المؤلفون: Cabanas-Valdés, Rosa, Calvo-Sanz, Jordi, Urrùtia, Gerard, Serra-Llobet, Pol, Pérez-Bellmunt, Albert, Germán-Romero, Ana

مصطلحات موضوعية: Ictus, Hemiparesi, Hemiplegia, Teràpia d'ones de xoc extracorpòries, ESWT, Espasticitat, Hipertonia, Accidente cerebrovascular, Hemiparesia, Hemiplejía, Terapia con ondas de choque extracorpóreas, Espasticidad, Hipertonía, Stroke, Hemiparesis, Extracorporeal shock wave therapy, Spasticity, Hypertonia

الوقت: 61

الوصف: Objective: To assess the effectiveness of Extracorporeal Shock Wave Therapy (ESWT) to reduce lower limb spasticity in adult stroke survivors. Data Sources: A systematic review of Medline/Pubmed, CENTRAL, CINAHL, PEDro database, REHABDATA, Scielo, Scopus, Web of Science, Trip Database, and Epistemonikos from 1980 to December 2018 was carried out. Review Methods: The bibliography was screened to identify clinical trials (controlled and before-after) that used ESWT to reduce spasticity in stroke survivors. Two reviewers independently screened references, selected relevant studies, extracted data, and assessed risk of bias by PEDro scale. The primary outcome was spasticity. Results: A total of 12 studies (278 participants) were included (5 randomized controlled trials, 1 controlled trial, and 6 before-after studies). A meta-analysis was performed by randomized controlled trials. A beneficial effect on spasticity was found. The mean difference (MD) was 0.58; 95% confidence interval (CI) 0.30 to 0.86 and also in subgroup analysis (short, medium, and long term). The MD for range of motion was 1.81; CI −0.20 to 3.82 and for lower limb function the standard mean difference (SMD) was 0.34; 95% CI −0.09 to 0.77. Sensitivity analysis demonstrated a better beneficial effect for myotendinous junction. MD was 1.5; 95% CI −2.44 to 5.44 at long-term (9 weeks). Conclusion: The ESWT (radial/focused) would be a good non-invasive rehabilitation strategy in chronic stroke survivors to reduce lower limb spasticity, increase ankle range of motion, and improve lower limb function. It does not show any adverse events and it is a safe and effective method. ; info:eu-repo/semantics/publishedVersion

العلاقة: Topics in Stroke Rehabilitation; 27;2; http://hdl.handle.net/20.500.12328/3990Test; https://dx.doi.org/10.1080/10749357.2019.1654242Test

الإتاحة: https://doi.org/20.500.12328/3990Test
https://doi.org/10.1080/10749357.2019.1654242Test
https://hdl.handle.net/20.500.12328/3990Test

المؤلفون: Salgueiro, Carina, Urrútia, Gerard, Cabanas-Valdés, Rosa

مصطلحات موضوعية: Telerehabilitació, Exercicis, Estabilitat del nucli, Equilibri, Ictus, Funció del tronc, Telerehabilitación, Ejercicios, Estabilidad central, Equilibrio, Accidente cerebrovascular, Función del tronco, Telerehabilitation, Exercises, Core stability, Balance, Stroke, Trunk function

الوقت: 61

الوصف: BACKGROUND:Telerehabilitation has been proposed as an effective strategy to deliver post-stroke specific exercise. OBJECTIVE:To assess the effectiveness and feasibility of core stability exercises guided by a telerehabilitation App after hospital discharge. METHODS:Extension of a prospective controlled trial. Subacute stage stroke survivors were included at the time of hospital discharge where they had participated in a previous 5-week randomized controlled trial comparing conventional physiotherapy versus core stability exercises. After discharge, patients from the experimental group were offered access to telerehabilitation to perform core stability exercises at home (AppG), while those from the control group were subject to usual care (CG). The Spanish-version of the Trunk Impairment Scale 2.0 (S-TIS 2.0), Function in Sitting Test (S-FIST), Berg Balance Scale (BBS), Spanish-version of Postural Assessment for Stroke Patients (S-PASS), the number of falls, Brunel Balance Assessment (BBA) and Gait were assessed before and after 3 months intervention. RESULTS:A total of 49 subjects were recruited. AppG showed greater improvement in balance in both sitting and standing position and gait compared with CG, although no statistically significant differences were obtained. CONCLUSION:Core stability exercises Telerehabilitation as a home-based guide appears to improve balance in post-stroke stage. Future studies are necessary to confirm the effects as well as identifying strategies to increase telerehabilitation adherence. ; info:eu-repo/semantics/publishedVersion

