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European Spine Journal : Official... Apr 2016Spondylodiscitis is a spinal infection affecting primarily the intervertebral disk and the adjacent vertebral bodies. Currently many aspects of the treatment of pyogenic... (Review)
Review
BACKGROUND
Spondylodiscitis is a spinal infection affecting primarily the intervertebral disk and the adjacent vertebral bodies. Currently many aspects of the treatment of pyogenic spondylodiscitis are still a matter of debate.
PURPOSE
The aim of this study was to review the currently available literature systematically to determine the outcome of patients with pyogenic spondylodiscitis for conservative and surgical treatment strategies.
METHODS
A systematic electronic search of MEDLINE, EMBASE, Cochrane Collaboration, and Web of Science regarding the treatment of pyogenic spondylodiscitis was performed. Included articles were assessed on risk of bias according the Cochrane Handbook for Systematic Reviews of Interventions, and the quality of evidence and strength of recommendation was evaluated according the GRADE approach.
RESULTS
25 studies were included. Five studies had a high or moderate quality of evidence. One RCT suggest that 6 weeks of antibiotic treatment of pyogenic spondylodiscitis results in a similar outcome when compared to longer treatment duration. However, microorganism-specific studies suggest that at least 8 weeks of treatment is required for S. aureus and 8 weeks of Daptomycin for MRSA. The articles that described the outcome of surgical treatment strategies show that a large variety of surgical techniques can successfully treat spondylodiscitis. No additional long-term beneficial effect of surgical treatment could be shown in the studies comparing surgical versus antibiotic only treatment.
CONCLUSION
There is a strong level of recommendation for 6 weeks of antibiotic treatment in pyogenic spondylodiscitis although this has only been shown by one recent RCT. If surgical treatment is indicated, it has been suggested by two prospective studies with strong level of recommendation that an isolated anterior approach could result in a better clinical outcome.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents; Child; Child, Preschool; Discitis; Female; Humans; Infant; Male; Middle Aged; Orthopedic Procedures; Prospective Studies; Spine; Treatment Outcome; Young Adult
PubMed: 26585975
DOI: 10.1007/s00586-015-4318-y -
International Journal of Microbiology 2020species are one of the main causes of bacterial food poisoning worldwide. Recently, WHO reported that the emergence of fluoroquinolone-resistant species is becoming a... (Review)
Review
BACKGROUND
species are one of the main causes of bacterial food poisoning worldwide. Recently, WHO reported that the emergence of fluoroquinolone-resistant species is becoming a public health issue around the world. The aim of the present systematic review and meta-analysis was to evaluate the prevalence of the antimicrobial susceptibility patterns of species, especially fluoroquinolone-resistant strains isolated from human and animal origins in Iran.
METHODS
Using related keywords and without date and language limitations, a comprehensive literature search was conducted in PubMed, Scopus, ISI Web of Knowledge, Google Scholar, and SID to identify relevant studies on the prevalence of the antimicrobial susceptibility patterns of species in Iran.
RESULTS
A total of 34 reports (9 in Persian and 25 in English) were selected based on inclusion and exclusion criteria. Disk diffusion, -test, and agar dilution were common methods used for antimicrobial susceptibility testing. The antibiotic resistance profiles of species against fluoroquinolones were as follows: 53.6%, 41.8%, and 0% to ciprofloxacin for , , and , respectively, 24.3% and 25.1% to enrofloxacin for and , respectively, 59.6% and 49.2% to nalidixic acid for and , respectively, and 87.3% and 64.7% to ofloxacin for and , respectively.
CONCLUSION
Our findings revealed a high prevalence of fluoroquinolone-resistant species in Iran. This calls for the use of more effective antibiotics with low resistance rates including aminoglycosides, chloramphenicol, and imipenem.
PubMed: 33488728
DOI: 10.1155/2020/8868197 -
Clinical Spine Surgery Dec 2016This is a systematic review and meta-analysis. (Meta-Analysis)
Meta-Analysis Review
Comparisons of Safety and Clinical Outcomes Between Multiple-level and Single-level Cervical Disk Replacement for Cervical Spondylosis: A Systematic Review and Meta-analysis.
STUDY DESIGN
This is a systematic review and meta-analysis.
OBJECTIVE
The aim of this study was to evaluate the efficacy and safety of multiple-level cervical disk replacement (CDR) over single-level CDR for the treatment of cervical spondylosis.
