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Systematic Literature (systematic + literature)
Terms modified by Systematic Literature Selected AbstractsSystematic review: frequency and reasons for consultation for gastro-oesophageal reflux disease and dyspepsiaALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 4 2009A. P. S. HUNGIN Summary Background, Upper gastrointestinal symptoms impose a substantial illness burden and management costs. Understanding perceptions and reasons for seeking healthcare is a prerequisite for meeting patients' needs effectively. Aim, To review systematically findings on consultation frequencies for gastro-oesophageal reflux disease (GERD) and dyspepsia and patients' reasons for consultation. Methods, Systematic literature searches. Results, Reported consultation rates ranged from 5.4% to 56% for GERD and from 26% to 70% for dyspepsia. Consultation for GERD was associated with increased symptom severity and frequency, interference with social activities, sleep disturbance, lack of timetabled work, higher levels of comorbidity, depression, anxiety, phobia, somatization and obsessionality. Some consulted because of fears that their symptoms represented serious disease; others avoided consultation because of this. Inconsistent associations were seen with medication use. Patients were less likely to consult if they felt that their doctor would trivialize their symptoms. Few factors were consistently associated with dyspepsia consultation. However, lower socio-economic status and Helicobacter pylori infection were associated with increased consultation. Conclusion, Patients' perceptions of their condition, comorbid factors and external reasons such as work and social factors are related to consultation rates for GERD. Awareness of these factors can guide the clinician towards a more effective strategy than one based on drug therapy alone. [source] Systematic review: the epidemiology of gastro-oesophageal reflux disease in primary care, using the UK General Practice Research DatabaseALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 5 2009H. EL-SERAG Summary Background, Gastro-oesophageal reflux disease (GERD) is a common diagnosis in primary care; however, there has been no comprehensive review of the epidemiology of GERD in this setting. Aim, To review systematically articles that used the General Practice Research Database to study the epidemiology of GERD. Methods, Systematic literature searches. Results, Seventeen articles fulfilled the inclusion criteria. The incidence of GERD in primary care was 4.5 new diagnoses per 1000 person-years in 1996 (95% CI: 4.4,4.7). A new diagnosis of GERD was associated with being overweight, obese or an ex-smoker. Prior diagnoses of ischaemic heart disease, peptic ulcer disease, nonspecific chest pain, nonspecific abdominal pain, chronic obstructive pulmonary disease and asthma were associated with a subsequent new GERD diagnosis. A first diagnosis of GERD was associated with an increased risk of a subsequent diagnosis of oesophageal adenocarcinoma, oesophageal stricture, chronic cough, sinusitis, chest pain, angina, gallbladder disease, irritable bowel syndrome or sleep problems. Mortality may be higher in patients with a GERD diagnosis than in those without in the first year after diagnosis, but not long term. Conclusion, The General Practice Research Database is an effective way of studying the epidemiology of GERD in a large population-based primary care setting. [source] Review article: the therapeutic and prognostic benefit of portal pressure reduction in cirrhosisALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 8 2008C. K. TRIANTOS Summary Background, Hepatic venous pressure gradient (HVPG) measurement is not a routinely used technique, despite its therapeutic and prognostic value. Aim, To review the role of HVPG from published literature. Methods, Systematic literature review. Results, In acute variceal bleeding, HVPG is prognostic identifying ,difficult to treat' group, which now has defined clinical correlations. In secondary prevention of portal hypertensive bleeding, a reduction to ,12 mmHg confers near complete protection against rebleeding. The target of ,20% HVPG reduction from baseline needs prospective assessment to test a change of therapy, if no reduction occurs. The acute HVPG response to beta-blockade needs further assessment. In primary prevention, the cost-effectiveness of HVPG measurement is not favourable given the efficacy of medical therapy. In chronic liver disease, wedge hepatic venous pressure (WHVP) is prognostic for survival. Pharmacological reduction in portal pressure decreases complications and improves survival, possibly independent of a concomitant improvement in liver function. This latter requires urgent confirmation as it is clinically very relevant. HVPG monitoring can be used to assess anti-viral therapy particularly in cirrhosis, ergonomically combined with transjugular biopsy. Conclusions, The prognostic and therapeutic value of HVPG is established beyond portal hypertensive bleeding for which there are some clinical surrogates. HVPG measurement