The evolution of the electronic age has led to the development of numerous medical databases on the World Wide Web, offering search facilities on a particular subject and the ability to perform ...citation analysis. We compared the content coverage and practical utility of PubMed, Scopus, Web of Science, and Google Scholar. The official Web pages of the databases were used to extract information on the range of journals covered, search facilities and restrictions, and update frequency. We used the example of a keyword search to evaluate the usefulness of these databases in biomedical information retrieval and a specific published article to evaluate their utility in performing citation analysis. All databases were practical in use and offered numerous search facilities. PubMed and Google Scholar are accessed for free. The keyword search with PubMed offers optimal update frequency and includes online early articles; other databases can rate articles by number of citations, as an index of importance. For citation analysis, Scopus offers about 20% more coverage than Web of Science, whereas Google Scholar offers results of inconsistent accuracy. PubMed remains an optimal tool in biomedical electronic research. Scopus covers a wider journal range, of help both in keyword searching and citation analysis, but it is currently limited to recent articles (published after 1995) compared with Web of Science. Google Scholar, as for the Web in general, can help in the retrieval of even the most obscure information but its use is marred by inadequate, less often updated, citation information.--Falagas, M. E., Pitsouni, E I., Malietzis, G. A., and Pappas, G. Comparison of Pub Med, Scopus, Web of Science, and Google Scholar: strengths and weaknesses.
Highlights • The genitourinary syndrome of menopause involves clinical signs and symptoms in both the genitals and the lower urinary tract. • In our study, Vaginal Maturation Value and Vaginal Health ...Index Score showed signs of improvement after CO2 -laser therapy. • Indications of alleviation of symptoms in the genitals and lower urinary tract were noted. • CO2 -laser therapy might be beneficial for the female sexual function and quality of life.
Introduction and hypothesis
Vaginal hysterectomy (VH) and pelvic floor repair (PFR) for the surgical management of pelvic organ prolapse (POP) are usually performed under regional anesthesia. The aim ...of this study is to evaluate the feasibility of performing VH and PFR under local anesthesia and to compare postoperative pain and patient recovery parameters with patients undergoing the same surgical procedure under regional anesthesia.
Methods
This was a single-center prospective cohort study of women with advanced POP. The standard care group consisted of 20 patients who underwent VH and PFR under a combined spinal-epidural (CSE) block, whereas the local anesthesia group consisted of 20 patients who underwent VH and PFR under local anesthesia and intravenous sedation. Primary outcomes included the intensity of postoperative pain and the percentage of patients with moderate/severe pain. Secondary outcomes included percentage of patients who used opioids, incidence of nausea/vomiting, level of sedation, and patient satisfaction rate.
Results
The median pain intensity at rest was significantly lower in the local anesthesia group at 2 h, 4 h, and 8 h postoperatively (median values: 0 vs 1.9, 0 vs 4.1, and 1 vs 2.7 respectively). The percentage of patients needing opioids was significantly lower for the local anesthesia group (35% vs 95%,
p
= 0.002). The proportion of patients presenting nausea and vomiting symptoms in the two groups was similar.
Conclusions
Local anesthesia for patients undergoing VH and PFR has been shown to be a viable alternative to regional anesthesia, offering reduced postoperative pain and less opioid use for the first 8 h.