العلاقة: NeuroRehabilitation; 51;1; Salgueiro, Carina; Urrútia, Gerard; Cabanas-Valdés, Rosa. Telerehabilitation for balance rehabilitation in the subacute stage of stroke: a pilot controlled trial. NeuroRehabilitation, 2022, 51(1), p. 91-99. Disponible en: . Fecha de acceso: 26 ene. 2024. DOI:10.3233/NRE-210332; http://hdl.handle.net/20.500.12328/3988Test; https://dx.doi.org/10.3233/NRE-210332Test

الإتاحة: https://doi.org/20.500.12328/3988Test
https://doi.org/10.3233/NRE-210332Test
https://hdl.handle.net/20.500.12328/3988Test

المؤلفون: Alonso, Pablo, Urrutia, Gerard

المصدر: Quaderns de la Fundació Dr. Antoni Esteve; Nº32. Epidemiología para periodistas y comunicadores; p. 57-65

مصطلحات موضوعية: estadística, bioestadística, periodismo científico, divulgación científica, epidemiologïa, salud

وصف الملف: application/pdf

العلاقة: https://www.raco.cat/index.php/QuadernsFDAE/article/view/289654/377980Test

الوصول الحر: https://www.raco.cat/index.php/QuadernsFDAE/article/view/289654Test

المؤلفون: Mullan Rebecca J, Bankhead Clare R, Kaur Jagdeep, Sood Amit, Raatz Heike, Mulla Sohail M, Burns Karen EA, Nordmann Alain J, Lampropulos Julianna F, Bucher Heiner C, Karanicolas Paul J, You John J, Elnour Nisrin, Soares Heloisa P, Kirpalani Haresh, Gwadry-Sridhar Femida, Mills Edward J, Adhikari Neill KJ, Djulbegovic Benjamin, Murad M Hassan, Strahm Brigitte, Elamin Mohamed B, Flynn David N, da Silva Suzana, Culebro Carolina, Kunz Regina, Urrutia Gerard, Alonso-Coello Pablo, Ferreira-Gonzalez Ignacio, Akl Elie A, Malaga German, Glasziou Paul, Bassler Dirk, Montori Victor M, Lane Melanie, Briel Matthias, Nerenberg Kara A, Vandvik Per, Coto-Yglesias Fernando, Schünemann Holger, Tuche Fabio, Chrispim Pedro, Cook Deborah J, Lutz Kristina, Ribic Christine M, Vale Noah, Erwin Patricia J, Perera Rafael, Zhou Qi, Heels-Ansdell Diane, Ramsay Tim, Walter Stephen D, Guyatt Gordon H

المصدر: Trials, Vol 10, Iss 1, p 49 (2009)

