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BMJ Open Ophthalmology Nov 2023To explore the current research about the role of optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA) in dysthyroid optic neuropathy... (Meta-Analysis)
Meta-Analysis
PURPOSE
To explore the current research about the role of optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA) in dysthyroid optic neuropathy (DON).
METHODS
Studies in the literature that focused on OCT, OCTA and DON were retrieved by searching PubMed, EMBASE, Cochrane databases and Clinical Trial before 20 June 2023. The methodological quality was assessed using the Newcastle-Ottawa scale. The quantitative calculation was performed using Review Manager V.5.3.
RESULTS
Twelve studies met the eligibility criteria and were included. DON group presented lower macular ganglion cell complex in the overall, superior and inferior hemifields compared with the non-DON group. Furthermore, the ganglion cell layer and inner plexiform layer in DON group was thinner in contrast to the non-DON group. The optic nerve head vessel density was lower in the DON group than that in the non-DON group. A reduction of radial peripapillary capillary vessel density could be seen in the DON group than the non-DON group in overall, inside disc, peripapillary, superior-hemifield, temporal and nasal. Besides, the macular superficial retinal capillary layer of non-DON and DON is lower than the healthy control group.
CONCLUSIONS
This study supported the potential value of OCT and OCTA metrics as novel biomarkers of DON. Ophthalmologists should comprehensively consider the retinal structure and microvasculature in dealing with DON.
ETHICS AND DISSEMINATION
This systematic review included data from published literature and was exempt from ethics approval. Results would be disseminated through peer-reviewed publication and presented at academic conferences engaging clinicians.
PROSPERO REGISTRATION NUMBER
CRD42023414907.
Topics: Humans; Tomography, Optical Coherence; Optic Disk; Angiography; Retinal Ganglion Cells; Optic Nerve Diseases
PubMed: 37996119
DOI: 10.1136/bmjophth-2023-001379 -
Trauma, Violence & Abuse Jul 2023Upskirting' - the non-consensual taking and/or dissemination of intimate images taken surreptitiously up a skirt - is a relatively new addition to the repertoire of...
Upskirting' - the non-consensual taking and/or dissemination of intimate images taken surreptitiously up a skirt - is a relatively new addition to the repertoire of men's violence against women and girls. Recently, it has received considerable media and public attention in many countries and some academic scrutiny. This systematic review explicates how scholars construct upskirting as a matter for academic inquiry and a social problem that requires remedy. Four research sub-questions address how scholarship constructs: the problem of upskirting; perpetrators of upskirting; victims of upskirting, and remedies. Five bibliographical databases were searched, yielding 26 sources that met the inclusion criteria. Most of the studies (16) and most of the earlier work are from the discipline of Law. Other studies come from a combination of Criminology, Media Studies, Cultural Studies, Psychology, Social Work, Sociology, and Computing. The predominance of legal scholarship has created a framing of upskirting which constructs it as an individual sexual act, for purposes of sexual gratification, as gender-neutral, as the act of aberrant individuals, and scrutinises the act of taking the photograph. By contrast, scholarship from other disciplines is more likely to locate upskirting as highly gendered behaviour in the context of gendered relations of power, and of violence against women and girls, and to consider both the act of taking the photograph and its dissemination online. We argue that future research ought to: approach upskirting as a form of violence against women and girls; be empirical and intersectional, and engage with victims and perpetrators.