A systematic review and meta-analysis was undertaken to assess the efficacy and safety of intravaginal energy-based therapies (laser and radiofrequency) on sexual health of cancer survivors (CS) ...(breast cancer (BCS) and/or gynecological cancer (GCS)). PubMed, Scopus, Web of Science, and Cochrane Library were searched until 21/02/2019. Quality of reporting, methodology, and body of evidence were assessed using STROBE, MINORS, and GRADE. Primary outcomes were dyspareunia, dryness, and sexual health (FSFI, FSDS-R). Secondary outcomes were burning, itching, dysuria, incontinence, Vaginal Health Index Score (VHIS), microbiome-cytokine evaluation, and adverse events. Main analyses, subgroup analyses, and sensitivity analyses were performed. Eight observational studies (
n
= 274) were eligible for inclusion. None of the studies evaluated radiofrequency. BCS and BCS-GCS were included in 87% and 13% of studies, respectively. All primary outcomes improved significantly with the exception of FSDS-R (dyspareunia (5 studies (
n
= 233), standardized mean difference (StdMD) (− 1.17), 95%CI − 1.59, − 0.75;
p
< 0.001;
I
2
= 55%), vaginal dryness (4 studies (
n
= 183), StdMD (− 1.98), 95%CI − 3.31, − 0.65;
p
= 0.003;
I
2
= 91%), FSFI (2 studies,
n
= 28, MD (12.79), 95%CI 7.69, 17.89;
p
< 0.001;
I
2
= 0%). Itching, dysuria, and VHIS increased significantly, while burning was not improved. Serious adverse events were not observed by any of the studies. Intravaginal laser therapies appear to have a positive effect on dyspareunia, vaginal dryness, and FSFI of CS. However, the quality of evidence is “very low,” with no data on intravaginal radiofrequency therapy. Further research with high-quality RCTs and long-term follow-up is needed to evaluate the value of energy-based devices as a therapeutic option for CS with sexual problems.
This retrospective case-control study aimed to compare 30 versus 40 W power of CO
2
laser for the therapy of genitourinary syndrome of menopause (GSM). Postmenopausal women with severe intensity of ...dyspareunia and dryness were eligible to be included in this study. Primary outcomes were dyspareunia and dryness. Secondary outcomes were itching/burning, dysuria, frequency and urgency, Female Sexual Function Index (FSFI), vaginal maturation value (VMV), and Vaginal Health Index Score (VHIS). One laser therapy was applied every month for 3 months. Outcomes were evaluated at baseline and 1 month following the 3rd therapy. Fifty (25 per group) women were included in this study. In the 30-W group, mean improvement of dyspareunia, dryness, itching/burning, FSFI, VMV, and VHIS was 6.1 ± 1.7, 6.0 ± 1.9, 5.9 ± 2.0, 16.6 ± 6.7, 29.9 ± 13.0, and 11.0 ± 2.9, respectively (within group comparisons all
p
< 0.001). In the 40-W group, mean improvement of dyspareunia, dryness, itching/burning, FSFI, VMV, and VHIS was 6.1 ± 1.7, 6.5 ± 2.0, 5.2 ± 2.5, 14.8 ± 7.1, 25.0 ± 13.4, and 10.5 ± 4.1, respectively (within-group comparisons, all
p
≤ 0.001). Comparison between 30 and 40 W revealed that mean improvement or presence of all GSM symptoms and clinical signs was not statistically significant different. CO
2
laser therapy may improve GSM symptoms and clinical signs. This improvement did not seem to associate to power of 30 or 40 W.
Abstract Objectives Hyaluronic acid is a protective barrier of the urothelium. A damaged glycosaminoglycan layer may increase the possibility of bacterial adherence and infection. This damage is ...proposed to be a causative factor in the development of interstitial cystitis, common urinary tract infections, and hemorrhagic cystitis due to posthematopoietic stem cell transplantation. The aim of this article was to review the available data regarding the use of hyaluronic acid as an alternative treatment of the above-mentioned conditions. Methods Articles relevant to our review that were archived by September 2006 were retrieved from PubMed. Results Nine relevant studies were identified and evaluated. Hyaluronic acid was administered intravesically at a dose of 40 mg every week for 4–6 wk; patients with noted improvement received two additional monthly doses. Short-term responses of patients with interstitial cystitis, hemorrhagic cystitis, and recurrent urinary tract infections were 30–73% (7 studies), 71% (1 study), and 100% (1 study), respectively. The treatment was well tolerated except for occasional development of bacterial cystitis. The cost of each intravesical installation of hyaluronic acid is 120 UK pounds (excluding the cost of the urinary catheterization). Conclusions The available clinical data regarding the effectiveness of hyaluronic acid as a potential treatment of patients with interstitial cystitis, recurrent urinary tract infections, and hemorrhagic cystitis are limited. There is need for randomized controlled trials for further investigation of this important therapeutics question; these clinical trials should be disease-specific, blinded, and controlled, and of a sufficient number of patients. Until such studies are available, intravesical instillation of hyaluronic acid cannot be unquestionably endorsed for use for the aforementioned diseases.
