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International Journal of Oral and... Jan 2020The aim was to compare clinical and radiological features of the two juvenile ossifying fibroma (JOF) variants, trabecular (JTOF) and juvenile psammomatoid ossifying... (Review)
Review
The aim was to compare clinical and radiological features of the two juvenile ossifying fibroma (JOF) variants, trabecular (JTOF) and juvenile psammomatoid ossifying fibroma (JPOF). An electronic search was undertaken in March 2019. Eligibility criteria included publications having sufficient clinical, radiological, and histological information to confirm the diagnosis. A total of 185 publications and 491 cases were included. Most JOFs, including both variants, showed bone expansion, were painless, presented no cortical perforation and no secondary aneurysmal bone cyst, did not cause tooth root resorption, and had a mixed unilocular radiodensity appearance and well-defined limits on radiological examination. Patients with JPOF were on average older than those with JTOF. Enucleation and curettage was associated with a considerably high recurrence rate, regardless of the anatomical location or variant type of the lesion. Enucleation followed by either curettage or peripheral osteotomy showed lower recurrence rates than enucleation only. When resection was performed, only one case of JTOF presented recurrence. In conclusion, JOF lesions presented high rates of recurrence after treatment by curettage and enucleation only. Although surgical resection of JOFs resulted in the virtual absence of recurrence, enucleation followed by peripheral osteotomy/curettage should be the treatment of choice for both JOF variants to avoid the disfigurement usually associated with surgical resection.
Topics: Bone Neoplasms; Fibroma, Ossifying; Humans; Neoplasm Recurrence, Local; Osteotomy; Paranasal Sinuses
PubMed: 31285096
DOI: 10.1016/j.ijom.2019.06.029 -
The Lancet. Global Health Jul 2019Buruli ulcer can cause disfigurement and long-term loss of function. It is underdiagnosed and under-reported, and its current distribution is unclear. We aimed to...
BACKGROUND
Buruli ulcer can cause disfigurement and long-term loss of function. It is underdiagnosed and under-reported, and its current distribution is unclear. We aimed to synthesise and evaluate data on Buruli ulcer prevalence and distribution.
METHODS
We did a systematic review of Buruli ulcer prevalence and used an evidence consensus framework to describe and evaluate evidence for Buruli ulcer distribution worldwide. We searched PubMed and Web of Science databases from inception to Aug 6, 2018, for records of Buruli ulcer and Mycobacterium ulcerans detection, with no limits on study type, publication date, participant population, or location. English, French, and Spanish language publications were included. We included population-based surveys presenting Buruli ulcer prevalence estimates, or data that allowed prevalence to be estimated, in the systematic review. We extracted geographical data on the occurrence of Buruli ulcer cases and M ulcerans detection from studies of any type for the evidence consensus framework; articles that did not report original data were excluded. For the main analysis, we extracted prevalence estimates from included surveys and calculated 95% CIs using Byar's method. We included occurrence records, reports to WHO and the Global Infectious Diseases and Epidemiology Network, and surveillance data from Buruli ulcer control programmes in the evidence consensus framework to grade the strength of evidence for Buruli ulcer endemicity. This study is registered with PROSPERO, number CRD42018116260.
FINDINGS
2763 titles met the search criteria. We extracted prevalence estimates from ten studies and occurrence data from 208 studies and five unpublished surveillance datasets. Prevalence estimates within study areas ranged from 3·2 (95% CI 3·1-3·3) cases per 10 000 population in Côte d'Ivoire to 26·9 (23·5-30·7) cases per 10 000 population in Benin. There was evidence of Buruli ulcer in 32 countries and consensus on presence in 12.
INTERPRETATION
The global distribution of Buruli ulcer is uncertain and potentially wider than currently recognised. Our findings represent the strongest available evidence on Buruli ulcer distribution so far and have many potential applications, from directing surveillance activities to informing burden estimates.
FUNDING
AIM Initiative.
Topics: Buruli Ulcer; Geographic Mapping; Global Health; Humans; Mycobacterium ulcerans; Prevalence
PubMed: 31200890
DOI: 10.1016/S2214-109X(19)30171-8 -
Neurological Research May 2017Growth hormone-secreting pituitary adenomas in adults can result in severe craniofacial disfigurement and potentially fatal medical complications. Surgical resection... (Meta-Analysis)
Meta-Analysis Review
Efficacy of transsphenoidal surgery in achieving biochemical cure of growth hormone-secreting pituitary adenomas among patients with cavernous sinus invasion: a systematic review and meta-analysis.
