration of ketamine in unipolar and bipolar depression: a meta-analysis of randomized clinical trials

BackgroundDue to unmet clinical needs for efficient drugs with a rapid onset of antidepressant effects, we aimed to evaluate the efficacy of single-dose ketamine in different subgroups of patients with major depression and establish whether repeated ketamine administration could be a viable strategy to maintain treatment gains.MethodsElectronic databases (Medline via PubMed, Embase, Cochrane Library, Trip Database) were systematically searched until February 22, 2019, for published peer-reviewed randomized controlled trials (RCTs) concerning a single and repeated administration of ketamine in patients with major depression. All relevant RCTs were selected and critically appraised, and a meta-analysis of eligible studies was performed.ResultsA total of 20 studies were included in the meta-analysis. The largest effect of ketamine vs. controls in reducing depressive symptoms was observed at 24 h (SMD = − 0.89; 95% CI − 1.24; − 0.53; p < 0.00001); however, a significant difference was shown for up to 7 days after a single dose. Significant differences compared with controls were observed for up to 7 days in treatment-resistant patients and when ketamine was added to ongoing antidepressant treatment, while there were no significant differences at 7 days when ketamine was used as monotherapy. In patients with major depression, initial antidepressant effects of ketamine were maintained during repeated dosing. At 2–3 weeks of repeated ketamine treatment, significant reduction of depression severity scores was observed: SMD = − 0.70; 95% CI − 1.15; − 0.25 or SMD = − 0.81; 95% CI − 1.41; − 0.20 (depending on the dosing regimen used); p ≤ 0.009 vs placebo.ConclusionsOur meta-analysis revealed rapid and robust antidepressant effects of single-dose ketamine in patients with treatment-resistant depression (TRD). By pooling data from RCTs, we showed for the first time that repeated ketamine administration is effective in sustaining initial antidepressant effects observed after single dosing.

Taurolidine lock solution for catheter-related bloodstream infections in pediatric patients: A meta-analysis.

Infection is one of the most commonly described complications, and a major cause of morbidity and mortality in pediatric patients treated using central venous catheters (CVCs). Taurolidine lock solutions have been used to decrease catheter-related bloodstream infections (CRBSIs) in both adult and pediatric patients. The purpose of this study was to systematically search the literature and conduct a meta-analysis to determine the efficacy of taurolidine in reducing CRBSI in children. We conducted an electronic search of the PubMed, EMBASE, Cochrane Library, TRIP Database, CINAHL, and Google Scholar databases for articles published up to 1st November 2019. Eligible studies included randomized controlled trials (RCTs) comparing the effects of taurolidine with control for preventing CRBSI in pediatric patients. Four studies were included. Our results indicated a statistical significant reduction in the total number of CRBSI with taurolidine as compared to control (RR: 0.23; 95% CI:0.13, 0.40; I2 = 0%; P<0.00001). The pooled analysis also indicated a statistical significant reduction in the incidence of CRBSI (defined as the number of CRBSI events/1000 catheter days) in the taurolidine group (MD: -1.12; 95% CI:-1.54, -0.71; I2 = 1%; P<0.00001). The number of catheters removed due to infection or suspected infection was not significantly different between the two groups (RR: 0.68; 95% CI:0.22, 2.10; I2 = 56%; P = 0.50) (Fig 5). The quality of the included studies was not high. The use of taurolidine as a catheter locking solution may significantly reduce CRBSI in pediatric patients. However, the quality of current evidence is not high and further high-quality large scale RCTs are needed to corroborate our results.

Foot Pain in High Heels Woman users: Systematic Literature Review and Meta-Analysis

In recent years, many women wear high heels. Wearing high heels that exceed the recommended usage of a maximum of three hours can harm the foot and body. Someone who suffers from foot pain will have a significant physical disability, difficulty in daily activities and an increase in falls and injuries. Thus far, there has been no meta-analysis study that strengthens the effect of wearing high heels on foot pain. Therefore, the author aimed to examine and determine whether there is an effect between wearing high-heeled shoes and foot pain problems. In searching literature review/literature studies, the author used a research database of PubMed and Trip database. The author also registered and installed publications more than one or duplicate, did abstracts screening, publications selection related to inclusion criteria and assessed the quality of studies using a developing Center for Evidence-Based Medicine (CEBM) tool. Of the 220 publications identified and after systematic literature screening, three data were used for meta-analysis. Comprehensive Meta-analysis software was used for statistical analysis. The effect of wearing high heels on foot pain is not statistically significant (p = 0.248), yet clinically the racial odds were 1.87. This result shows that woman who wears high heels has a risk of 1.87 times more likely to have foot pain.