Topics: Male; Humans; Female; Sex Offenses; Sexual Behavior; Violence; Men; Sexual Partners; Intimate Partner Violence
PubMed: 35414319
DOI: 10.1177/15248380221082091 -
Platelets May 2018Disseminated intravascular coagulation (DIC) has a well-examined pathophysiology, yet some essential elements remain undetermined. During DIC, platelets play an... (Meta-Analysis)
Meta-Analysis Review
Disseminated intravascular coagulation (DIC) has a well-examined pathophysiology, yet some essential elements remain undetermined. During DIC, platelets play an important role in the development of micro thrombosis, but changes in platelet function parameters and their association with development of DIC have not been established. The present systematic review investigated reported associations between platelet function (activation, aggregation, and adhesion) and DIC. We performed a literature search in Embase and PubMed, following the Preferred Reporting Items for Systematic and Meta-Analyses (PRISMA) guidelines. In total, 22 articles were included; 14 human studies, seven animal studies, and one with both human and animal subjects. Platelet activation markers were generally reported to be higher in both DIC patients and animals with DIC than healthy controls, and higher among patients with DIC than patients without DIC. Six human and six animal studies investigated platelet aggregation, which were overall reported to be lower in DIC than in non-DIC or in healthy controls in both human and animal studies. Platelet aggregation was deemed to be confounded by low platelet counts, which are known to affect platelet aggregation analyses even within the reference interval. In conclusion, platelet activation analyses showed promise in diagnosis of DIC, but semi-automatization and standardization are warranted before these can be implemented in daily clinical practice. Changes in platelet aggregation analyses during DIC remain inconclusive, and further studies including adjustment for low platelet count are needed to clarify the role of platelet aggregation in DIC.
Topics: Animals; Biomarkers; Blood Coagulation; Blood Platelets; Disease Models, Animal; Disseminated Intravascular Coagulation; Humans; Platelet Activation; Platelet Aggregation; Platelet Function Tests; Population Surveillance
PubMed: 29517400
DOI: 10.1080/09537104.2018.1442567 -
Pathogens (Basel, Switzerland) Dec 2022, a rare, highly virulent filamentous fungus with high rates of intrinsic resistance to antifungals, has been associated with different types of infections in... (Review)
Review
BACKGROUND
, a rare, highly virulent filamentous fungus with high rates of intrinsic resistance to antifungals, has been associated with different types of infections in immunocompromised as well as immunocompetent individuals.
OBJECTIVE
To systematically address all relevant evidence regarding disseminated infections in the literature.
METHODS
We searched Medline via PubMed and Scopus databases through July 2022. We performed a qualitative synthesis of published articles reporting disseminated infections from in humans.
RESULTS
A total of 87 studies describing 142 cases were included in our systematic review. The pathogen was most frequently reported in disseminated infections in Spain (n = 47), Australia (n = 33), the USA (n = 21), and Germany (n = 10). Among 142 reported cases, 48.5% were males. Underlying conditions identified for the majority of patients included malignancy (72.5%), hemopoietic stem cell transplantation (23.2%), solid organ transplantation (16%), and AIDS (2%). Lungs, central nervous system, skin, eyes, heart and bones/joints were the most commonly affected organs. Neutropenia was recorded in 52% of patients. The mortality rate was as high as 87.3%.
CONCLUSIONS
To the best of our knowledge, this is the first systematic review conducted on disseminated infections due to this rare microorganism. Physicians should be aware that can cause a diversity of infections with high mortality and primarily affects immunocompromised and neutropenic patients.
PubMed: 36678415
DOI: 10.3390/pathogens12010067 -
Neurology, Psychiatry, and Brain... Sep 2020To describe the main neurological manifestations related to coronavirus infection in humans. (Review)
Review
OBJECTIVE
To describe the main neurological manifestations related to coronavirus infection in humans.
METHODOLOGY
A systematic review was conducted regarding clinical studies on cases that had neurological manifestations associated with COVID-19 and other coronaviruses. The search was carried out in the electronic databases PubMed, Scopus, Embase, and LILACS with the following keywords: "coronavirus" or "Sars-CoV-2" or "COVID-19" and "neurologic manifestations" or "neurological symptoms" or "meningitis" or "encephalitis" or "encephalopathy," following the Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
RESULTS
Seven studies were included. Neurological alterations after CoV infection may vary from 17.3% to 36.4% and, in the pediatric age range, encephalitis may be as frequent as respiratory disorders, affecting 11 % and 12 % of patients, respectively. The Investigation included 409 patients diagnosed with CoV infection who presented neurological symptoms, with median age range varying from 3 to 62 years. The main neurological alterations were headache (69; 16.8 %), dizziness (57, 13.9 %), altered consciousness (46; 11.2 %), vomiting (26; 6.3 %), epileptic crises (7; 1.7 %), neuralgia (5; 1.2 %), and ataxia (3; 0.7 %). The main presumed diagnoses were acute viral meningitis/encephalitis in 25 (6.1 %) patients, hypoxic encephalopathy in 23 (5.6 %) patients, acute cerebrovascular disease in 6 (1.4 %) patients, 1 (0.2 %) patient with possible acute disseminated encephalomyelitis, 1 (0.2 %) patient with acute necrotizing hemorrhagic encephalopathy, and 2 (1.4 %) patients with CoV related to Guillain-Barré syndrome.