SUMMARY OF BACKGROUND DATA
Some authors advocate for the multiple-level CDR instead of anterior decompression and fusion in cervical multiple-level spondylosis. However, whether the efficacy and safety of multi-level CDR are as favorable as that of single-level CDR remains controversial.
METHODS
MEDLINE, EMBASE, and Cochrane library databases were searched up to November 2015 for controlled studies that compared the clinical outcomes of single-level and multiple-level CDR for the treatment of cervical spondylosis. The following outcomes were extracted and analyzed: prevalence of heterotopic ossification and reoperation, preoperative and postoperative Neck Disability Index scores, preoperative and postoperative Visual Analog Scale scores, and success rate using the Odom grading system.
RESULTS
Ten studies involving 1402 patients were included: including 3 randomized controlled trials, 5 prospective studies, and 3 retrospective studies. No significant differences between single-level and multiple-level groups were found in terms of the prevalence of heterotopic ossification and reoperation rate, Neck Disability Index score, Visual Analog Scale score, and success rate using the Odom grading system.
CONCLUSIONS
On the basis of this meta-analysis, clinical outcomes of multiple-level CDR are similar to those of single-level CDR for cervical spondylosis, which suggests the multiple-level CDR is as effective and safe as the single-level CDR. Nonetheless, more well-designed studies are needed for further evaluation.
Topics: Cervical Vertebrae; Databases, Factual; Humans; Spondylosis; Total Disc Replacement; Treatment Outcome
PubMed: 27322653
DOI: 10.1097/BSD.0000000000000399 -
Antimicrobial Resistance and Infection... Aug 2023Vancomycin-resistant Staphylococcus aureus, identified as a "high priority antibiotic-resistant pathogen" by the World Health Organization, poses a significant threat to... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
Vancomycin-resistant Staphylococcus aureus, identified as a "high priority antibiotic-resistant pathogen" by the World Health Organization, poses a significant threat to human health. This systematic review and meta-analysis aimed to estimate the pooled prevalence of vancomycin-resistant Staphylococcus aureus in Ethiopia.
METHODS
This systematic review and meta-analysis was reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies that reported VRSA prevalence due to infection or carriage from human clinical specimens were extensively searched in bibliographic databases and grey literatures using entry terms and combination key words. Electronic databases like PubMed, Google Scholar, Wiley Online Library, African Journal Online, Scopus, Science Direct, Embase, and ResearchGate were used to find relevant articles. In addition, the Joanna Briggs Institute quality appraisal tool was used to assess the quality of the included studies. Stata version 14 software was used for statistical analysis. Forest plots using the random-effect model were used to compute the overall pooled prevalence of VRSA and for the subgroup analysis. Heterogeneity was assessed using Cochrane chi-square (I) statistics. After publication bias was assessed using a funnel plot and Egger's test, trim & fill analysis was carried out. Furthermore, sensitivity analysis was done to assess the impact of a single study on pooled effect size.
RESULTS
Of the 735 studies identified, 31 studies that fulfilled the eligibility criteria were included for meta-analysis consisted of 14,966 study participants and 2,348 S. aureus isolates. The overall pooled prevalence of VRSA was 14.52% (95% CI: 11.59, 17.44). Significantly high level of heterogeneity was observed among studies (I = 93.0%, p < 0.001). The region-based subgroup analysis depicted highest pooled prevalence of 47.74% (95% CI: 17.79, 77.69) in Sidama region, followed by 14.82% (95% CI: 8.68, 19.88) in Amhara region, while Oromia region had the least pooled prevalence 8.07% (95% CI: 4.09, 12.06). The subgroup analysis based on AST methods depicted a significant variation in pooled prevalence of VRSA (6.3% (95% CI: 3.14, 9.43) for MIC-based methods, and 18.4% (95% CI: 14.03, 22.79) for disk diffusion AST method) which clearly showed that disk diffusion AST method overestimates the pooled VRSA prevalence. The total number of S. aureus isolates was found to be the responsible variable for the existence of heterogeneity among studies (p = 0.033).
CONCLUSION
This study showed an alarmingly high pooled prevalence of VRSA necessitating routine screening, appropriate antibiotic usage, and robust infection prevention measures to manage MRSA infections and control the emergence of drug resistance. Furthermore, mainly attributable to the overestimation of VRSA burden while using disk diffusion method, there is an urgent need to improve the methods to determine vancomycin resistance in Ethiopia and incorporate MIC-based VRSA detection methods in routine clinical laboratory tests, and efforts should be directed at improving it nationally.