Ernest Syndrome: A Systematic Review of the Literature.

To conduct a systematic review of the available evidence regarding the clinical characteristics and treatment of Ernest syndrome. A systematic search was carried out in the EBSCOhost, Embase, MEDLINE, ScienceDirect, Scopus, Web of Science, and Trip databases. The free terms "stylomandibular ligament" and "Ernest syndrome" were used, and the Boolean operator "OR" was used for connection of the terms. The research protocol was registered in PROSPERO (CRD42018112914). The results of this study are presented according to the PRISMA statement, and risk of bias was assessed according to the Quality Assessment Tool for Quantitative Studies of the Effective Public Health Practice Project. A total of 57 articles were found, 5 of which met the selection criteria and were included in this review. The selected articles represent a population of 81 patients with primarily unilateral pain in the periauricular and mandibular areas. Diagnosis was established according to clinical history, recognition of pain on palpation of the mandibular angle, and remission following infiltration with local anesthesia. Concerning the treatments applied, infiltration with corticosteroids was highly successful, as was partial resection of the stylomandibular ligament and part of the styloid process. Furthermore, in refractory cases, the application of radiofrequency thermoneurolysis was described. The analyzed studies allow a better understanding of Ernest syndrome and the proposal of a tendinosis model for this condition. However, the evidence is scarce, and it is therefore necessary to carry out additional studies with better methodologic designs.

Does pediatric septoplasty compromise midfacial growth? A systematic review.

Septal deviation is an important cause of impaired nasal breathing among pediatric patients. A widespread solution to septal deviation is septoplasty. However, there are certain controversies surrounding the effect of this technique on pediatric patients and its influence on the growth centers of the nose. The objective of this review is to study if there is a strong and valid evidence in the literature that supports a detrimental effect of pediatric septo- and rhinoseptoplasty in facial growth DATA SOURCES: Pubmed (Medline), the Cochrane Library, EMBASE and Trip Database. The outcome assessed was the midfacial growth after pediatric septoplasty. Eight publications met the inclusion criteria. None found major disturbances in facial growth. Only minor nasal anomalies were reported by 4 authors. Septoplasty in pediatric patients does not seem to affect midfacial growth according to available evidence. However, due to their design, the degree of recommendation of these studies was not superior to level C.

Comparison of diagnostic accuracy of saline infusion sonohysterography, transvaginal sonography, and hysteroscopy in evaluating the endometrial polyps in women with abnormal uterine bleeding: a systematic review and meta-analysis.

IntroductionIn women with abnormal uterine bleeding (AUB), endometrial polyps are a frequent finding, and the risk of a focal (pre)malignancy in a polyp is up to 6%. Because of this reported risk, the detection of polyps in these women is important.AimTo evaluate and compare the diagnostic accuracy of saline infusion sonohysterography, transvaginal sonography, and hysteroscopy in detecting endometrial polyps in women with AUB.Material and methodsThe searches were conducted by two independent researchers to find the relevant studies published from 1/1/2009 until the end of 30/06/2019. We searched for published literature in English language in MEDLINE, EMBASETM, The Cochrane Library, and Trip database. For literature published in other languages, we searched national databases (Magiran and SID), KoreaMed, and LILACS. The risk of bias of every article was evaluated by using QUADAS-2.ResultsAfter selection and quality assessment, 11 studies were included. Based on the random effect model the total prevalence of endometrial polyps in women with abnormal uterine bleeding was 38%. The sensitivity and specificity of saline infusion sonohysterography in diagnosis of endometrial polyps were 0.87 and 0.86, respectively. The sensitivity and specificity of transvaginal ultrasonography were 0.62 and 0.73 and the sensitivity and specificity of hysteroscopy were 0.92 and 0.85, respectively.ConclusionsAlthough that sonohysterography is a safe and relatively cheap method, which allows ruling out or confirming endometrial polyps, it cannot be replaced with hysteroscopy due to the fact that hysteroscopy combined with biopsy is the gold standard for ruling out malignancies in an endometrial polyp.