CONCLUSION
Coronaviruses have important neurotropic potential and they cause neurological alterations that range from mild to severe. The main neurological manifestations found were headache, dizziness and altered consciousness.
PubMed: 32834527
DOI: 10.1016/j.npbr.2020.05.008 -
Critical Reviews in Oncology/hematology Mar 2016Head and neck Langerhans cell sarcoma (HNLCS) is a rare malignant tumor carrying a poor prognosis. The aim of this work was to perform a systematic review of HNLCS... (Review)
Review
Head and neck Langerhans cell sarcoma (HNLCS) is a rare malignant tumor carrying a poor prognosis. The aim of this work was to perform a systematic review of HNLCS cases, examine outcomes, and develop an evidence-based management algorithm. We performed a systematic literature search yielding 16 studies with 17 cases of HNLCS; 33 studies with 55 Non-HNLCS were used as a comparison. Mean disease-specific survival was 20.5 months (SE ± 5.1) for HNLCS versus 26.2 months (SE±4.2) for non-HNLCS. There was no significant difference in disease-specific (p = 0.768) or disease-free survival (p = 0.880) between the two cohorts. There was a significant difference in both disease-specific (p = 0.044) and disease-free survival (p = 0.001) between local, locoregional and disseminated disease favoring more limited disease. HNLCS appears to present later, with more disseminated disease. Surgery remains the mainstay of treatment of local disease, however clear margins do not guarantee clearance.
Topics: Disease Management; Head and Neck Neoplasms; Humans; Langerhans Cell Sarcoma; Prognosis
PubMed: 26777877
DOI: 10.1016/j.critrevonc.2015.12.017 -
Archives of Academic Emergency Medicine 2023Abstract. (Review)
Review
UNLABELLED
Abstract.
INTRODUCTION
Rhabdomyolysis (RM) may cause some complications such as compartment syndrome and disseminated intravascular coagulation (DIC), which can affect its prognosis. This systematic review and meta-analysis aimed to investigate the prevalence of the mentioned complications following RM.
METHODS
Medline, Embase, and Scopus databases were searched using keywords related to compartment syndrome, DIC, and rhabdomyolysis with appropriate combination. Cohort and cross-sectional studies that conducted research on the prevalence of compartment syndrome and DIC in patients with RM were included in the present study. The desired data were extracted from the included studies and meta-analysis was conducted on them to calculate pooled prevalence of these complications.
RESULTS
Twenty articles were included in our systematic review. The rate of compartment syndrome reported in these studies ranged from 0 to 30.7%. Our meta-analysis revealed the pooled prevalence of 4% (95% confidence interval (CI): 2.20 to 7.40) for compartment syndrome in these studies. The pooled prevalence of this complication was 7.1% (95% CI: 2.90 to 16.00) among patients with severe RM and 4.4% (95% CI: 1.80 to 10.00) in traumatic RM. The rate of DIC reported in the included studies ranged from 0 to 40.47%. Our meta-analysis showed the pooled prevalence of 8.3% (95% CI: 03.90 to 16.50) for this complication among RM patients.
CONCLUSION
We reported the rates of compartment syndrome and DIC in RM patients based on rhabdomyolysis etiologies through an epidemiologic systematic review and meta-analysis. The rate of compartment syndrome was slightly higher in patients with severe RM and its rate in patients with traumatic RM was close to the overall rate of compartment syndrome.