OBJECTIVES
Growth hormone-secreting pituitary adenomas in adults can result in severe craniofacial disfigurement and potentially fatal medical complications. Surgical resection leading to remission of the disease is dependent on complete surgical resection of the tumor. Lesions that invade the cavernous sinus may not be safely accessible via an endonasal transsphenoidal surgery (TSS), and the rates of biochemical remission of patients with residual disease vary widely in the literature. We conducted a meta-analysis to examine the prevalence of biochemical remission after TSS among patients with growth hormone-secreting pituitary adenomas with and without cavernous sinus invasion.
METHODS
Embase, PubMed, and Cochrane Library databases were searched for relevant publications. Fourteen studies with 972 patients with biochemically confirmed growth hormone-secreting pituitary adenomas were included in the meta-analysis.
RESULTS
The overall remission prevalence under a fixed-effect model was 47.6% (95% CI = 40.8-54.4%) for patients with invasive macroadenomas (I = 74.6%, p < 0.01); 76.4% (95% CI = 72.2-80.1%) for patients with non-invasive macroadenomas (I = 59.6%, p = 0.03); and 74.2% (95% CI = 66.3-80.7%) for patients with non-invasive microadenomas (I = 36.4, p = 0.10). The significant difference among the three groups resulted from the difference between patients with or without cavernous sinus invasion (p = 0.01) and not from the size of adenomas among those without cavernous sinus invasion (p = 0.66).
DISCUSSION
The prevalence of biochemical remission in patients with cavernous sinus invasion was lower than in patients without cavernous sinus invasion after TSS for acromegaly.
Topics: Adenoma; Cavernous Sinus; Databases, Bibliographic; Growth Hormone-Secreting Pituitary Adenoma; Humans; Neurosurgical Procedures; Remission Induction; Sphenoid Bone
PubMed: 28301972
DOI: 10.1080/01616412.2017.1296653 -
PloS One 2023Post-mortem brain donation affords the opportunity to characterise disease by exploring global neuropathological changes. Such opportunities are essential to progress...
PURPOSE
Post-mortem brain donation affords the opportunity to characterise disease by exploring global neuropathological changes. Such opportunities are essential to progress knowledge of CNS tumours such as Glioblastoma. A comprehensive understanding of the experience of consenting to brain donation is crucial to maximising consent rates while providing patient-centred care. This review aimed to synthesise the reported facilitators and barriers according to potential donors, next-of-kin (NOK) and clinician respondents.
DESIGN
Database searches included Embase, Medline, PsycINFO, Psychology and Behavioural Science and Scopus. Search terms focused on motivations, attitudes and psychosocial experiences of brain donation. Exclusions included organ transplantation and brain death. All studies were assessed for quality and validity using tools from the Joanna Briggs Institute. To determine perceptions of benefit and harm, a method guided by the thematic analysis of Braun and Clarke was employed to reflexively assess and identify common themes and experiences.
RESULTS
40 studies (15 qualitative, 25 quantitative) were included involving participants with paediatric cancer, neurodegenerative and psychological diseases. Perceptions of benefit included benefit to future generations, aiding scientific research, avoidance of waste, improved treatments and the belief that donation will bring consolation or aid in the grieving process. Perceptions of harm included a perceived conflict with religious beliefs, disfigurement to the donor, emotional distress at the time of autopsy and discord or objections within the family.
CONCLUSION
Brain donation can afford a sense of purpose, meaning and empowerment for donors and their loved ones. Careful strategies are required to mitigate or reduce potential harms during the consent process.
Topics: Child; Humans; Tissue and Organ Procurement; Tissue Donors; Brain; Attitude; Autopsy
PubMed: 38117774
DOI: 10.1371/journal.pone.0295438 -
BioMed Research International 2021Vitiligo is a disfiguring skin disease with profound psychosocial impacts, such as anxiety, but the reported effect sizes of associations vary. We aimed to conduct a... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Vitiligo is a disfiguring skin disease with profound psychosocial impacts, such as anxiety, but the reported effect sizes of associations vary. We aimed to conduct a meta-analysis to quantify the strength of association between anxiety and vitiligo and to estimate the prevalence of anxiety among individuals with vitiligo.
METHODS
A systematic literature search was performed in five online databases (MEDLINE, Embase, Web of Science, Cochrane Library, and PsycINFO) from inception until March 20, 2020. All of the eligible studies were comprehensively reviewed, and all of the available data were analyzed according to our predefined criteria.
RESULTS
Twenty-one studies involving 3259 patients in 11 countries were included in this meta-analysis. Compared with the healthy control group, patients with vitiligo often had concomitant anxiety (OR = 6.14 [95% CI: 3.35-11.24], = 30.1%). The pooled prevalence of anxiety in female patients was significantly higher than that in males (OR = 2.24 [95% CI: 1.31-3.84], = 0.0%). Subgroup analysis showed that the pooled prevalence of clinical anxiety disorder and anxiety symptoms was 12% (95% CI: 7%-16%, = 76.3%) and 34% (95% CI: 21%-46%, = 94.7%), respectively. No publication bias has been detected by Begg's funnel plot and Egger's test.
