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Journal of Neuroimaging : Official... May 2022Angiocentric gliomas (AGs) are epileptogenic low-grade gliomas in young patients. We aimed to investigate the MRI findings of AGs and systematically review previous... (Review)
Review
BACKGROUND AND PURPOSE
Angiocentric gliomas (AGs) are epileptogenic low-grade gliomas in young patients. We aimed to investigate the MRI findings of AGs and systematically review previous publications and three new cases.
METHODS
We searched PubMed, Elsevier's abstract and citation database, and Embase databases and included 50 patients with pathologically proven AGs with analyzable preoperative MRI including 3 patients from our institution and 47 patients from 38 publications (median age, 13 years [range, 2-83 years]; 35 men). Two board-certified radiologists reviewed all images. The relationships between seizure/epilepsy history and MRI findings were statistically analyzed. Moreover, clinical and imaging differences were evaluated between supratentorial and brainstem AGs.
RESULTS
Intratumoral T1-weighted high-intensity areas, stalk-like signs, and regional brain parenchymal atrophy were observed in 23 out of 50 (46.0%), 10 out of 50 (20.0%), and 14 out of 50 (28.0%) patients, respectively. Intratumoral T1-weighted high-intensity areas were observed significantly more frequently in patients with stalk-like signs (positive, 9/10 vs. negative, 14/40, p = .0031) and regional atrophy (13/14 vs. 10/36, p = .0001). There were significant relationships between the length of seizure/epilepsy history and presence of intratumoral T1-weighted high-intensity area (median 3 years vs. 0.5 years, p = .0021), stalk-like sign (13.5 vs. 1 year, p < .0001), and regional atrophy (14 vs. 0.5 years, p < .0001). Patients with brainstem AGs (n = 7) did not have a seizure/epilepsy history and were significantly younger than those with supratentorial AGs (median, 5 vs. 13 years, p < .0001, respectively).
CONCLUSIONS
Intratumoral T1-weighted high-intensity areas, stalk-like signs, and regional brain atrophy were frequent imaging features in AG. We also found that affected age was different between supratentorial and brainstem AGs.
Topics: Adolescent; Atrophy; Brain Neoplasms; Female; Glioma; Humans; Magnetic Resonance Imaging; Male; Neuroimaging; Seizures
PubMed: 35201652
DOI: 10.1111/jon.12983 -
Journal of Hand Therapy : Official... 2017Systematic review. (Review)
Review
STUDY DESIGN
Systematic review.
INTRODUCTION
It is accepted that the etiology of carpal tunnel syndrome (CTS) is multifactorial. One of the most commonly accepted etiologic factors for CTS is compromise of the kinematic behavior and excursion of the median nerve.
PURPOSE OF THE STUDY
The objective of this systematic review was to establish if there is a relationship between impaired median nerve excursion and CTS.
METHODS
A systematic review, following the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines, was conducted. Studies were sought where in vivo median nerve excursion was compared between people with CTS to an appropriate control group. Quality appraisal for each study was conducted using the Newcastle-Ottawa Scale by 2 independent evaluators.
RESULTS
Ten case-control studies using ultrasound imaging to quantify median nerve excursion were included. All studies were rated as of "moderate" methodologic quality having scored 6 or 7 (of 9 stars) for the Newcastle-Ottawa Scale. Seven of the 10 studies concluded that median nerve excursion was reduced in a CTS population when compared with controls.
CONCLUSION
The literature suggests that median nerve excursion is reduced in people with CTS when compared with healthy controls.
LEVEL OF EVIDENCE
3a.
Topics: Carpal Tunnel Syndrome; Humans; Median Nerve; Motion
PubMed: 27692791
DOI: 10.1016/j.jht.2016.09.002 -
Hernia : the Journal of Hernias and... Dec 2021Preoperative progressive pneumoperitoneum (PPP) is a technique that has been used since 1947 to expand the abdominal cavity volume, for presurgical preparation of... (Review)
Review
INTRODUCTION
Preoperative progressive pneumoperitoneum (PPP) is a technique that has been used since 1947 to expand the abdominal cavity volume, for presurgical preparation of patients with large hernias. This systematic review attempts to answer some unresolved questions about PPP, while using the evidence to clarify the different forms that the procedure has taken over time.
PURPOSE
The purpose of the paper was to analyze the literature about PPP and gather information about the procedure and its indications, advantages, and disadvantages.
METHODS
A systematic review was carried out according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria. The database searches, in English and Spanish, were made using the terms "preoperative pneumoperitoneum," "progressive pneumoperitoneum," "preoperative pneumoperitoneum," and "progressive pneumoperitoneum," for the period between 1 January 1940 and 31 May 2019. Indications, techniques, results, and complications were registered. The statistical analysis was based on means, standard deviations, medians, mode, and interquartile ranges for quantitative variables, and frequencies and percentages for categories.