مصطلحات موضوعية: Medicine (General), R5-920

الوصف: Abstract Background Randomized clinical trials (RCTs) stopped early for benefit often receive great attention and affect clinical practice, but pose interpretational challenges for clinicians, researchers, and policy makers. Because the decision to stop the trial may arise from catching the treatment effect at a random high, truncated RCTs (tRCTs) may overestimate the true treatment effect. The Study Of Trial Policy Of Interim Truncation (STOPIT-1), which systematically reviewed the epidemiology and reporting quality of tRCTs, found that such trials are becoming more common, but that reporting of stopping rules and decisions were often deficient. Most importantly, treatment effects were often implausibly large and inversely related to the number of the events accrued. The aim of STOPIT-2 is to determine the magnitude and determinants of possible bias introduced by stopping RCTs early for benefit. Methods/Design We will use sensitive strategies to search for systematic reviews addressing the same clinical question as each of the tRCTs identified in STOPIT-1 and in a subsequent literature search. We will check all RCTs included in each systematic review to determine their similarity to the index tRCT in terms of participants, interventions, and outcome definition, and conduct new meta-analyses addressing the outcome that led to early termination of the tRCT. For each pair of tRCT and systematic review of corresponding non-tRCTs we will estimate the ratio of relative risks, and hence estimate the degree of bias. We will use hierarchical multivariable regression to determine the factors associated with the magnitude of this ratio. Factors explored will include the presence and quality of a stopping rule, the methodological quality of the trials, and the number of total events that had occurred at the time of truncation. Finally, we will evaluate whether Bayesian methods using conservative informative priors to "regress to the mean" overoptimistic tRCTs can correct observed biases. Discussion A better understanding of the extent to which tRCTs exaggerate treatment effects and of the factors associated with the magnitude of this bias can optimize trial design and data monitoring charters, and may aid in the interpretation of the results from trials stopped early for benefit.

وصف الملف: electronic resource

العلاقة: http://www.trialsjournal.com/content/10/1/49Test; https://doaj.org/toc/1745-6215Test

الوصول الحر: https://doaj.org/article/e1148e1197a4473dbfb3d71c3d7b03e2Test

المؤلفون: Santero, Marilina, Meade, Adriana, Selva, A, Acosta-Dighero, Roberto, Meza, Nicolás, Quintana Ruiz, Maria Jesús, Bracchiglione, Javier, Requeijo, Carolina, Salazar, Josefina, Rodríguez Grijalva, Gerardo, Solà, Ivan, Urrútia, Gerard, Bonfill, X. (Xavier), Universitat Autònoma de Barcelona

مصطلحات موضوعية: Drug therapy, Esophageal neoplasms, Immunotherapy, Molecular targeted therapy, Review, Stomach neoplasms

الوصف: Altres ajuts: acords transformatius de la UAB ; To identify, describe, and organize the available evidence regarding systemic oncological treatments compared to best supportive care (BSC) for advanced gastresophageal cancer. We conducted a thorough search across MEDLINE (PubMed), EMbase (Ovid), The Cochrane Library, Epistemonikos, PROSPERO, and Clinicaltrials.gov. Our inclusion criteria encompassed systematic reviews, randomized controlled trials, quasi-experimental and observational studies involving patients with advanced esophageal or gastric cancer receiving chemotherapy, immunotherapy or biological/targeted therapy compared to BSC. The outcomes included survival, quality of life, functional status, toxicity, and quality of end-of-life care. We included and mapped 72 studies, comprising SRs, experimental and observational designs, 12 on esophageal cancer, 51 on gastric cancer, and 10 both locations. Most compared schemes including chemotherapy (47 studies), but did not report therapeutic lines. Moreover, BSC as a control arm was poorly defined, including integral support and placebo. Data favor the use of systemic oncological treatments in survival outcomes and BSC in toxicity. Data for outcomes including quality of life, functional status, and quality of end-of-life care were limited. We found sundry evidence gaps specifically in assessing new treatments such as immunotherapy and important outcomes such as functional status, symptoms control, hospital admissions, and the quality of end-life care for all the treatments. There are important evidence gaps regarding new for patients with advanced gastresophageal cancer and the effect of systemic oncological treatments on important patient-centered outcomes beyond survival. Future research should clearly describe the population included, specifying previous treatments and considering therapeutic, and consider all patient-centered outcomes. Otherwise, it will be complex to apply research results into practice.

