Publications by authors named "Patricia Erwin"
Background: Local recurrence (LR) rates of dermatofibrosarcoma protuberans (DFSP) treated with different surgical modalities are unknown.
Objective: To evaluate the differences in LR rates of DFSP treated with wide local excision (WLE) versus Mohs micrographic surgery (MMS).
Materials And Methods: Pertinent studies of DFSP treated with either WLE or MMS were identified through a search of multiple databases, including Ovid MEDLINE (1946-2018), Embase (1988-2018), Web of Science (1975-2018), and Scopus (1970-2018).
Background: Complete removal of melanoma is a primary goal of excision, and local recurrence is one measure to evaluate the efficacy of surgical technique.
Objective: To compare published local recurrence rates for melanoma treated with Mohs micrographic surgery (MMS) or staged excision versus wide local excision (WLE).
Methods And Materials: Search of 6 databases identified comparative and noncomparative studies that reported local recurrence rates after MMS, staged excision, or WLE for melanoma.
Background: Comprehensive treatment recommendations for Merkel cell carcinoma are complex. We aimed to systematically review the published data on recurrence and mortality rates associated with various treatment approaches for Merkel cell carcinoma.
Methods: Search of MEDLINE, Embase, Web of Science, and Scopus from inception to August 2015.
Aims: Percutaneous mitral balloon valvotomy PMBV is an acceptable alternative to Mitral valve surgery for patients with mitral stenosis. The purpose of this study was to explore the immediate results of PMBV with respect to echocardiographic changes, outcomes, and complications, using a -analysis approach.
Methods: MEDLINE, and EMBASE databases were searched (01/2012 to 10/2018) for original research articles regarding the efficacy and safety of PMBV.
Objective: To conduct a systematic review and meta-analysis describing the association of thyroid function with posttraumatic stress disorder (PTSD) in adults.
Methods: The authors conducted a comprehensive search from databases' inception to July 20, 2018. The meta-analysis included studies that reported mean values and standard deviation (SD) of thyroid hormone levels (thyroid-stimulating hormone [TSH], free thyroxine [FT4], free triiodothyronine [FT3], total T4 [TT4], and total T3 [TT3]) in patients with PTSD compared with controls.
A Systematic Review on the Efficacy of Intravenous Racemic Ketamine for Bipolar Depression.
J Clin Psychopharmacol
September 2021
Background: Ketamine, a glutamate N-methyl-d-aspartate receptor antagonist, has shown rapid antidepressant effects in treatment-resistant depression. We conducted a systematic review of studies evaluating the efficacy of intravenous ketamine augmentation in treatment-resistant depression patients with bipolar disorder.
Methods: Major databases were searched for open-label and randomized controlled trials (RCT).
Introduction: The high failure rate of clinical trials in traumatic brain injury (TBI) may be attributable, in part, to the use of untested or insensitive measurement instruments. Of more than 1,000 clinical outcome assessment measures (COAs) for TBI, few have been systematically vetted to determine their performance within specific "contexts of use (COU)." As described in guidance issued by the U.
View Article and Find Full Text PDFIntroduction: Chronic kidney disease (CKD) is widely prevalent, associated with morbidity and mortality, but may be lessened with timely implementation of evidence-based strategies including blood pressure (BP) control. Nonetheless, an evidence-practice gap persists. We synthesize the evidence for clinician-facing interventions to improve hypertension management in CKD patients in primary care.
View Article and Find Full Text PDFA Systematic Review of Intra-Articular Ketamine for Postoperative Analgesia.
Am J Phys Med Rehabil
November 2020
Background: This systematic review appraises the evidence from human clinical trials comparing postoperative pain scores and opioid consumption in patients receiving intra-articular ketamine versus other modalities of analgesia after orthopedic joint procedures.
Methods: Studies were identified from Embase, Scopus, and OVID Medline databases. Included studies compared patients receiving intra-articular ketamine versus other modalities of analgesia.
Article Synopsis
- The study compares the risk of infective endocarditis between bioprosthetic and mechanical valves in heart valve replacement, noting increased usage of bioprosthetic valves in younger patients despite ongoing debates about their safety.
- Researchers conducted a meta-analysis using data from multiple medical databases, including 13 study groups with nearly 44,000 patients, focusing on the rates of infective endocarditis over an average follow-up of 10.4 years.
- Findings suggest that patients with bioprosthetic valves are at a 59% higher risk of developing infective endocarditis compared to those with mechanical valves, highlighting the need for careful consideration in valve choice discussions.
Objectives: The purpose of this study was to determine if health literacy is associated with mortality, hospitalizations, or emergency department (ED) visits among patients living with heart failure (HF).
Background: Growing evidence suggests an association between health literacy and health-related outcomes in patients with HF.
Methods: We searched Embase, MEDLINE, PsycINFO, and EBSCO CINAHL from inception through January 1, 2019, with the help of a medical librarian.
