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Modern Rheumatology Aug 2023The objective of this study is to provide evidence for the revision of clinical practice guidelines for the management of antineutrophil cytoplasmic antibody... (Meta-Analysis)
Meta-Analysis
Systematic review and meta-analysis for 2023 clinical practice guidelines of the Japan Research Committee of the Ministry of Health, Labour, and Welfare for Intractable Vasculitis for the management of ANCA-associated vasculitis.
OBJECTIVES
The objective of this study is to provide evidence for the revision of clinical practice guidelines for the management of antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis by the Japan Research Committee for Intractable Vasculitis.
METHODS
PubMed, CENTRAL, and the Japan Medical Abstracts Society databases were searched for articles published between 2015 and 2020 to update the systematic review for existing clinical questions, while PubMed, CENTRAL, EMBASE, and the Japan Medical Abstracts Society were searched for articles published between 2000 and 2020 to conduct a systematic review for newly developed clinical questions. The certainty of evidence was assessed with the GRADE approach.
RESULTS
For remission induction, when used in conjunction with cyclophosphamide or rituximab, reduced-dose glucocorticoid lowered the risk of serious adverse events compared to standard-dose glucocorticoid. Avacopan improved sustained remission at 12 months compared to high-dose glucocorticoid. Addition of plasma exchange to remission induction therapy did not reduce the risk of death, end-stage kidney disease, or relapse. For remission maintenance, rituximab reduced the risk of relapse compared to azathioprine. Long-term rituximab or azathioprine reduced the risk of relapse compared to short-term rituximab or azathioprine, respectively.
CONCLUSIONS
This systematic review provided evidence required to develop the 2023 clinical practice guideline for the management of ANCA-associated vasculitis.
Topics: Humans; Azathioprine; Immunosuppressive Agents; Rituximab; Glucocorticoids; Japan; Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis; Remission Induction; Antibodies, Antineutrophil Cytoplasmic; Recurrence
PubMed: 36112482
DOI: 10.1093/mr/roac114 -
The International Journal of Medical... Aug 2018Since the introduction of wearable head-up displays, there has been much interest in the surgical community adapting this technology into routine surgical practice. (Review)
Review
INTRODUCTION
Since the introduction of wearable head-up displays, there has been much interest in the surgical community adapting this technology into routine surgical practice.
METHODS
We used the keywords augmented reality OR wearable device OR head-up display AND surgery using PubMed, EBSCO, IEEE and SCOPUS databases. After exclusions, 74 published articles that evaluated the utility of wearable head-up displays in surgical settings were included in our review.
RESULTS
Across all studies, the most common use of head-up displays was in cases of live streaming from surgical microscopes, navigation, monitoring of vital signs, and display of preoperative images. The most commonly used head-up display was Google Glass. Head-up displays enhanced surgeons' operating experience; common disadvantages include limited battery life, display size and discomfort.
CONCLUSIONS
Due to ergonomic issues with dual-screen devices, augmented reality devices with the capacity to overlay images onto the surgical field will be key features of next-generation surgical head-up displays.
Topics: Computer Simulation; Equipment Design; Humans; Surgeons; Surgery, Computer-Assisted; Wearable Electronic Devices
PubMed: 29708640
DOI: 10.1002/rcs.1914 -
Medicina (Kaunas, Lithuania) Jun 2023Endoscopes are increasingly being used in middle ear surgery as an adjunct to or replacement for the operative microscope. The superior visualization of hidden areas and... (Review)
Review
Endoscopes are increasingly being used in middle ear surgery as an adjunct to or replacement for the operative microscope. The superior visualization of hidden areas and a minimally invasive transcanal approach to the pathology are some of the endoscope's advantages. The aim of this review is to compare the surgical outcomes of a totally endoscopic transcanal approach with a conventional microscopic approach for type 1 tympanoplasty in patients with chronic otitis media (COM) in order to establish if endoscopic myringoplasty (EM) could be a better alternative to microscopic myringoplasty (MM). A literature review was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis recommendations. The selected articles were identified by searching PubMed Central, PubMed, MEDLINE and Embase databases for the relevant publications. Only studies where the same surgeon in the department performed both endoscopic and microscopic myringoplasty have been included in the review. The results suggest that with an endoscopic approach, minimally invasive myringoplasty can be achieved with a similar graft success rate and postoperative air-bone gap (ABG) improvement, a shorter operative time and less postoperative complications compared to a microscopic approach.