وصف الملف: application/pdf

العلاقة: Instituto de Salud Carlos III PI18/00034; Journal of Evidence-Based Medicine; Vol. 16 Núm. 2 (june 2023), p. 216-236; https://ddd.uab.cat/record/282901Test; urn:10.1111/jebm.12539; urn:oai:ddd.uab.cat:282901; urn:scopus_id:85163092273; urn:articleid:17565391v16n2p216; urn:pmid:37303304; urn:oai:egreta.uab.cat:publications/ab885867-976a-4fd8-b7d5-08a9ab3a93a6

الإتاحة: https://ddd.uab.cat/record/282901Test

المؤلفون: Szigethy, Endre, Dorantes, Rosario, Sugrañes, Miguel, Madera, Meisser, Sola, Ivan, Urrútia, Gerard, Bonfill, Xavier

المساهمون: Universitat Autònoma de Barcelona

المصدر: Clinical and Translational Oncology ; volume 26, issue 1, page 178-189 ; ISSN 1699-3055

مصطلحات موضوعية: Cancer Research, Oncology, General Medicine

الوصف: Purpose Anticancer drug use at the end of life places potential extra burdens on patients and the healthcare system. Previous articles show variability in methods and outcomes; thus, their results are not directly comparable. This scoping review describes the methods and extent of anticancer drug use at end of life. Methods Systematic searches in Medline and Embase were conducted to identify articles reporting anticancer drug use at the end of life. Results We selected 341 eligible publications, identifying key study features including timing of research, disease status, treatment schedule, treatment type, and treatment characteristics. Among the subset of 69 articles of all cancer types published within the last 5 years, we examined the frequency of anticancer drug use across various end of life periods. Conclusion This comprehensive description of publications on anticancer drug use at end of life underscores the importance of methodological factors when designing studies and comparing outcomes.

الإتاحة: https://doi.org/10.1007/s12094-023-03234-1Test

المؤلفون: Salazar, Josefina, Bracchiglione, Javier, Savall-Esteve, Olga, Antequera, Alba, Bottaro-Parra, David, Gutiérrez-Valencia, Marta, Martínez-Peralta, Susana, Pericay, Carles, Tibau, Ariadna, Bonfill, Xavier, Acosta-Dighero, Roberto, Auladell-Rispau, Ariadna, Cantero-Fortiz, Yahveth, Hernandez, Edgar, Irassar, Juan, Meade, Adriana-G, Meinardi, Pamela, Merchán-Galvis, Angela, Meza, Nicolas, Quintana, María Jesús, Requeijo, Carolina, Rodriguez-Grijalva, Gerardo, Salas-Gama, Karla, Santero, Marilina, Selva, Anna, Solà, Ivan, Urrútia, Gerard

المساهمون: Instituto de Salud Carlos III, European Regional Development Fund

المصدر: BMC Cancer ; volume 23, issue 1 ; ISSN 1471-2407

مصطلحات موضوعية: Cancer Research, Genetics, Oncology

الوصف: Background Patients with advanced pancreatic cancer have a poor prognosis and high burden of cancer-related symptoms. It is necessary to assess the trade-off of clinical benefits and possible harms of treatments with anticancer drugs (TAD). This systematic review aims to compare the effectiveness of TAD versus supportive care or no treatment, considering all patient-important outcomes. Methods We searched PubMed, Embase, Cochrane Library, and Epistemonikos. Two reviewers performed selection, data extraction and risk of bias assessment. We assessed certainty of the evidence using the GRADE approach. Results We included 14 randomised controlled trials. Chemotherapy may result in a slight increase in overall survival (MD: 2.97 months (95%CI 1.23, 4.70)) and fewer hospital days (MD: -6.7 (-8.3, -5.1)), however, the evidence is very uncertain about its effect on symptoms, quality of life, functional status, and adverse events. Targeted/biological therapy may result in little to no difference in overall survival and a slight increment in progression-free survival (HR: 0.83 (95%CI 0.63, 1.10)), but probably results in more adverse events (RR: 5.54 (95%CI 1.24, 23.97)). The evidence is very uncertain about the effect of immunotherapy in overall survival and functional status. Conclusions The evidence is very uncertain about whether the benefits of using treatment with anticancer drugs outweigh their risks for patients with advanced pancreatic cancer. This uncertainty is further highlighted when considering immunotherapy or a second line of chemotherapy and thus, best supportive care would be an appropriate alternative. Future studies should assess their impact on all patient-important outcomes to inform patients in setting their goals of care.