PubMed: 37671275
DOI: 10.22037/aaem.v11i1.2083 -
Neurology(R) Neuroimmunology &... Nov 2021Since the onset of the COVID-19 pandemic, a growing number of reports have described cases of acute disseminated encephalomyelitis (ADEM) and acute hemorrhagic...
BACKGROUND AND OBJECTIVES
Since the onset of the COVID-19 pandemic, a growing number of reports have described cases of acute disseminated encephalomyelitis (ADEM) and acute hemorrhagic leukoencephalitis (AHLE) following infection with COVID-19. Given their relatively rare occurrence, the primary objective of this systematic review was to synthesize their clinical features, response to treatments, and clinical outcomes to better understand the nature of this neurologic consequence of COVID-19 infection.
METHODS
Patients with a history of COVID-19 infection were included if their reports provided adequate detail to confirm a diagnosis of ADEM or AHLE by virtue of clinical features, radiographic abnormalities, and histopathologic findings. Cases purported to be secondary to vaccination against COVID-19 or occurring in the context of a preexisting relapsing CNS demyelinating disease were excluded. Case reports and series were identified via PubMed on May 17, 2021, and 4 additional cases from the authors' hospital files supplemented the systematic review of the literature. Summary statistics were used to describe variables using a complete case analysis approach.
RESULTS
Forty-six patients (28 men, median age 49.5 years, 1/3 >50 years old) were analyzed, derived from 26 case reports or series originating from 8 countries alongside 4 patient cases from the authors' hospital files. COVID-19 infection was laboratory confirmed in 91% of cases, and infection severity necessitated intensive care in 67%. ADEM occurred in 31 cases, whereas AHLE occurred in 15, with a median presenting nadir modified Rankin Scale score of 5 (bedridden). Anti-MOG seropositivity was rare (1/15 patients tested). Noninflammatory CSF was present in 30%. Hemorrhage on brain MRI was identified in 42%. Seventy percent received immunomodulatory treatments, most commonly steroids, IV immunoglobulins, or plasmapheresis. The final mRS score was ≥4 in 64% of patients with adequate follow-up information, including 32% who died.
DISCUSSION
In contrast to ADEM cases from the prepandemic era, reported post-COVID-19 ADEM and AHLE cases were often advanced in age at onset, experienced severe antecedent infection, displayed an unusually high rate of hemorrhage on neuroimaging, and routinely had poor neurologic outcomes, including a high mortality rate. Findings are limited by nonstandardized reporting of cases, truncated follow-up information, and presumed publication bias.
Topics: Brain; COVID-19; Encephalomyelitis, Acute Disseminated; Glucocorticoids; Humans; Immunoglobulins, Intravenous; Immunologic Factors; Intensive Care Units; Leukoencephalitis, Acute Hemorrhagic; Magnetic Resonance Imaging; Plasmapheresis; SARS-CoV-2; Severity of Illness Index
PubMed: 34452974
DOI: 10.1212/NXI.0000000000001080 -
Critical Care Medicine Mar 2015To evaluate the efficacy and safety of heparin in patients with sepsis, septic shock, or disseminated intravascular coagulation associated with infection. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To evaluate the efficacy and safety of heparin in patients with sepsis, septic shock, or disseminated intravascular coagulation associated with infection.
DESIGN
Systematic review and metaanalysis.
DATA SOURCES
Randomized controlled trials from MEDLINE, EMBASE, CENTRAL, Global Health, Scopus, Web of Science, the International Clinical Trials Registry Platform (inception to April 2014), conference proceedings, and reference lists of relevant articles.
STUDY SELECTION AND DATA EXTRACTION
Two reviewers independently identified and extracted trial-level data from randomized trials investigating unfractionated or low molecular heparin administered to patients with sepsis, severe sepsis, septic shock, or disseminated intravascular coagulation associated with infection. Internal validity was assessed in duplicate using the Risk of Bias tool. The strength of evidence was assessed in duplicate using Grading of Recommendations Assessment, Development, and Evaluation methodology. Our primary outcome was mortality. Safety outcomes included hemorrhage, transfusion, and thrombocytopenia.