Systemic therapy for nonmetastatic castrate-resistant prostate cancer (M0 CRPC): A systematic review and network meta-analysis (NMA).

113 Background: The treatment landscape for M0 CRPC has changed following the demonstrated efficacy of new agents in recent randomized control trials (RCT). However, the comparative effectiveness of these novel agents is unknown. This NMA indirectly compared the efficacy and safety of available therapies for M0 CRPC. Methods: A literature search of MEDLINE (Ovid), EBM Reviews, HealthSTAR, PubMed, PubMed Central, CINAHL, and TRIP Database was performed. Studies were screened by two independent reviewers. Hazard ratios (HR) and confidence intervals were extracted for the primary outcome metastasis-free survival (MFS) and the secondary outcomes overall survival (OS) and grade 3 or higher adverse events (AE). Bone MFS was used as a surrogate for MFS when MFS was not reported. Risk of bias was assessed using the Cochrane Collaboration tool. A Bayesian NMA was performed using a fixed-effects model. Results: Four RCT were analyzed (n=5549). Each trial compared either apalutamide (APA), enzalutamide (ENZA), darolutamide (DARO), or denosumab (DENO) plus androgen deprivation therapy (ADT) to placebo plus ADT. Risk of bias was low. For MFS, APA and ENZA had similar efficacy (Table), and Surface Under the Cumulative Ranking Analysis demonstrated a 59% probability that APA was preferred for MFS, followed by ENZA (41%). There was a trend for improved OS for APA, DARO and ENZA, but no meaningful differences between these agents. APA, ENZA, and DARO had a similar risk of AEs and all had a greater risk of AEs compared to DENO. Conclusions: APA and ENZA appear to be the most efficacious treatments for MFS in M0 CRPC, though more data for OS is required. Compared to DARO, APA and ENZA’s demonstrated efficacy is not at the expense of added toxicity.[Table: see text]

Abstract WP371: Role of Troponin as a Biomarker for Predicting Outcome After Ischemic Stroke: A Meta-Analysis

Background: After acute ischemic stroke, a higher level of troponin has been considered as an important biomarker for predicting mortality. The aim of the study was to quantitatively assess the prognostic significance of the effect of baseline troponin levels on mortality in patients with acute ischemic stroke using a meta-analysis approach. Design: The following electronic databases, PubMed, EMBASE, SCOPUS, Web of Science, Cochrane Central Register of Controlled Trials , TRIP Database, ClinicalTrials.govwas used for getting the relevant article from literuare. Data were extracted in standardized data collection by two independent investigators. Any disagreements were resolved by consensus. All the statistical analyses were performed in STATA software. Results: 18 studies were included in the present meta-analysis involving a total of 8723 patients. The pooled results suggested that the elevated serum troponin level was associated with in -hospital mortality (RR 2.39, 95% CI 1.37 to 3.41), at the end of last follow up mortality (RR 1.75; 95% CI 1.38 to 2.11) and for overall mortality (RR 1.82; 95% CI 1.47 to 2.17). Sensitivity analysis by removing a single study by turns indicated that there was no obvious impact of any individual study on the pooled risk estimate. No significant publication bias was observed. Conclusion: Our findings indicate that a higher level of troponinmight be an important prognostic biomarker for in hospital and follow up mortality in patients with acute ischemic stroke. The study might have clinical implications by using troponin as a prognostic biomarker for patient stratification and early intervention.

Cuidador primario, agente transmisor de infecciones asociadas a la atención de salud: revisión de literatura

