This systematic review aims to synthesize the available evidence investigating the effectiveness and safety of conservative management of occult pneumothorax in mechanically ventilated patients.

Occult pneumothorax is air within the pleural cavity that is diagnosed on a CT scan but was not suspected on the basis of preceding clinical examination or supine chest x-ray. Currently, there is no consensus on how to manage occult pneumothoraces, especially in patients requiring mechanical ventilation. It is common practice to place a prophylactic intercostal catheter to stop the potential development of a tension pneumothorax; however, there is a 20% risk of major complications from the intercostal catheter insertion. Recent evidence suggests that occult pneumothorax in mechanically ventilated patients can be managed conservatively, rather than using a prophylactic intercostal catheter as first-line management.

This review will include studies investigating stable patients of all ages who were diagnosed with Register of Controlled Trials will be searched. International Clinical Trials Registry, Australian New Zealand Clinical Trials Registry, and ClinicalTrials.gov will be searched for unpublished studies. All included studies will be critically appraised using standardized JBI tools, with no exclusions based on methodological quality. Studies will, where possible, be pooled in statistical meta-analysis, with impact of methodological quality to be explored through sensitivity analysis.

The aim of this review is to i) evaluate the effectiveness of current rehabilitation interventions in promoting short-, moderate-, and long-term physical activity maintenance among patients post-stroke, and ii) to investigate the intervention characteristics associated with the promotion of physical activity maintenance among patients post-stroke.

Physical activity and exercise can positively impact post-stroke recovery. However, few patients participate in the recommended levels of physical activity after a stroke. To design better post-stroke programs, the characteristics of current interventions that promote physical activity maintenance need to be identified.

Randomized controlled trials including adults (age ≥ 18) post-stroke, assessing physical activity via subjective or objective measures with a minimum three-month follow-up, and published in English will be considered for inclusion.

Literature searches will be conducted using MEDLINE, Embase, PsycINFO, CINAHL, SPORTDiscus, and Cochrane Central Register of Controlled Trials. The quality of the randomized controlled trials will be assessed using Cochrane’s risk of bias tool. Interventions will be coded using the Behaviour Change Technique Taxonomy version 1. Standardized mean differences of physical activity levels between intervention and control groups will be calculated using study-specific measures and interpreted as small (<0.40), medium (0.40-0.70), or large (>0.70). Meta-analysis of effect sizes will be conducted for short- (three months), moderate- (six months), and long-term (≥12 months) follow-ups. Univariable and multivariable random effects meta-regression using intervention characteristics (setting, delivery method, delivery type, duration, outcome measure, and behavior change techniques) will be conducted to identify predictors of maintenance.

PROSPERO CRD42019131056.

PROSPERO CRD42019131056.

The objective of this scoping review is to systematically identify assessment instruments that are used for the self-report of pain by hospitalized stroke patients with communication problems.

To the best of the authors’ knowledge, there are no existing instruments specifically dedicated to measuring pain in stroke patients with communication problems. Pain measurement instruments currently in use may complicate pain assessment in these patients. Additionally, there is a lack of consensus regarding these patients’ ability to self-report pain using existing pain instruments.

The review will consider studies that focus on hospitalized adults where at least one subgroup has been diagnosed with stroke as well as associated communication problems attributable to a stroke. The concept of interest is assessment instruments used for the self-report of pain by these patients. The scoping review will include systematic reviews, quantitative studies of any design, and mixed methods studies.

The search will occur meeting the inclusion criteria will be assessed in detail, with relevant data extracted and reported in tabular as well as descriptive format that aligns with the objectives and scope of this review.

The objective of this review is to map the available evidence on adverse drug events and costs related to the use of opioids in hospitalized patients with post-operative pain.

Post-operative pain is the most prevalent type of acute pain, affecting 80% of patients undergoing surgery. The main drug used in the treatment of post-operative pain is the opioid analgesic. These alleviate pain but cause adverse drug events. These events may result in lack of expected improvement in health status, the emergence of a new pathology, change in an organic function, or a harmful response due to the use of medicament.

This review will consider studies that include adult (18 years or over) post-operative patients experiencing pain from any type of surgery. Patients must be hospitalized in tertiary hospitals and taking opioid analgesics by any route of administration. Studies must report adverse events and associated costs of adverse drug events. Quantitative and qualitative studies, theses, and text and opinion papers guese will be included, with no date limit METHODS A three-step search strategy will be utilized for this review. The databases to be searched include MEDLINE (PubMed), CINAHL, LILACS, Scopus, Embase, and Google Scholar. Studies published in English, Spanish, and Portuguese will be included. selleck chemicals llc The extracted data will be presented in diagrammatic or tabular form in a manner that aligns with the objective of this scoping review, and a narrative summary will be provided.

The objective of this scoping review was to examine and map fasting times for intubated adult patients in the intensive care unit prior to general anesthesia, and patient outcomes following the cessation of enteral nutrition.

Malnutrition in critically ill patients in the intensive care unit has been associated with increased infectious morbidity, increased length of intensive care unit and hospital stay, increased rate of infections, increased number of ventilator days, and impaired wound healing. One potential contributor to malnutrition is prolonged fasting times prior to general anesthesia. The American Society of Parenteral and Enteral Nutrition and the Society of Critical Care Medicine recommend minimizing fasting times prior to surgery; however, neither gives guidelines for intubated patients in the intensive care unit. By limiting fasting times with cuffed endotracheal tubes, nutritional goals could be improved without additional complications.

This scoping review considered studies that included patients in the intensive care unit who were 18 years and older possessing a cuffed endotracheal tube, requiring enteral nutrition, and undergoing surgery requiring general anesthesia.