MEASUREMENTS AND MAIN RESULTS
We included nine trials enrolling 2,637 patients. Eight trials were of unclear risk of bias and one was classified as having low risk of bias. In trials comparing heparin to placebo or usual care, the risk ratio for death associated with heparin was 0.88 (95% CI, 0.77-1.00; I2 = 0%; 2,477 patients; six trials; moderate strength of evidence). In trials comparing heparin to other anticoagulants, the risk ratio for death was 1.30 (95% CI, 0.78-2.18; I2 = 0%; 160 patients; three trials; low strength of evidence). In trials comparing heparin to placebo or usual care, major hemorrhage was not statistically significantly increased (risk ratio, 0.79; 95% CI, 0.53-1.17; I2 = 0%; 2,392 patients; three trials). In one small trial of heparin compared with other anticoagulants, the risk of major hemorrhage was significantly increased (2.14; 95% CI, 1.07-4.30; 48 patients). Important secondary and safety outcomes, including minor bleeding, were sparsely reported.
CONCLUSIONS
Heparin in patients with sepsis, septic shock, and disseminated intravascular coagulation associated with infection may be associated with decreased mortality; however, the overall impact remains uncertain. Safety outcomes have been underreported and require further study. Increased major bleeding with heparin administration cannot be excluded. Large rigorous randomized trials are needed to evaluate more carefully the efficacy and safety of heparin in patients with sepsis, severe sepsis, and septic shock.
Topics: Anticoagulants; Blood Transfusion; Disseminated Intravascular Coagulation; Hemorrhage; Heparin; Heparin, Low-Molecular-Weight; Humans; Randomized Controlled Trials as Topic; Sepsis; Shock, Septic; Thrombocytopenia
PubMed: 25493972
DOI: 10.1097/CCM.0000000000000763 -
Mycoses Oct 2023Sporotrichosis is a subcutaneous mycosis caused by a dimorphic fungus belonging to the genus Sporothrix. This fungal infection can affect both humans and domestic... (Review)
Review
Sporotrichosis is a subcutaneous mycosis caused by a dimorphic fungus belonging to the genus Sporothrix. This fungal infection can affect both humans and domestic animals, and in recent years, an increase in the geographic spread and prevalence of sporotrichosis has been observed globally. This systematic review aimed to examine the clinical-epidemiological and therapeutic aspects related to sporotrichosis co-infection with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS). An extensive electronic search was conducted on databases including PubMed, Web of Science, Lilacs, Medline, Embase, Scopus and SciELO was performed to identify clinical cases of people living with HIV (PLWH) with sporotrichosis published until May 2023. As a result, we found that most co-infected patients were male, representing 71.76% (94/131) of cases. The most prevalent age group was 41-50 years, with a mean age of 36.98 years. The countries with the highest number of cases were Brazil (75.57%, 99/131) and the United States (16.03%, 21/131). The most frequent clinical presentation was systemic dissemination, accounting for 69.47% (91/131) of the cases, followed by cutaneous dissemination with 13% (17/131). The mean CD4 cell count was 154.07 cells/μL, and most patients used amphotericin B with at least one azole, which represented 47.33% (62/131) of cases, followed by azole monotherapy in 17.56% (23/131) of cases. As for the outcome, 51.15% (67/131) of the patients remained alive, and 37.4% (49/131) died. Therefore, it was concluded that sporotrichosis in PLWH is a disease with a high prevalence in Brazil and may be associated with systemic clinical manifestations requiring longer periods of systemic antifungal therapy.
Topics: Animals; Humans; Male; Adult; Middle Aged; Female; Sporotrichosis; Acquired Immunodeficiency Syndrome; HIV; Coinfection; Antifungal Agents; Sporothrix; Azoles; Brazil
PubMed: 37376902
DOI: 10.1111/myc.13627