Introducción: Las Infecciones Asociadas a la Atención en Salud representan un problema de salud pública, aumentan los costos en la atención médica, la morbilidad y mortalidad, existen factores de riesgo ya identificados, entre ellos los humanos, sin embargo “el cuidador” se ha estudiado poco, siendo este un reservorio que pudiera ser el principal agente transmisor de una o varias infecciones. Objetivo: indagar en la evidencia científica actual relacionada a infecciones comunes, factores de riesgo, los conocimientos, prácticas y aptitudes del cuidador y su relación con las Infecciones Asociadas a la Atención en Salud. Metodología: Revisión sistemática de la literatura, realizada en base de datos electrónicas: PubMed, BVS, Trip Database, Science Direct, Ebsco Host y Google académico; se analizaron documentos publicados de 2013 a 2018, en idioma inglés, portugués y español, se usaron los términos MESH y DeCs “infección nosocomial”, “epidemiología”, “cuidadores” y “atención al paciente”, se plantea una pregunta PICO, los estudios seleccionados incluyeron metaanálisis, ensayos clínicos controlados aleatorios, revisiones sistemáticas y estudios cualitativos, los criterios de exclusión fueron estudios con cuidadores en domicilios y en unidades de cuidados intensivos adultos y pediátricos. Resultados y conclusiones: se obtuvieron 419 artículos, 15 que cumplieron con los criterios de inclusión los cuales muestran los tipos de infecciones más comunes, factores de riesgo, conocimientos, prácticas y aptitudes del cuidador en la prevención de IAAS, concluyendo que existe poca evidencia científica, deficiencias del conocimiento, programas e intervenciones dirigidas al cuidador para la prevención de las IAAS.

Effectiveness of non-pharmacological strategies in the management of type 2 diabetes in primary care: a protocol for a systematic review and network meta-analysis

IntroductionDespite the increasing number of drugs and various guidelines on the management of type 2 diabetes mellitus (T2DM), several patients continue with the disease uncontrolled. There are several non-pharmacological treatments...

Protocol for a Systematic Review of Mobile Phone Technology for Managing Side Effects of Chemotherapy in Cancer Patients:A Research Protocol

Introduction: Mobile phone technology is an evolving trend in the medical field for rendering health-related care services to the needy. Chemotherapy is one of the cancer treatments which leads to certain side effects. These side effects can be managed well with the help of mobile phones, which became an essential thing in our life in recent decades. Aim: To identify the efficacy of using mobile phone technology for managing side effects associated with chemotherapy and improvement in quality of life. Materials and Methods: A systematic review will be conducted on randomised control trials and non-randomised control trials. In this review, Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) will be followed and a literature search will be conducted in PubMed-Medline, CINHAL Cochrane Library, Scopus, Science Direct, Ovid, J-Gate, and Trip databases. The literature search for this systematic review will be done on studies published between 2007 and 2019. The quality of the study will be assessed by the JBI clinical appraisal checklist for Randomised Controlled Trials (RCTs) and Non-Randomised Controlled Trials (Non-RCTs). Studies will be included based on predetermined inclusive criteria like studies published in the English language, with keywords like cancer patients, smartphone/android applications, chemotherapy, quality of life. Results: A descriptive synthesis of the findings of the selected studies will be carried out which will be presented in a narrative summary with statistical findings incorporated. Conclusion: This review will provide up-to-date evidence to support or oppose the hypothesis that mobile phone technology plays an effective role in managing side effects associated with chemotherapy and improve the quality of life of cancer patients.

DIAGNOSTIC VALUE OF MICRO RNA BIOMARKERS AS AN EARLY DIAGNOSTIC METHOD OF ORAL SQUAMOUS CELL CARCINOMA

Background To date, biopsy is the gold standard for diagnosis of oral squamous cell carcinoma (OSCC). Due to its limitations and late diagnosis of OSCC, it's necessary to develop new techniques that allow an early diagnosis of oral cancer. Recent studies indicate that micro RNAs biomarkers (miRNAs) present in body fluids such as blood, plasma, serum, and saliva offer an effective method for the early diagnosis of OSCC. Objective To describe the diagnostic value of miRNAs biomarkers in body fluids as a method of early diagnosis of OSCC. Method An electronic search was carried out in the following databases: Pubmed, Trip Database, Epistemonikos, Cochrane Library, Scopus, Ebsco, and Bireme. From the selected studies, a retrograde search was performed. Results A total of 24 articles, published between 2008 and 2017, met the selection criteria and were included in this review. The studies support the use of miRNAs biomarkers as a potential tool to obtain an early diagnosis of OSCC. Conclusions According to the studies analyzed in this review, miRNAs biomarkers in body fluids have an undoubted potential, although their diagnostic value should be considered moderate until new studies demonstrate and validate their use as an early diagnosis method of OSCC.