RESULTS
The qualitative synthesis was made on the basis of 53 articles that reported the treatment of a total of 1216 patients. The most frequent indication for PPP was a large incisional hernia with loss of domain. The most common technique employed a spinal needle or multipurpose catheter by the anatomical method in the left hypochondrium. In spite of the heterogeneity of the data and the management of different volumes of air and daily insufflations, 99.6% of visceral reintroduction and 86% of primary fascial closure was achieved. Complications had an incidence of 12%, mostly minor, and there were five mortalities.
CONCLUSION
Preoperative progressive pneumoperitoneum (PPP) is a beneficial and safe technique to use in preparing patients with large hernias, but the procedure is not free of complications. The technique has evolved through the years and, although many variations exist, it is possible to establish an algorithm for its application.
Topics: Hernia, Ventral; Herniorrhaphy; Humans; Incisional Hernia; Insufflation; Pneumoperitoneum; Pneumoperitoneum, Artificial; Preoperative Care
PubMed: 32519198
DOI: 10.1007/s10029-020-02247-x -
HPB : the Official Journal of the... Oct 2015To review the evidence on the safety and efficacy of hepatopancreatoduodenectomy for biliary and gallbladder cancers. (Review)
Review
OBJECTIVES
To review the evidence on the safety and efficacy of hepatopancreatoduodenectomy for biliary and gallbladder cancers.
METHODS
Medline and EMBASE were systematically searched for papers describing hepatopancreatoduodenectomy in patients with biliary and gallbladder cancers.
RESULTS
Eighteen studies involving 397 patients were reviewed. A major hepatectomy was undertaken in 81.3% of the 397 patients, and the R0 resection rate was 71.3%. The morbidity and mortality rates were 78.9% and 10.3%, respectively. The 5-year overall survival rate ranged from 3% to 50% (median = 31%). The 5-year survival rate in patients who underwent a curative resection was 18-68.8% (median = 51.3%), and 0% in patients who received a non-curative resection.
CONCLUSIONS
A hepatopancreatoduodenectomy is a challenging procedure with high morbidity and mortality rates. However, this procedure can provide a chance of long-term survival in patients in whom a curative resection is feasible.
PubMed: 26507924
DOI: 10.1111/hpb.12511 -
Annals of Medicine and Surgery (2012) Mar 2024Hepatic angiosarcoma is a rare type of tumour. In adults, the diagnosis remains challenging as the clinical manifestations are generally nonspecific and are usually made... (Review)
Review
BACKGROUND
Hepatic angiosarcoma is a rare type of tumour. In adults, the diagnosis remains challenging as the clinical manifestations are generally nonspecific and are usually made too late when complications or metastases are already present, associated with a poor prognosis. Due to the lack of agreement regarding the optimal treatment approach, a comprehensive analysis of the evidence in the literature on the surgical and survival outcomes in terms of disease-free survival time (DFS) and overall survival (OS) for patients treated for primary hepatic angiosarcoma is needed.
STUDY DESIGN
A systematic review of articles published in Pubmed, EMBASE, and Scopus, from 2000 to 2023 with the search terms hepatic angiosarcoma and liver resection or hepatectomy. Pooled individual data concerning the prognosis following various therapies was analyzed.
RESULTS
A total of 15 articles involving 886 patients were eligible for inclusion. The male population represents 66.2% (=586) of the population, with a median age of 57 years (41-66). The median survival rate was 7 months. The median OS after surgical resection was 17.18 months (SD 12.6) vs. 3.72 months (SD 4.6) for patients treated without a surgical approach. The median DFS was 15.2 months (SD 11).
CONCLUSION
Primary liver angiosarcoma remains a surgical challenge with a poor prognosis even with complete surgical resection and adjuvant therapy. Surgical management shows increased overall survival in comparison with non-surgical management. Early diagnosis could change the natural history of the disease. The literature available is scarce, and further studies are required to create standardized diagnostic and treatment protocols.
PubMed: 38463049
DOI: 10.1097/MS9.0000000000001584 -
Journal of Epidemiology and Community... Aug 2017Public sector austerity measures in many high-income countries mean that public health budgets are reducing year on year. To help inform the potential impact of these... (Review)
Review
BACKGROUND
Public sector austerity measures in many high-income countries mean that public health budgets are reducing year on year. To help inform the potential impact of these proposed disinvestments in public health, we set out to determine the return on investment (ROI) from a range of existing public health interventions.