Topics: Humans; Myringoplasty; Tympanic Membrane Perforation; Treatment Outcome; Endoscopy; Otitis Media; Chronic Disease; Retrospective Studies
PubMed: 37374278
DOI: 10.3390/medicina59061074 -
Oral Diseases Nov 2023To systematically identify and summarise current research on the utility of confocal microscopy in oral squamous cell carcinoma and oral epithelial dysplasia in oral... (Review)
Review
OBJECTIVE
To systematically identify and summarise current research on the utility of confocal microscopy in oral squamous cell carcinoma and oral epithelial dysplasia in oral potentially malignant disorders.
METHODS
Databases Medline, Embase, Evidence-Based Medicine, and Web of Science were searched with articles screened and included if their primary objective was the use of a confocal microscope in diagnosis of oral cancer or epithelial dysplasia, in vivo or ex vivo.
RESULTS AND DISCUSSION
Twenty-eight relevant studies were identified of which 21 studies included oral squamous cell carcinoma specimens. Fifteen studies included in vivo use. The studies included both qualitative and fluorescence confocal microscope and reflectance confocal microscope analysis along with quantitative analysis of carcinoma and dysplasia. Thirteen studies reported the predictive value of their confocal device in the diagnosis of dysplasia and carcinoma. The quantitative software-based studies show promise in objectifying the diagnostic process for identifying abnormalities within the microstructure of the oral mucosa.
CONCLUSIONS
There was heterogeneity in the criteria for diagnosis of dysplasia and oral squamous cell carcinoma with experience levels of assessors impacting method efficacy. Both qualitative and quantitative confocal assessment methodologies have been explored, the latter highlighting the potential of future machine-augmented diagnostic precision.
Topics: Humans; Mouth Neoplasms; Carcinoma, Squamous Cell; Squamous Cell Carcinoma of Head and Neck; Mouth Diseases; Precancerous Conditions; Microscopy, Confocal; Head and Neck Neoplasms
PubMed: 35765235
DOI: 10.1111/odi.14291 -
Malaria Journal Sep 2015An accurate estimate of Plasmodium vivax prevalence is essential for the successful implementation of malaria control and elimination programmes. Prevalence estimates... (Comparative Study)
Comparative Study Review
BACKGROUND
An accurate estimate of Plasmodium vivax prevalence is essential for the successful implementation of malaria control and elimination programmes. Prevalence estimates both inform control strategies and are used in their evaluation. Light microscopy is the main method for detecting Plasmodium parasitaemia in the peripheral blood, but compared to molecular diagnostics, such as polymerase chain reaction (PCR), has limited sensitivity.
METHODS
A systematic review and meta-analysis was conducted to assess the effect of detection method on the prevalence of P. vivax and to quantify the extent to which P. vivax infections are undetected by microscopy. Embase, Medline and the Cochrane Database were searched for studies reporting prevalence by PCR and by microscopy and that contained all of the following key words: vivax, PCR, and malaria. Prevalence estimates and study meta-data were extracted systematically from each publication. Combined microscopy:PCR prevalence ratios were estimated by random effects meta-analysis. Sensitivity and specificity of microscopy were calculated using PCR as the gold standard.
RESULTS
Of 874 studies reviewed, 40 met the criteria for inclusion contributing 54 prevalence pairs. The prevalence of P. vivax infection measured by PCR was consistently higher than the prevalence measured by microscopy with sub-patent parasitaemia. The mean prevalence of infection detected by microscopy was 67 % (95 % CI 59-73 %) lower than the prevalence detected by PCR. The detection of sub-patent parasitaemia did not vary according to the microscopy method (thick or, thick and thin smears), the PCR prevalence (as a measure of the true P. vivax prevalence), the type of blood used or DNA extraction method.
CONCLUSIONS
Quantifying P. vivax parasitaemia by PCR rather than microscopy consistently increased prevalence estimates by a factor of 2.3. Whilst the sensitivity of microscopy can be improved by better methods, molecular methods have potential to be scaled up to improve the detection of P. vivax transmission reservoirs.
