Impacts• An extensive search to identify the literature relevant to the review question is a key component of a review.• Designing an extensive search often requires expertise of information scientists.• Inclusion of sources other than peer reviewed journals can be an important source of information. SummaryThis article is the fourth of six articles addressing systematic reviews in animal agriculture and veterinary medicine. Previous articles in the series have introduced systematic reviews, discussed study designs and hierarchies of evidence, and provided details on conducting randomized controlled trials, a common design for use in systematic reviews. This article describes development of a review protocol and the first two steps in a systematic review: formulating a review question, and searching the literature for relevant research. The emphasis is on systematic reviews of questions related to interventions. The review protocol is developed prior to conducting the review and specifies the plan for the conduct of the review, identifies the roles and responsibilities of the review team and provides structured definitions related to the review question. For intervention questions, the review question should be defined by the PICO components: population, intervention, comparison and outcome(s). The literature search is designed to identify all potentially relevant original research that may address the question. Search terms related to some or all of the PICO components are entered into literature databases, and searches for unpublished literature also are conducted. All steps of the literature search are documented to provide transparent reporting of the process.
ObjectiveTo evaluate the evidence published on the treatment of idiopathic chylothorax (IC) in small animals.Study designSystematic literature review.Sample populationDogs and cats with IC.MethodsA literature search was performed in three bibliographic databases in July 2018 for publications on IC in dogs and cats. Articles meeting criteria for inclusion were evaluated for treatment, survival, outcome data, and level of evidence (LoE) with a modified Oxford Level of Evidence (mOLE) and GRADE (Grading of Recommendations, Assessment, Development and Evaluations) system.ResultsEleven of 313 identified articles met the inclusion criteria. Only one study was identified in dogs as having higher LoE by using the mOLE system, whereas no study was identified as such in either species with the GRADE system. Surgery was the primary treatment in all dogs and in 93% (68/73) of cats. Medical therapy was the primary treatment in 7% (5/73) of cats. The most common surgical treatment combined thoracic duct ligation (TDL) and subtotal pericardiectomy (SP; 40%; 34/84) in dogs and TDL in cats (51% [37/73]).ConclusionThe body of literature for IC treatment in small animals was limited to one higher LoE study in dogs and none in cats. No strong conclusion could be drawn regarding the effectiveness of any one surgical method in dogs or cats, and no evidence was found to support medical therapy as a primary treatment.Clinical significanceThe best available evidence regarding the treatment of IC is published in dogs and provides some support for surgical treatment with either TDL + cisterna chyli ablation or TDL + SP. Additional evidence is required to confirm this finding.
Serials appearing on the third edition of the "Basic List of Veterinary Medical Serials" met expanded objective measures of quality and impact as well as subjective perceptions of value by both librarians and veterinary practitioners.
X-linked agammaglobulinemia (XLA) is a primary B-cell deficiency syndrome with an incidence of 5 to 10 cases per million. The current treatment approach includes intravenous immunoglobulin and aggressive antibiotic regimens for infections. Besides recurrent infections, XLA patients may present with other manifestations, such as alopecia, enteropathy, amyloidosis, and neutropenia. Neutropenia, which has been shown in up to 25% of affected patients, might also contribute to the degree of severity of bacterial infections that have been reported in these cases. Here we present our experience with the granulocyte colony-stimulant factor, filgrastim (Neupogen), in the treatment of neutropenia in a 14-month-old child with XLA.
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