Background: When opioid-induced constipation is treated with centrally acting opioid antagonists, there may be opioid withdrawal or aggravation of pain due to inhibition of μ-opioid analgesia. This led to the development of peripherally acting μ-opioid receptor antagonists (PAMORAs).
Aim: To evaluate the efficacy of available PAMORAs and other approved or experimental treatments for relieving constipation in patients with opioid-induced constipation, based on a systematic review and meta-analysis of published studies.
Background: No consensus exists regarding optimal strategy for antifungal prophylaxis following lung transplant.
Objective: To review data regarding antifungal prophylaxis on the development of fungal infections.
Study Selection/appraisal: We searched MEDLINE, Embase, and Scopus for eligible articles through December 10, 2019.
Study Objective: To summarize interventions that impact the experience of older adults in the emergency department (ED) as measured by patient experience instruments.
Methods: This is a systematic review to evaluate interventions aimed to improve geriatric patient experience in the ED. We searched Ovid CENTRAL, Ovid EMBASE, Ovid MEDLINE and PsycINFO from inception to January 2019.
Objective: Shared decision-making (SDM) is a process of collaboration between patients and clinicians. An increasing number of educational programs to teach SDM have been developed. We aimed to summarize and evaluate the body of evidence assessing the outcomes of these programs.
View Article and Find Full Text PDFBackground: Atrial fibrillation (AF) is a leading source of emboli that precipitate cerebrovascular accident (CVA) which is correlated with left atrial appendage (LAA) morphology. We aimed to elaborate the relationship between CVA and LAA morphology in AF patients.
Methods: Medline and EMBASE databases were thoroughly searched between 2010-2018 for studies that included atrial fibrillation patients and classified them into two groups based on CVA occurrence.
Background And Objectives: High-flow nasal cannula (HFNC) oxygen may provide tailored benefits in patients with preset treatment limitations. The objective of this study was to assess the effectiveness of HFNC oxygen in patients with do-not-intubate (DNI) and/or do-not-resuscitate (DNR) orders.
Methods: We conducted a systematic review of interventional and observational studies.
Article Synopsis
- Patients with limited English proficiency (LEP) face challenges in end-of-life decision making and advance care planning, which can lead to disparities in their care.
- A systematic review was conducted, analyzing eight studies from the US and Australia that utilized various interventions, such as trained personnel and multimedia, to address these disparities.
- While the interventions showed some success in increasing advance directive completion and changing treatment preferences, there are still few options available for LEP patients, and more research is needed to assess the effectiveness of these interventions.
Purpose: To assess the rates and variability of do-not-intubate orders in patients with acute respiratory failure.
Methods: We conducted a systematic review of observational studies that enrolled adult patients with acute respiratory failure requiring noninvasive ventilation or high-flow nasal cannula oxygen from inception to 2019.
Results: Twenty-six studies evaluating 10,755 patients were included.
Objectives: Treatment burden is the workload of healthcare for people with long-term conditions (LTC) and its impact on well-being. A method of measurement is required to identify those experiencing high burden and to measure intervention efficacy. Our aim was to identify, examine and appraise validated patient-reported measures (PRMs) of treatment burden in stroke.
View Article and Find Full Text PDFIntroduction: There is a considerable implementation gap in managing early stage chronic kidney disease (CKD) in primary care despite the high prevalence and risk for increased morbidity and mortality associated with CKD. This systematic review aims to synthesise the evidence of efficacy of implementation interventions aimed at primary care practitioners (PCPs) to improve CKD identification and management. We further aim to describe the interventions' behavioural change components.
View Article and Find Full Text PDFBackground And Objectives: Dialysis is a preference-sensitive decision where prognosis may play an important role. Although patients desire risk prediction, nephrologists are wary of sharing this information. We reviewed the performance of prognostic indices for patients starting dialysis to facilitate bedside translation.
View Article and Find Full Text PDFArticle Synopsis
- The study investigates the impact of weight loss on central hemodynamics in obese individuals who do not have overt heart failure.
- Researchers reviewed multiple studies and found that a median weight loss of 43 kg led to significant improvements in heart rate, arterial pressure, and cardiac function over a median period of 9.7 months.
- The authors conclude that weight loss can have beneficial hemodynamic effects in obese patients, highlighting the need for further randomized trials focusing on weight loss strategies in those with heart failure and preserved ejection fraction.
Serum cystatin C has been proposed as a kidney biomarker to inform drug dosing. We conducted a systematic review to synthesize available data for the association between serum cystatin C and drug pharmacokinetics, dosing, and clinical outcomes in adults (≥18 years). PubMed, Ovid MEDLINE, Ovid EMBASE, EBSCO CINAHL, and Scopus were systematically searched from 1946 to September 2017 to identify candidate studies.
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