should now be part of everyday clinical practice. [source] Systematic review: the epidemiology of eosinophilic oesophagitis in adultsALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 6 2010R. J. Sealock Summary Background, The epidemiology of eosinophilic oesophagitis (EoE) in adults remains unclear. Aim, To estimate the prevalence and incidence of EoE through a systematic review of published literature. Methods, We conducted systematic literature searches in PubMed in September 2009. Studies were excluded if they contained any participants below 18 years of age, published in languages other than English, or had no exact reporting of prevalence or incidence rates. Results, Nine studies fulfilled the criteria; one evaluated a population-based sample, one examined patients referred from a defined geographical region and seven studies examined the prevalence in a total of 6018 patients in clinic or hospital settings. The lowest prevalence was reported in population-based studies (4 and 0.23 per 1000), followed by studies of unselected patients (1.0%, 6.5%) and highest in the other five clinic/hospital based studies (2.2,48.2%). Men were more affected in seven of eight studies (64.5,100%). The sample size weighted average prevalence from the population-based studies was 0.03%. For studies evaluating symptomatic patients, it was 2.8%. Conclusions, The prevalence of EoE in adults varies considerably based on the study sampling frame: high in dysphagia patients, quite low in population-based studies and intermediate among unselected endoscopy patients. [source] Review article: specifically targeted anti-viral therapy for hepatitis C , a new era in therapyALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 1 2010C. M. Lange Aliment Pharmacol Ther 2010; 32: 14,28 Summary Background, Novel, directly acting anti-viral agents, also named ,specifically targeted anti-viral therapy for hepatitis C' (STAT-C) compounds, are currently under development. Aim, To review the potential of STAT-C agents which are currently under clinical development, with a focus on agents that target HCV proteins. Methods, Studies evaluating STAT-C compounds were identified by systematic literature search using PubMed as well as databases of abstracts presented in English at recent liver and gastroenterology congresses. Results, Numerous directly-acting anti-viral agents are currently under clinical phase I,III evaluation. Final results of phase II clinical trials evaluating the most advanced compounds telaprevir and boceprevir indicate that the addition of these NS3/4A protease inhibitors to pegylated interferon-alfa and ribavirin strongly improves the chance to achieve a SVR in treatment-naive HCV genotype 1 patient as well as in prior nonresponders and relapsers to standard therapy. Monotherapy with directly acting anti-virals is not suitable. NS5B polymerase inhibitors in general have a lower anti-viral efficacy than protease inhibitors. Conclusions, STAT-C compounds in addition to pegylated interferon-alfa and ribavirin can improve SVR rates at least in HCV genotype 1 patients. Future research needs to evaluate whether a SVR can be achieved by combination therapies of STAT-C compounds in interferon-free regimens. [source] Meta-analysis: surveillance with ultrasound for early-stage hepatocellular carcinoma in patients with cirrhosisALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 1 2009A. SINGAL Summary Background, A majority of studies investigating the accuracy of ultrasound for detecting hepatocellular carcinoma (HCC) do not reflect how this test is used for surveillance vs. diagnosis. Aim, To determine the performance characteristics of surveillance with ultrasound for the detection of HCC, particularly early HCC as defined by the Milan criteria. Methods, A systematic literature review using the MEDLINE and SCOPUS databases yielded six studies that evaluated the accuracy of ultrasound for HCC at any stage and 13 studies that were specific to early HCC. Results, Surveillance ultrasound detected the majority of tumours before they presented clinically, with a pooled sensitivity of 94%. However, ultrasound was less effective for detecting early HCC with a sensitivity of 63%. Alpha-fetoprotein provided no additional benefit to ultrasound. Meta-regression analysis demonstrated a significantly higher sensitivity for early HCC with ultrasound every 6 months than with annual surveillance. Current studies have limitations such as verification bias and are of suboptimal quality. Conclusions, Surveillance with ultrasound demonstrates limited sensitivity for early HCC, although this may be improved by testing at 6-month intervals. Currently available evidence evaluating surveillance ultrasound has significant limitations and future studies are necessary to determine optimal surveillance methods for early HCC. [source] Systematic review: clinical efficacy of chelator agents and zinc in the initial treatment of Wilson diseaseALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 9 2009M. WIGGELINKHUIZEN Summary Background, No consensus is available on the optimal initial treatment in Wilson disease. Aim, To