TRIAL REGISTRATION
PROSPERO registration identification number: CRD42023422043.
Topics: Humans; Vancomycin-Resistant Staphylococcus aureus; Ethiopia; Methicillin-Resistant Staphylococcus aureus; Staphylococcus aureus; Prevalence; Anti-Bacterial Agents
PubMed: 37649060
DOI: 10.1186/s13756-023-01291-3 -
Journal of Bodywork and Movement... Jul 2022To investigate the effect of disk training and tape application on diminished proprioception after Lateral Ankle Sprain (LAS) in active populations. (Review)
Review
OBJECTIVE
To investigate the effect of disk training and tape application on diminished proprioception after Lateral Ankle Sprain (LAS) in active populations.
ELIGIBILITY CRITERIA
Only clinical trials investigating the effectiveness of disk training and ankle tape on proprioception deficits following LAS by assessing JPS or kinaesthesia were included.
INFORMATION SOURCES
Electronic databases of PubMed, MEDLINE, SPORTDiscus, CINAHL, Web of Science, Cochrane and PEDro were searched. The main search was conducted in February 2022.
RISK OF BIAS
The physiotherapy Evidence Database (PEDro) scale was utilised to assess the methodological quality of each article.
RESULT
The search yielded six studies investigating the effects of disk training and four studies investigating the effects of inelastic tape. Five articles showed a significant improvement on JPS after disk training. However, no difference across different intervention groups was observed in one study. Only one trial presented an immediate significant improvement when taped, while another study showed that external ankle supports significantly improved JPS after 2 weeks and after 2 months. Three of four studies found no immediate improvement on proprioceptive deficits by the use of tape.
CONCLUSIONS
This review found that disk training may improve impaired proprioception after LAS, whilst the efficacy of inelastic tape was not evident due to methodological quality of the few available studies. Further studies are needed to establish whether these interventions can be used clinically with sufficient evidence.
Topics: Ankle; Ankle Injuries; Ankle Joint; Humans; Physical Therapy Modalities; Proprioception
PubMed: 35710223
DOI: 10.1016/j.jbmt.2022.04.001 -
Ultrasound in Obstetrics & Gynecology :... Jul 2017To analyze the diagnostic accuracy of two- (2D) and three- (3D) dimensional saline contrast sonohysterography (SCSH) in the detection of endometrial polyps and... (Meta-Analysis)
Meta-Analysis Review
Accuracy of saline contrast sonohysterography in detection of endometrial polyps and submucosal leiomyomas in women of reproductive age with abnormal uterine bleeding: systematic review and meta-analysis.
OBJECTIVE
To analyze the diagnostic accuracy of two- (2D) and three- (3D) dimensional saline contrast sonohysterography (SCSH) in the detection of endometrial polyps and submucosal uterine leiomyomas in women of reproductive age with abnormal uterine bleeding compared with gold standard hysteroscopy.
METHODS
A systematic review of diagnostic studies that compared 2D- and/or 3D-SCSH with hysteroscopy and anatomopathology was conducted according to PRISMA and SEDATE recommendations. The databases MEDLINE, EMBASE and The Cochrane Library were searched electronically using specific terms with no restriction on language or publication year. Quality assessment of included studies was performed using the QUADAS-2 tool. Meta-analysis was performed with the Meta-DiSk program and data presented as forest plots and summary receiver-operating characteristics (SROC) curves. Pooled sensitivity, specificity and positive (LR+) and negative (LR-) likelihood ratios of SCSH in the detection of uterine cavity abnormalities were calculated.
RESULTS
A total of 1398 citations were identified and five studies were included in the systematic review and meta-analysis. Pooled sensitivity and specificity of 2D-SCSH in detecting endometrial polyps were 93% (95% CI, 89-96%) and 81% (95% CI, 76-86%), respectively, with pooled LR+ of 5.41 (95% CI, 2.60-11.28) and LR- of 0.10 (95% CI, 0.06-0.17). In the detection of submucosal uterine leiomyomas, pooled sensitivity and specificity were 94% (95% CI, 89-97%) and 81% (95% CI, 76-86%), respectively, with pooled LR+ of 4.25 (95% CI, 2.20-8.21) and LR- of 0.11 (95% CI, 0.05-0.22). 2D-SCSH had good accuracy in detecting endometrial polyps and submucosal uterine leiomyomas, with areas under the SROC curves of 0.97 ± 0.02 and 0.97 ± 0.03, respectively. Studies that analyzed the diagnostic accuracy of 3D-SCSH could not be compared due to high heterogeneity related to menopausal status, type of technique used and primary outcome being investigation of infertility.