CONCLUSION
Patients with vitiligo have high anxiety comorbidity, with female predominance. Dermatologists and psychiatrists should be vigilant to the presence of anxiety, apply appropriate interventions to reduce the psychological impacts in a timely manner, and thus promote recovery in vitiligo patients. However, due to some objective limitations (poor information about the OR and diversity in assessment tools among included studies), findings should be interpreted with caution.
Topics: Anxiety; Anxiety Disorders; Comorbidity; Databases, Factual; Depression; Female; Humans; Male; Prevalence; Vitiligo
PubMed: 34055993
DOI: 10.1155/2021/6663646 -
Wound Repair and Regeneration :... Jan 2021Pathological scars can result in functional impairment, disfigurement, a psychological burden, itch, and even chronic pain. We conducted a systematic review to... (Meta-Analysis)
Meta-Analysis
Pathological scars can result in functional impairment, disfigurement, a psychological burden, itch, and even chronic pain. We conducted a systematic review to investigate the influence of incisional Negative Pressure Wound Therapy (iNPWT) on scarring. PubMed, EMBASE and CINAHL were searched for preclinical and clinical comparative studies that investigated the influence of iNPWT on scarring-related outcomes. Individual studies were assessed using the OHAT Risk of Bias Rating Tool for Human and Animal studies. The body of evidence was rated using OHAT methodology. Six preclinical studies and nine clinical studies (377 patients) were identified. Preclinical studies suggested that iNPWT reduced lateral tension on incisions, increased wound strength, and reduced scar width upon histological assessment. Two clinical studies reported improved patient-reported scar satisfaction as measured with the PSAS (1 year after surgery), POSAS, and a VAS (both 42, 90, and 180 days after surgery). Five clinical studies reported improved observer-reported scar satisfaction as measured with the VSS, SBSES, OSAS, MSS, VAS, and POSAS (7, 15, 30, 42, 90, 180, and 365 days after surgery). Three clinical studies did not detect significant differences at any point in time (POSAS, VAS, and NRS). Because of imprecision concerns, a moderate level of evidence was identified using OHAT methodology. Preclinical as well as clinical evidence indicates a beneficial influence of iNPWT on scarring. Moderate level evidence indicates that iNPWT decreases scar width and improves patient and observer-reported scar satisfaction.
Topics: Animals; Cicatrix; Humans; Negative-Pressure Wound Therapy; Surgical Wound Infection; Wound Healing
PubMed: 32789902
DOI: 10.1111/wrr.12858 -
British Journal of Nursing (Mark Allen... Feb 2019to explore the factors affecting quality of life in patients who experience facial disfigurement resulting from surgical treatment for head and neck cancer.
AIM:
to explore the factors affecting quality of life in patients who experience facial disfigurement resulting from surgical treatment for head and neck cancer.
BACKGROUND:
the number of people diagnosed with head and neck cancers has been rising over the past 30 years. This, combined with the improved survivorship of cancer patients, has led to a need to understand how these patients adapt to the physical, social and emotional toll of cancer and facial disfigurement and how these affect quality of life.
METHODOLOGY:
a systematic search of four nursing and psychological-focused databases was undertaken using pertinent keywords.
FINDINGS:
following a thematic analysis, four main themes and one subtheme emerged; changes within the self, social support; social reintegration; and help from healthcare professionals, which had the subtheme of information.
CONCLUSION:
facial disfigurement has a significant effect on patients' quality of life. Nurses are ideally placed to identify, inform and support patients and their family and friends.
Topics: Adaptation, Psychological; Body Image; Face; Head and Neck Neoplasms; Humans; Quality of Life
PubMed: 30746969
DOI: 10.12968/bjon.2019.28.3.180 -
Indian Journal of Plastic Surgery :... Mar 2020Chronic tenosynovitis of the upper extremities caused by ( ) is uncommon, but symptoms may overlap with other more common diseases. Late diagnosis and treatment... (Review)
Review
Chronic tenosynovitis of the upper extremities caused by ( ) is uncommon, but symptoms may overlap with other more common diseases. Late diagnosis and treatment can lead to disfiguration of structures and rupture of tendons, resulting in worse cosmetic outcomes after reconstruction. We present a clinical case and literature review of in patients with chronic tenosynovitis of upper extremities. PubMed was queried for cases of upper extremities tenosynovitis caused by . The keywords " ," "tenosynovitis" and synonyms were used for search in different combinations. Manuscripts, with no specific data or another condition, where the infection was not located in the upper extremities, were reviews, or not in English, were excluded from the study. We described 23 reported cases of tenosynovitis of the upper extremity caused by . An immunosuppressed state was present in eight (34.8%) cases, and 12 (52.2%) patients received immunosuppressive treatment. A long-time period between the first appearance of symptoms and the definitive diagnosis was identified (median: 7 months, interquartile range: 9). The most frequent symptoms were local swelling (65.2%), pain (56.5%), mass effect (26%), and stiffness (13%). Tendon rupture was found in three (13%) patients as a complication of the disease. Moreover, seven (30.4%) patients underwent previous surgeries to try to relieve the symptoms before definitive diagnosis was achieved. is an important differential causal pathogen for tenosynovitis of the upper extremities. Although rare, raising awareness about this infectious disease is imperative to avoid inadequate management and hazardous aesthetic sequelae.