assess systematically the available literature of treatment in newly presenting patients with a presymptomatic, hepatic or neurological presentation of Wilson disease. Methods, A systematic literature search of the MEDLINE, EMBASE and COCHRANE databases was performed. Original studies on clinical efficacy of d -penicillamine, trientine, tetrathiomolybdate or zinc monotherapy as initial treatment in Wilson disease were included. A descriptive analysis of the relevant published data was performed. Results, One randomized trial and 12 observational studies met the inclusion criteria. These studies were quite heterogeneous and generally of low validity. Nevertheless, according to currently available data, patients with hepatic presentation of Wilson disease are probably most effectively treated by d -penicillamine. Zinc seems to be preferred above d -penicillamine for treatment of presymptomatic and neurological patients, as in these subgroups, the tolerance profile is in favour of zinc, while no obvious differences in clinical efficacy could be observed. Conclusions, There is lack of high-quality evidence to estimate the relative treatment effects of the available drugs in Wilson disease. Therefore, multicentre prospective randomized controlled comparative trials are necessary. [source] Larval chaetotaxy of Coleoptera (Insecta) as a tool for evolutionary research and systematics: less confusion, more clarityJOURNAL OF ZOOLOGICAL SYSTEMATICS AND EVOLUTIONARY RESEARCH, Issue 2 2007A. Y. Solodovnikov Abstract Chaetotaxy of beetle larvae is a significant source of characters for descriptive and phylogenetic aspects of systematics of this largest group of animals of comparable age. Survey of the mostly modern systematic literature employing larval chaetotaxy in Coleoptera reveals, however, that contrary to some general claims for the utility of this character set, use of larval chaetotaxy is rather limited. This is mostly because researchers find working with larval chaetotaxy difficult and time consuming. Factors that make exploration of chaetotaxy so cumbersome are methodologically analysed here and divided into two categories: intrinsic and operational. It is revealed that the most dangerous of them are operational, which arise from the multiplication of inconsistencies coming from different levels of comparative morphological research. As a result, ill-defined assessments of larval chaetotaxy may bring more confusion than clarity to the systematics of beetles, especially to its phylogenetic component which is intuitively avoided by researchers who refuse to use chaetotaxy. This paper attempts to scrutinize the sources of these inconsistencies undermining studies of larval chaetotaxy in hope of eliminating them from present and future systematic studies of Coleoptera. Some methodological issues raised here are also applicable to adult Coleoptera, to other insects and invertebrates, or to the proper ways of exploring the comparative morphology of living organisms, underlying evolutionary and systematic research. Zusammenfassung Die larvale Chaetotaxie von Käfern stellt wichtige Merkmale für deskriptive und phylogenetische Aspekte der Systematik dieser größten Tiergruppe zur Verfügung. Die Auswertung überwiegend moderner systematischer Schriften, in denen larvale Chaetotaxie bei Käfern angewendet wird, hat jedoch ergeben, dass, entgegen der allgemeinen Behauptung der Nützlichkeit dieses Merkmalskomplexes, dessen tatsächliche Anwendung recht begrenzt bleibt. Dies rührt haupsächlich daher, dass larvale Chaetotaxie als schwierig und zeitraubend angesehen wird. Die Faktoren, welche chaetotaxonomische Untersuchungen erschweren, werden hier methodologisch analysiert und in zwei Gruppen unterteilt: intrinsische Faktoren und operationale Faktoren. Es wird aufgezeigt, dass die operationalen Faktoren die größten Gefahren mit sich bringen, bedingt durch die Multiplikation widersprüchlicher Befunde von verschiedenen Ebenen vergleichend-morphologischer Forschung. Als Resultat können fehlgeleitete Bewertungen larvaler Chaetotaxie mehr zur Verwirrung als zur Aufklärung der Käfersystematik beitragen. Dies trifft insbesondere auf die phylogenetische Komponente der Systematik zu, die von Forschern, welche die Verwendung der Chaetotaxie ablehnen, intuitiv gemieden wird. Die vorliegende Arbeit versucht, die Quellen der widersprüchlichen Befunde zu ergründen, welche den Wert von Untersuchungen zur larvalen Chaetotaxie untergraben, sodass sie in aktuellen und zukünftigen systematisch-coleopterologischen Untersuchungen vermieden werden können. Einige der hier erörterten methodologischen Gesichtspunkte sind auch anwendbar auf adulte Käfer, andere Insekten und Wirbellose oder allgemein auf die korrekte Vorgehensweise bei der Erforschung der vergleichenden Morphologie lebender Organismen, die der Systematik und Evolutionsforschung zugrunde liegen. [source] Meta-analysis: antibiotic prophylaxis to prevent peristomal infection following percutaneous endoscopic gastrostomyALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 6 2007N. S. JAFRI Summary Background Despite numerous guidelines recommending