METHODS
We conducted systematic searches on all relevant databases (including MEDLINE; EMBASE; CINAHL; AMED; PubMed, Cochrane and Scopus) to identify studies that calculated a ROI or cost-benefit ratio (CBR) for public health interventions in high-income countries.
RESULTS
We identified 2957 titles, and included 52 studies. The median ROI for public health interventions was 14.3 to 1, and median CBR was 8.3. The median ROI for all 29 local public health interventions was 4.1 to 1, and median CBR was 10.3. Even larger benefits were reported in 28 studies analysing nationwide public health interventions; the median ROI was 27.2, and median CBR was 17.5.
CONCLUSIONS
This systematic review suggests that local and national public health interventions are highly cost-saving. Cuts to public health budgets in high income countries therefore represent a false economy, and are likely to generate billions of pounds of additional costs to health services and the wider economy.
Topics: Health Promotion; Public Health
PubMed: 28356325
DOI: 10.1136/jech-2016-208141 -
Drugs - Real World Outcomes Mar 2018Medication errors and adverse drug events are universal problems contributing to patient harm but the magnitude of these problems in Africa remains unclear. (Review)
Review
BACKGROUND
Medication errors and adverse drug events are universal problems contributing to patient harm but the magnitude of these problems in Africa remains unclear.
OBJECTIVE
The objective of this study was to systematically investigate the literature on the extent of medication errors and adverse drug events, and the factors contributing to medication errors in African hospitals.
METHODS
We searched PubMed, MEDLINE, EMBASE, Web of Science and Global Health databases from inception to 31 August, 2017 and hand searched the reference lists of included studies. Original research studies of any design published in English that investigated adverse drug events and/or medication errors in any patient population in the hospital setting in Africa were included. Descriptive statistics including median and interquartile range were presented.
RESULTS
Fifty-one studies were included; of these, 33 focused on medication errors, 15 on adverse drug events, and three studies focused on medication errors and adverse drug events. These studies were conducted in nine (of the 54) African countries. In any patient population, the median (interquartile range) percentage of patients reported to have experienced any suspected adverse drug event at hospital admission was 8.4% (4.5-20.1%), while adverse drug events causing admission were reported in 2.8% (0.7-6.4%) of patients but it was reported that a median of 43.5% (20.0-47.0%) of the adverse drug events were deemed preventable. Similarly, the median mortality rate attributed to adverse drug events was reported to be 0.1% (interquartile range 0.0-0.3%). The most commonly reported types of medication errors were prescribing errors, occurring in a median of 57.4% (interquartile range 22.8-72.8%) of all prescriptions and a median of 15.5% (interquartile range 7.5-50.6%) of the prescriptions evaluated had dosing problems. Major contributing factors for medication errors reported in these studies were individual practitioner factors (e.g. fatigue and inadequate knowledge/training) and environmental factors, such as workplace distraction and high workload.
CONCLUSION
Medication errors in the African healthcare setting are relatively common, and the impact of adverse drug events is substantial but many are preventable. This review supports the design and implementation of preventative strategies targeting the most likely contributing factors.
PubMed: 29138993
DOI: 10.1007/s40801-017-0125-6 -
Frontiers in Endocrinology 2023Hypoglycemia is a sporadic and serious adverse reaction of trimethoprim-sulfamethoxazole (TMP-SMX) due to its sulfonylurea-like effect. This study explored the clinical...
OBJECTIVE
Hypoglycemia is a sporadic and serious adverse reaction of trimethoprim-sulfamethoxazole (TMP-SMX) due to its sulfonylurea-like effect. This study explored the clinical characteristics, risk factors, treatment, and prognosis of TMP-SMX-induced hypoglycemia.
METHODS
Case reports and series of TMP-SMX-induced hypoglycemia were systematically searched using Chinese and English databases. Primary patient and clinical information were extracted for analysis.
RESULTS
A total of 34 patients were reported from 31 studies (16 males and 18 females). The patients had a median age of 64 years (range 0.4-91), and 75.8% had renal dysfunction. The median duration of a hypoglycemic episode was six days (range 1-20), and the median minimum glucose was 28.8 mg/dL (range 12-60). Thirty-two patients (97.0%) showed neuroglycopenic symptoms, with consciousness disturbance (30.3%) and seizure (24.2%), sweating (18.2%), confusion (15.2%), asthenia (12.1%) being the most common symptoms. Fifteen patients (44.1%) had elevated serum insulin levels, with a median of 31.8 μU/mL (range 3-115.3). C-peptide increased in 13 patients (38.2%), with a median of 7.7 ng/mL (range 2.2-20). Complete recovery from symptoms occurred in 88.2% of patients without sequelae. The duration of hypoglycemia symptoms was 8 hours to 47 days after the intervention. Interventions included discontinuation of TMP-SMX, intravenous glucose, glucagon, and octreotide.