CONCLUSIONS
2D-SCSH proved to be a highly sensitive method for detection of endometrial polyps and submucosal uterine leiomyomas, making it a potential first-line diagnostic method in the work-up for women with abnormal uterine bleeding. More studies are needed on 3D-SCSH in women of reproductive age. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.
Topics: Contrast Media; Female; Humans; Hysteroscopy; Leiomyoma; Polyps; Randomized Controlled Trials as Topic; Sensitivity and Specificity; Sodium Chloride; Uterine Hemorrhage; Uterine Neoplasms
PubMed: 27862503
DOI: 10.1002/uog.17352 -
Frontiers in Aging Neuroscience 2022As a non-pharmacological therapy, acupuncture has significant efficacy in treating Mild Cognitive Impairment (MCI) compared to pharmacological therapies. In recent...
BACKGROUND
As a non-pharmacological therapy, acupuncture has significant efficacy in treating Mild Cognitive Impairment (MCI) compared to pharmacological therapies. In recent years, advances in neuroimaging techniques have provided new perspectives to elucidate the central mechanisms of acupuncture for MCI. Many acupuncture brain imaging studies have found significant improvements in brain function after acupuncture treatment of MCI, but the underlying mechanisms of brain regions modulation are unclear.
OBJECTIVE
A meta-analysis of functional magnetic resonance imaging studies of MCI patients treated with acupuncture was conducted to summarize the effects of acupuncture on the modulation of MCI brain regions from a neuroimaging perspective.
METHODS
Using acupuncture, neuroimaging, magnetic resonance, and Mild Cognitive Impairment as search terms, PubMed, EMBASE, Web of Science, Cochrane Library, Cochrane Database of Systematic Reviews, Cochrane Database of Abstracts of Reviews of Effects (DARE), Google Scholar, China National Knowledge Infrastructure (CNKI), China Biology Medicine disk (CBM disk), Wanfang and Chinese Scientific Journal Database (VIP) for brain imaging studies on acupuncture on MCI published up to April 2022. Voxel-based neuroimaging meta-analysis of fMRI data was performed using voxel-based d Mapping with Permutation of Subject Images (SDM-PSI), allowing for Family-Wise Error Rate (FWER) correction correction for correction multiple comparisons of results. Subgroup analysis was used to compare the differences in brain regions between the acupuncture treatment group and other control groups. Meta-regression was used to explore demographic information and altered cognitive function effects on brain imaging outcomes. Linear models were drawn using MATLAB 2017a, and visual graphs for quality evaluation were produced using R software and RStudio software.
RESULTS
A total of seven studies met the inclusion criteria, with 94 patients in the treatment group and 112 patients in the control group. All studies were analyzed using the regional homogeneity (ReHo) method. The experimental design of fMRI included six task state studies and one resting-state study. The meta-analysis showed that MCI patients had enhanced activity in the right insula, left anterior cingulate/paracingulate gyri, right thalamus, right middle frontal gyrus, right median cingulate/paracingulate gyri, and right middle temporal gyrus brain regions after acupuncture treatment. Further analysis of RCT and longitudinal studies showed that Reho values were significantly elevated in two brain regions, the left anterior cingulate/paracingulate gyrus and the right insula, after acupuncture. The MCI group showed stronger activity in the right supramarginal gyrus after acupuncture treatment compared to healthy controls. Meta-regression analysis showed that the right anterior thalamic projection ReHo index was significantly correlated with the MMSE score after acupuncture treatment in all MCI patients.
CONCLUSIONS
Acupuncture therapy has a modulating effect on the brain regions of MCI patients. However, due to the inadequate experimental design of neuroimaging studies, multi-center neuroimaging studies with large samples are needed better to understand the potential neuroimaging mechanisms of acupuncture for MCI. In addition, machine learning algorithm-based predictive models for evaluating the efficacy of acupuncture for MCI may become a focus of future research.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022287826, identifier: CRD 42022287826.
PubMed: 36212046
DOI: 10.3389/fnagi.2022.914049 -
BMC Musculoskeletal Disorders Apr 2022Lumbar total disc replacement (TDR) is an alternative to lumbar fusion in the treatment of lower back pain and reduces the risk of adjacent segment degeneration....