Background Advances in surgery have considerably lowered postoperative morbidity. However, infection remains a considerable morbidity factor. The aim of this review is to identify the potential ...benefit(s) of the perioperative administration of probiotics/synbiotics to patients undergoing abdominal surgery. Methods We searched PubMed, Scopus, Web of Science, and Cochrane library to identify randomized controlled trials (RCTs) that studied the perioperative administration of probiotics/synbiotics to patients undergoing abdominal surgery. Results Nine RCTs studying 733 patients were included in our review. The incidence of postoperative pneumonia, cholangitis, and any infections as well as the duration of postoperative hospital stay and length of antibiotic therapy were lower among patients receiving probiotics than in the control group six RCTs, 355 patients, odds ratio (OR) 0.24, 95% confidence interval (CI) 0.09-0.68; three RCTs, 209 patients, OR 0.18, 95% CI 0.05-0.57; seven RCTs, 514 patients, OR 0.26, 95% CI 0.12-0.55; five RCTs, 313 patients, OR -2.70, 95% CI -5.15 to -0.25; four RCTs, 250 patients, OR -4.01, 95% CI -5.11 to -2.92, respectively, while the incidence of postoperative wound infection, urinary tract infection, intra-abdominal abscess, and mortality was not different between patients of the compared groups (six RCTs, 355 patients, OR 0.52, 95% CI 0.23-1.18; five RCTs, 313 patients, OR 0.44, 95% CI 0.04-5.54; four RCTs, 226 patients, OR 0.44, 95% CI 0.12-1.59; nine RCTs, 685 patients, OR 0.98, 95% CI 0.29-3.29, respectively). Conclusion The use of probiotics/synbiotics may reduce postoperative infections after abdominal surgery. This is a promising infection-preventive measure that may decrease morbidity, length of antibiotic therapy, duration of hospital stay, and pressure for emergence of antimicrobial resistance. However, the results of this meta-analysis should be interpreted with caution due to the significant heterogeneity of the studies included.
This study aimed to assess the effect of the Microablative Fractional CO
Laser (CO
-laser) therapy on vaginal pathophysiology and the symptoms of the Genitourinary Syndrome of Menopause (GSM).
...Postmenopausal women with moderate to severe symptoms of GSM underwent three sessions of CO
-laser therapy at monthly intervals. Participants were evaluated at baseline and 4 weeks after the last treatment.
The primary outcomes were Vaginal Maturation Value (VMV) and Vaginal Health Index Score (VHIS). Secondary outcomes included symptoms of GSM, Female Sexual Function Index (FSFI), International Consultation on Incontinence Questionnaire of Female Urinary Tract Symptoms (ICIQ-FLUTS) and Urinary Incontinence Short Form (ICIQ-UI SF), Urogenital Distress Inventory (UDI-6) and King's Health Questionnaire (KHQ).
Fifty-three postmenopausal women completed this study. VMV, VHIS and FSFI increased significantly. Dyspareunia, dryness, burning, itching, dysuria, frequency, urgency, urgency incontinence, stress incontinence and scores on the ICIQ-FLUTS, ICIQ-UI SF, UDI-6 and KHQ decreased significantly. Factors predicting for which women the CO
-laser therapy was more effective were not identified.