الإتاحة: https://doi.org/10.1186/s12885-023-11207-4Test

المؤلفون: Salazar, Josefina, Bracchiglione, Javier, Acosta-Dighero, Roberto, Meza, Nicolas, Meade, Adriana-G., Quintana, María Jesús, Requeijo, Carolina, Rodríguez-Grijalva, Gerardo, Santero, Marilina, Selva, Anna, Solà, Ivan, Bonfill, Xavier, Salas, Karla, Antequera, Alba, Auladell-Rispau, Ariadna, Urrútia, Gerard, Meinardi, Pamela, Irassar, Juan, Simancas, Daniel, Dorantes, Rosario, Merchán, Angela, Cantero, Yahveth, Hernandez, Edgar, Sugrañes, Miguel

المساهمون: Instituto de Salud Carlos III, European Regional Development Fund, Universitat Autònoma de Barcelona

المصدر: Supportive Care in Cancer ; volume 31, issue 2 ; ISSN 0941-4355 1433-7339

مصطلحات موضوعية: Oncology

الوصف: Purpose To identify, describe, and organise currently available evidence regarding systemic oncological treatments (SOTs) (chemotherapy, targeted/biological therapies, and immunotherapy) compared to best supportive care (BSC) for patients with advanced pancreatic cancer (PC). Methods We conducted a scoping review and evidence mapping, adhering to PRISMA-ScR checklist. We searched MEDLINE, EMBASE, Cochrane Library, Epistemonikos, PROSPERO, and clinicaltrials.gov for eligible studies. We included systematic reviews (SRs), randomised controlled trials (RCTs), quasi-experimental, and observational studies evaluating SOTs compared to BSC or no treatment in patients with advanced PC. Two independent reviewers performed the screening process and data extraction. We developed evidence maps as an interactive visualization display, including the assessed interventions and outcomes. Results Of the 50,601 records obtained from our search, we included 43 studies: 2 SRs, 16 RCTs, 4 quasi-experimental studies, 20 observational studies, and 1 protocol for a quasi-experimental study. Forty-two studies reported survival-related outcomes and most favoured SOTs, while five reported toxicity and most favoured BSC. Other patient-centred outcomes, such as quality of life, were scarcely reported. Conclusions This study highlights the current evidence gaps in studies assessing treatments for patients with advanced PC, mainly the lack of reports of non-survival-related outcomes, pointing out research areas that need further attention to make better recommendations for these patients.

الإتاحة: https://doi.org/10.1007/s00520-022-07564-8Test

المؤلفون: Requeijo, Carolina, Bracchiglione, Javier, Meza, Nicolás, Acosta-Dighero, Roberto, Salazar, Josefina, Santero, Marilina, Meade, Adriana-G, Quintana, María Jesús, Rodríguez-Grijalva, Gerardo, Selva, Anna, Solà, Ivan, Urrútia, Gerard, Bonfill Cosp, Xavier

المصدر: Clinical Epidemiology ; volume Volume 15, page 1069-1085 ; ISSN 1179-1349

الإتاحة: https://doi.org/10.2147/clep.s431498Test
https://www.dovepress.com/getfile.php?fileID=94226Test

المؤلفون: Reveiz, Ludovic, Delgado, Martha B., Urrutia, Gerard, Ortiz, Zuma, Dieguez, Marcelo Garcia, Marti Carvajal, Arturo, Calgua, Erwin, Weyra, Armando, Ciapponi, Agustin, Hidalgo, Ricardo, Pantoja, Tomas, Sanchez, Luis Maria, Pecino, Flora Martinez, Tristanl, Mario

مصطلحات موضوعية: clinical trial, conflict of interest, ethics committees, publication bias, randomized controlled trials, RANDOMIZED-TRIALS, BIAS, REGISTRATION, PUBLICATION, STATEMENT, IMPACT, 03 Good Health and Well-being, 03 Salud y bienestar

وصف الملف: 6 páginas

العلاقة: MEDLINE:16968597; https://doi.org/10.1590/S1020-49892006000600014Test; https://repositorio.uc.cl/handle/11534/78774Test; WOS:000239400300009

الإتاحة: https://doi.org/10.1590/S1020-49892006000600014Test
https://repositorio.uc.cl/handle/11534/78774Test