BACKGROUND CONTEXT
Lumbar total disc replacement (TDR) is an alternative to lumbar fusion in the treatment of lower back pain and reduces the risk of adjacent segment degeneration. Heterotopic ossification (HO) has been identified as a common complication following lumbar TDR.
PURPOSE
This systematic review aims to determine the prevalence, risk factors and clinical and radiological impact of HO following lumbar TDR.
STUDY DESIGN
Systematic Review.
METHODS
MEDLINE, Scopus, PubMed and Cochrane Central were searched for articles that referred to lumbar TDR and HO. The hits were assessed against inclusion and exclusion criteria. Data from each included study was extracted and analysed with respect to the study aims.
RESULTS
Twenty-six studies were included in this review and the pooled prevalence of HO was estimated to be between 13.2% (participants) and 15.3% (vertebral levels). TDR clinical outcomes were not found to be reduced by HO and there was insufficient data to identify a given impact upon radiological outcomes. Age and follow up time were identified as potential risk factors for HO.
CONCLUSIONS
This review was hampered by inconsistencies in the reporting of HO across the studies. We therefore recommend that a set of guidelines should be produced to aid future researchers and reduce the risk of bias.
Topics: Humans; Intervertebral Disc Degeneration; Low Back Pain; Lumbar Vertebrae; Lumbosacral Region; Ossification, Heterotopic; Total Disc Replacement; Treatment Outcome
PubMed: 35461244
DOI: 10.1186/s12891-022-05322-9 -
Current Reviews in Musculoskeletal... Jul 2019To assess complications after minimally invasive spinal surgeries including transforaminal lumbar interbody fusion (MI-TLIF) by reviewing the most recent literature. (Review)
Review
PURPOSE OF REVIEW
To assess complications after minimally invasive spinal surgeries including transforaminal lumbar interbody fusion (MI-TLIF) by reviewing the most recent literature.
RECENT FINDINGS
Current literature demonstrates that minimally invasive surgery (MIS) in spine has improved clinical outcomes and reduced complications when compared with open spinal procedures. Recent studies describing MI-TLIF primarily for degenerative disk disease, spondylolisthesis, and vertebral canal stenosis cite over 89 discrete complications, with the most common being radiculitis (ranging from 2.8 to 57.1%), screw malposition (0.3-12.7%), and incidental durotomy (0.3-8.6%). Minimally invasive spine surgery has a distinct set of complications in comparison with other spinal procedures. These complications vary based on the exact MIS procedure and indication. The most frequently documented MI-TLIF complications in current published literature were radiculitis, screw malposition, and incidental durotomy.
PubMed: 31302861
DOI: 10.1007/s12178-019-09574-2 -
Clinical and Experimental Dental... Feb 2024To assess which decontamination method(s) used for the debridement of titanium surfaces (disks and dental implants) contaminated with bacterial, most efficiently... (Meta-Analysis)
Meta-Analysis Review
Effectiveness of mechanical and chemical decontamination methods for the treatment of dental implant surfaces affected by peri-implantitis: A systematic review and meta-analysis.
OBJECTIVE
To assess which decontamination method(s) used for the debridement of titanium surfaces (disks and dental implants) contaminated with bacterial, most efficiently eliminate bacterial biofilms.
MATERIAL AND METHODS
A systematic search was conducted in four electronic databases between January 1, 2010 and October 31, 2022. The search strategy followed the PICOS format and included only in vitro studies completed on either dental implant or titanium disk samples. The assessed outcome variable consisted of the most effective method(s)-chemical or mechanical- removing bacterial biofilm from titanium surfaces. A meta-analysis was conducted, and data was summarized through single- and multi-level random effects model (p < .05).
RESULTS
The initial search resulted in 5260 articles after the removal of duplicates. After assessment by title, abstract, and full-text review, a total of 13 articles met the inclusion criteria for this review. Different decontamination methods were assessed, including both mechanical and chemical, with the most common method across studies being chlorhexidine (CHX). Significant heterogeneity was noted across the included studies. The meta-analyses only identified a significant difference in biofilm reduction when CHX treatment was compared against PBS. The remaining comparisons did not identify significant differences between the various decontamination methods.
CONCLUSIONS
The present results do not demonstrate that one method of decontamination is superior in eliminating bacterial biofilm from titanium disk and implant surfaces.
Topics: Humans; Peri-Implantitis; Dental Implants; Titanium; Decontamination; Chlorhexidine; Bacteria
PubMed: 38345466
DOI: 10.1002/cre2.839