PubMed: 32367915
DOI: 10.1055/s-0040-1709377 -
Supportive Care in Cancer : Official... Oct 2019Head and neck cancer (HNC) is a relatively common cancer which causes a significant health burden, impacting individuals physically and psychologically. HNC treatment...
PURPOSE
Head and neck cancer (HNC) is a relatively common cancer which causes a significant health burden, impacting individuals physically and psychologically. HNC treatment may result in facial disfigurement, eating and communication difficulties, and body image disturbances. We aimed to (1) identify HNC-specific patient-reported outcome measures (PROMs) used to assess body image, (2) evaluate their conceptual coverage, (3) appraise their development process and psychometric properties, and (4) determine appropriate body image PROM(s) for use in the HNC setting.
METHODS
Online databases were searched (July 2007-July 2017) for studies that assessed body image in patients with HNC. Studies were screened for eligibility. In addition, we searched three PROM databases for relevant PROMs. From available body image frameworks, we compiled a conceptual schema consisting of 18 clinically relevant body image issues important in the HNC setting, against which PROMs were assessed. Selected measures were appraised for psychometric characteristics, content, and readability.
RESULTS
A total of 245 records were retrieved. 18 studies with PROMs met our inclusion criteria, reporting eight PROMs. The PROM databases searched yielded 62 measures. After screening, eleven measures were short-listed and appraised. The Derriford Appearance Scale (DAS)-59, DAS-24, and body image scale (BIS) cover > 55% of issues within the body image conceptual schema; were developed based on literature, patient interviews, and clinician opinions; and have evidence of internal consistency (Cronbach alpha > 0.7), validity, and responsiveness.
CONCLUSIONS
We recommend the DAS-24 and BIS as having adequate coverage of HNC-related issues, and suitable for use in future research.
Topics: Body Image; Databases, Factual; Head and Neck Neoplasms; Humans; Patient Reported Outcome Measures; Psychometrics
PubMed: 31203508
DOI: 10.1007/s00520-019-04919-6 -
Plastic and Reconstructive Surgery Jan 2019A patient's health-related quality of life can be significantly impacted by facial scarring and disfigurement. Facial soft-tissue reconstruction should aim to improve... (Meta-Analysis)
Meta-Analysis
BACKGROUND
A patient's health-related quality of life can be significantly impacted by facial scarring and disfigurement. Facial soft-tissue reconstruction should aim to improve this, with outcomes measured from the patient's perspective using patient-reported outcome measures. This systematic review identifies patient-reported outcome measures for soft-tissue facial reconstruction and appraises their methodologic and psychometric properties using up-to-date methods.
METHODS
A systematic search of the MEDLINE, Embase, PsychINFO, and Cochrane databases was performed. Identified patient-reported outcome measures were assessed using the updated Consensus-Based Standards for the Selection of Health Measurement Instruments checklist. Psychometric properties were also assessed and a modified Grading of Recommendation Assessment, Development and Evaluation analysis was performed to aid in recommendations for future questionnaire use.
RESULTS
Thirty-four studies covering nine patient-reported outcome measures were included. Methodologic quality and psychometric evidence were variable. FACE-Q, Skin Cancer Index, Patient Outcome of Surgery-Head/Neck, and the Derriford Appearance Scale 59/24 all demonstrated high enough evidence to be recommended as having potential for inclusion in future studies.
CONCLUSIONS
This is the first systematic review to identify and critically appraise patient-reported outcome measures for soft-tissue facial reconstruction using internationally accepted criteria. Four questionnaires were deemed to have adequate levels of methodologic and psychometric evidence, although further studies should be conducted before they are used routinely in patients undergoing facial reconstruction. Through the use of psychometrically well-validated questionnaires, it is hoped that patients' concerns can be truly appreciated, the level of care improved, and the quality of reconstructive options offered advanced.
Topics: Facial Injuries; Female; Humans; Injury Severity Score; Male; Patient Reported Outcome Measures; Quality Assurance, Health Care; Quality of Life; Plastic Surgery Procedures; Risk Assessment; Soft Tissue Injuries; Wound Healing
PubMed: 30334937
DOI: 10.1097/PRS.0000000000005112