prophylactic antibiotics prior to percutaneous endoscopic gastrostomy, their use remains controversial. Aim To conduct a systematic literature review and performed meta-analyses to determine the benefit of antibiotic prophylaxis for percutaneous endoscopic gastrostomy placement. Methods We performed a systematic literature review by searching healthcare databases and grey literature for randomized-controlled trials of antibiotic prophylaxis against wound infection after percutaneous endoscopic gastrostomy. Relative risks were calculated for individual trials and data pooled using fixed-effects model. Relative risk reduction, absolute risk reduction and number needed to treat were calculated and are reported with 95% confidence intervals. Results Ten randomized-controlled trials met the inclusion criteria and 1059 cases were pooled. Overall findings indicated that antibiotic prophylaxis resulted in a relative risk reduction of 64% and an absolute risk reduction of 15%. Number needed to treat to prevent one wound infection was 8. Cephalosporin prophylaxis was associated with a relative risk reduction of 64%, absolute risk reduction of 10% and number needed to treat of 10, whereas penicillin-based prophylaxis was associated with a relative risk reduction of 62%, absolute risk reduction of 13% and number needed to treat of 8. Conclusions Antibiotic prophylaxis prior to percutaneous endoscopic gastrostomy is effective in reducing the incidence of percutaneous endoscopic gastrostomy site wound infection. Based on sensitivity analyses, penicillin-based prophylaxis should be the prophylaxis of choice. [source] Temporal changes in UK birth order and the prevalence of atopyALLERGY, Issue 8 2010S. Upchurch To cite this article: Upchurch S, Harris JM, Cullinan P. Temporal changes in UK birth order and the prevalence of atopy. Allergy 2010; 65: 1039,1041. Abstract Background:, Many studies have reported an inverse association between birth order and the risk of respiratory allergic disease. In recent decades, the prevalence of atopy has increased alongside reductions in fertility rates. Aims of the study:, To quantitate how much of the increased prevalence of atopy, measured by skin prick test or specific IgE, can be attributed to temporal changes in family size in the United Kingdom. Methods:, Through a systematic literature review (MEDLINE, 1965,2009), five studies of UK populations were identified and their data were included in the calculation of a summary odds ratio for the risk of atopy for each birth order. Information on changes in UK family sizes between 1960 and 2001 was obtained from Eurostat. On this basis, expected increases in the prevalence of atopy were calculated by weighting the proportion in each birth order category for 1960 and 2001 by the summary odds ratio for that category and then calculating the relative risk of atopy in 2001 compared with 1960. Results:, The pooled summary odds ratios for atopy were 0.90, 0.69 and 0.69 for those born second, third and fourth (or higher), respectively. The expected relative increase in the prevalence of atopy resulting from a change in family size between 1960 and 2001 was 3%. Conclusions:, Despite the strong associations between birth order and atopy, reductions in family size in the last 40 years account for little of the increase in atopy. [source] Insulin resistance and cancer: Epidemiological evidenceCANCER SCIENCE, Issue 5 2010Shoichiro Tsugane Over the last 60 years, Japanese people have experienced a rapid and drastic change in lifestyle, including diet. Suspicions have been raised that so-called ,Westernization', characterized by a high-calorie diet and physical inactivity, is associated with increasing trends in the incidence of cancer of the colon, liver, pancreas, prostate, and breast, as well as type 2 diabetes. Epidemiological evidence from our prospective study, the Japan Public Health Center-based Prospective (JPHC) study, and systematic literature reviews generally support the idea that factors related to diabetes or insulin resistance are associated with an increased risk of colon (mostly in men), liver, and pancreatic cancers. These cancers are inversely associated with physical activity and coffee consumption, which are known to decrease the risk of type 2 diabetes. The suggested mechanism of these effects is that insulin resistance and the resulting chronic hyperinsulinemia and increase in bioavailable insulin-like growth factor 1 (IGF1) stimulate tumor growth. In contrast, associations with diabetes are less clear for cancer of the colon in women, and breast and prostate, which are known to be related to sex hormones. The effect of insulin resistance or body fat on sex-hormone production and bioavailability may modify their carcinogenic effect differently from cancers of the colon in men, and liver and pancreas. In conclusion, there is substantial evidence to show that cancers of the colon, liver, and pancreas are associated with insulin resistance, and that these cancers can be prevented by increasing physical activity, and possibly coffee consumption. (Cancer Sci 2010; 101: 1073,1079) [source] | ||||||||||