This study suggests that intravaginal CO
-laser therapy for postmenopausal women with clinical signs and symptoms of GSM may be effective in improving both vaginal pathophysiology and reported symptoms.
In this metaanalysis of randomized controlled trials (RCTs) we aimed to compare the in vivo and in vitro activity and the safety of per os itraconazole and fluconazole treatment of uncomplicated ...acute vaginal/vulvovaginal candidiasis in nonpregnant women. We used PubMed, Scopus, Web of Science, and Cochrane Library to identify the studies that were relevant to our metaanalysis RCTs. Six RCTs were included in this study that comprised 1092 enrolled patients with signs and symptoms of vaginal/vulvovaginal candidiasis that was confirmed by microscopy and/or microbiologic cultures that were obtained from the ectocervix and/or vaginal fundus. Overall, there was no difference between itraconazole and fluconazole regarding clinical cure and improvement at the first and second scheduled visit assessments (pooled odds ratio OR, 0.94 95% CI, 0.6-1.48 and 1.09 95% CI, 0.68-1.75, respectively), mycologic cure at the first and second scheduled visit assessments (OR, 0.73 95% CI, 0.31-1.7 and 0.71 95% CI, 0.49-1.03, respectively), withdrawal of patients because of severe adverse events (OR, 0.72 95% CI, 0.16-3.32), and adverse events noted from the nervous and digestive systems (OR, 1.07 95% CI, 0.42-2.73 and 1.84 95% CI, 0.3-11.27, respectively). In conclusion, effectiveness and safety of oral itraconazole and fluconazole in the treatment of acute uncomplicated vaginal/vulvovaginal candidiasis are similar.
•Intravaginal laser therapy appears promising for the treatment of genitourinary syndrome of menopause.•Available studies consistently indicate alleviation of all symptoms of genitourinary syndrome ...of menopause.•Sexual function and quality of life may improve to a clinically meaningful degree.•Local pathophysiology may regain premenopausal status.•Quality of evidence is “low” or “very low” and randomised controlled trials are not available.
This study aimed to identify and then synthesize all available data regarding the efficacy of laser therapy for postmenopausal women with genitourinary syndrome of menopause (GSM) with/without urinary incontinence (UI). PubMed, Scopus, Web of Science, Cochrane Library and ClinicalTrials.gov were searched in October 2016. The keywords were “laser genitourinary syndrome of menopause”, “laser vulvovaginal atrophy”, “laser vaginal atrophy” and “laser women incontinence”. Quality of reporting and risk of bias of the included studies were assessed according to STROBE and MINORs checklists, respectively. Quality of the body of evidence was evaluated with the GRADE approach. Fourteen studies involving 542 participants were included in this systematic review and meta-analysis. All GSM symptoms (dryness/dyspareunia/itching/burning/dysuria/urgency/frequency) and UI decreased significantly and consistently in all available publications. The pooled mean differences for the various symptoms were: dryness −5.5(95%CI:−6.7,−4.4;7studies;I2:0%), dyspareunia −5.6(95%CI:−6.8,−4.5;7 studies;I2:0%), itching −4(95%CI:−5.7,−2.2;6 studies;I2:79%), burning −3.9(95%CI:−5.9,−2;6 studies;I2:87%), dysuria −2.9(95%CI:−5.1,−0.7;4 studies;I2:90%) and UI −4.9(95%CI:−6.4,−3.4;2 studies;I2:0%). Because urgency/frequency was assessed by different methodologies the data could not be meta-analyzed. Furthermore, KHQ, UDI-6, MCS12/PCS12, FSFI, overall sexual satisfaction and measurements of the effect of laser therapy on the local pathophysiology improved significantly. In conclusion, laser therapy for postmenopausal women with GSM appears promising. It may reduce symptom severity, improve quality of life of postmenopausal women and restore the vaginal mucosa to premenopausal status. However, the quality of the body of evidence is “low” or “very low” and, thus, evidence-based modification of current clinical practice cannot be suggested.