CONCLUSION
Hypoglycemia is a rare and serious adverse effect of TMP-SMX. Physicians should be aware of this potential adverse effect, especially in patients with renal insufficiency, increased drug doses, and malnutrition.
Topics: Male; Female; Humans; Infant; Child, Preschool; Child; Adolescent; Young Adult; Adult; Middle Aged; Aged; Aged, 80 and over; Trimethoprim, Sulfamethoxazole Drug Combination; Risk Factors; Hypoglycemia; Renal Insufficiency; Glucose
PubMed: 36843590
DOI: 10.3389/fendo.2023.1059522 -
Clinical Microbiology and Infection :... Aug 2022Many postmortem studies address the cardiovascular effects of COVID-19 and provide valuable information, but are limited by their small sample size. (Review)
Review
BACKGROUND
Many postmortem studies address the cardiovascular effects of COVID-19 and provide valuable information, but are limited by their small sample size.
OBJECTIVES
The aim of this systematic review is to better understand the various aspects of the cardiovascular complications of COVID-19 by pooling data from a large number of autopsy studies.
DATA SOURCES
We searched the online databases Ovid EBM Reviews, Ovid Embase, Ovid Medline, Scopus, and Web of Science for concepts of autopsy or histopathology combined with COVID-19, published between database inception and February 2021. We also searched for unpublished manuscripts using the medRxiv services operated by Cold Spring Harbor Laboratory.
STUDY ELIGIBILITY CRITERIA
Articles were considered eligible for inclusion if they reported human postmortem cardiovascular findings among individuals with a confirmed SARS coronavirus type 2 (CoV-2) infection.
PARTICIPANTS
Confirmed COVID-19 patients with post-mortem cardiovascular findings.
INTERVENTIONS
None.
METHODS
Studies were individually assessed for risk of selection, detection, and reporting biases. The median prevalence of different autopsy findings with associated interquartile ranges (IQRs).
RESULTS
This review cohort contained 50 studies including 548 hearts. The median age of the deceased was 69 years. The most prevalent acute cardiovascular findings were myocardial necrosis (median: 100.0%; IQR, 20%-100%; number of studies = 9; number of patients = 64) and myocardial oedema (median: 55.5%; IQR, 19.5%-92.5%; number of studies = 4; number of patients = 46). The median reported prevalence of extensive, focal active, and multifocal myocarditis were all 0.0%. The most prevalent chronic changes were myocyte hypertrophy (median: 69.0%; IQR, 46.8%-92.1%) and fibrosis (median: 35.0%; IQR, 35.0%-90.5%). SARS-CoV-2 was detected in the myocardium with median prevalence of 60.8% (IQR 40.4-95.6%).
CONCLUSIONS
Our systematic review confirmed the high prevalence of acute and chronic cardiac pathologies in COVID-19 and SARS-CoV-2 cardiac tropism, as well as the low prevalence of myocarditis in COVID-19.
Topics: Aged; Autopsy; COVID-19; Humans; Lung; Myocarditis; SARS-CoV-2
PubMed: 35339672
DOI: 10.1016/j.cmi.2022.03.021 -
Food & Function Jan 2023Anthocyanins have multiple health benefits. However, they are prone to degradation during gastrointestinal digestion, impeding their utilization. Various encapsulation... (Meta-Analysis)
Meta-Analysis Review
Anthocyanins have multiple health benefits. However, they are prone to degradation during gastrointestinal digestion, impeding their utilization. Various encapsulation systems have been proposed to improve their bioaccessibility and bioavailability. This review aims to provide a systematic evaluation and meta-analysis of published studies examining the effect of microencapsulation on the bioaccessibility of anthocyanins. A comprehensive and systematic literature search of three databases (Scopus, PubMed, and Web of Science) was conducted. Studies were selected according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria and were reviewed independently by two investigators. Overall, 34 articles were included in the systematic review and 24 were included in the meta-analysis. The fold changes in bioaccessibility between encapsulated and non-encapsulated anthocyanins from eligible studies were calculated. The median and 95% confidence intervals (CI) of the fold changes for spray-drying (median 1.23, 95% CI 0.91-1.92), freeze-drying (median 1.19, 95% CI 0.61-1.28), simple coacervation (median 1.80, 95% CI 1.41-3.20), and complex coacervation (median 1.61, 95% CI 0.21-25.00) were calculated. Simple coacervation showed a promising protection against degradation during digestion. However, when a large number of anthocyanins cannot be released from the microparticles during digestion, encapsulation impedes the bioaccessibility of anthocyanins.
Topics: Anthocyanins; Biological Availability; Freeze Drying
PubMed: 36594512
DOI: 10.1039/d2fo01997c