Topics: Humans; Malaria, Vivax; Microscopy; Molecular Diagnostic Techniques; Prevalence; Sensitivity and Specificity
PubMed: 26390924
DOI: 10.1186/s12936-015-0884-z -
Cell Biology International Nov 2023Breast cancer is a commonly known cancer type and the leading cause of cancer death among females. One of the unresolved problems in cancer treatment is the increased... (Review)
Review
Breast cancer is a commonly known cancer type and the leading cause of cancer death among females. One of the unresolved problems in cancer treatment is the increased resistance of the tumor to existing treatments, which is a direct result of apoptotic defects. Calculating an alternative to cell death (autophagy) may be the ultimate solution to maximizing cancer cell death. Our aim in this study was to investigate the potential of free nanoparticles (un-drug-loaded) in the induction or inhibition of autophagy and consider this effect on the therapy process. When the studies met the inclusion criteria, the full texts of all relevant articles were carefully examined and classified. Of the 25 articles included in the analysis, carried out on MCF-7, MDA-MB-231, MDA-MB-231-TXSA, MDA-MB-468, SUM1315, and 4T1 cell lines. Twenty in vitro studies and five in vivo/in vitro studies applied five different autophagy tests: Acridine orange, western blot, Cyto-ID Autophagy Detection Kit, confocal microscope, and quantitative polymerase chain reaction. Nanoparticles (NPs) in the basic format, including Ag, Au, Y O , Se, ZnO, CuO, Al, Fe, vanadium pentoxide, and liposomes, were prepared in the included articles. Three behaviors of NPs related to autophagy were seen: induction, inhibition, and no action. Screened and presented data suggest that most of the involved free NPs (metallic NPs) in this systematic review had reactive oxygen species-mediated pathways with autophagy induction (36%). Also, PI3K/Akt/mTOR and MAPK/ERK signaling pathways were mentioned in just four studies (16%). An impressive percentage of studies (31%) did not examine the NP-related autophagy pathway.
PubMed: 37671447
DOI: 10.1002/cbin.12081 -
British Journal of Neurosurgery Aug 2022Augmented reality (AR) has become a promising tool in neurosurgery. It can minimise the anatomical challenges faced by conventional endoscopic or microscopic... (Review)
Review
BACKGROUND
Augmented reality (AR) has become a promising tool in neurosurgery. It can minimise the anatomical challenges faced by conventional endoscopic or microscopic transsphenoidal reoperations and can assist in intraoperative guidance, preoperative planning, and surgical training.
OBJECTIVES
The aims of this systematic review are to describe, compare, and evaluate the use of AR in endoscopic and microscopic transsphenoidal surgery, incorporating the latest primary research.
METHODS
A systematic review was performed to explore and evaluate existing primary evidence for using AR in transsphenoidal surgery. A comprehensive search of MEDLINE and EMBASE was conducted from database inception to 11th August 2021 for primary data on the use of AR in microscopic and endoscopic endonasal skull base surgery. Additional articles were identified through searches on PubMed, Google Scholar, JSTOR, SCOPUS, Web of Science, Engineering Village, IEEE transactions, and HDAS. A synthesis without meta-analysis (SWiM) analysis was employed quantitatively and qualitatively on the impact of AR on landmark identification, intraoperative navigation, accuracy, time, surgeon experience, and patient outcomes.
RESULTS
In this systematic review, 17 studies were included in the final analysis. The main findings were that AR provides a convincing improvement to landmark identification, intraoperative navigation, and surgeon experience in transsphenoidal surgery, with a further positive effect on accuracy and time. It did not demonstrate a convincing positive effect on patient outcomes. No studies reported comparative mortalities, morbidities, or cost-benefit indications.
CONCLUSION
AR-guided transsphenoidal surgery, both endoscopic and microscopic, is associated with an overall improvement in the areas of intraoperative guidance and surgeon experience as compared with their conventional counterparts. However, literature on this area, particularly comparative data and evidence, is very limited. More studies with similar methodologies and quantitative outcomes are required to perform appropriate meta-analyses and to draw significant conclusions.
Topics: Augmented Reality; Endoscopy; Humans; Neurosurgery; Neurosurgical Procedures; Surgery, Computer-Assisted
PubMed: 35393900
DOI: 10.1080/02688697.2022.2057435 -
Global Spine Journal Oct 2022Systematic Review and Meta-Analysis. (Review)
Review
STUDY DESIGN
Systematic Review and Meta-Analysis.
OBJECTIVES
Various minimally invasive surgical techniques have been developed as alternatives to conventional surgery. According to recent studies, endoscopic spinal surgery (ESS) (biportal ESS [BESS] or uniportal ESS [UESS]) is more favorable compared with microscopic spinal surgery (MSS). This systematic review and meta-analysis aimed to assess the latest evidence on the use of ESS compared with MSS in lumbar spinal stenosis.
METHODS
A systematic electronic search using PubMed, Embase, Cochrane Central Database, and Korea Med was performed until December 2019 to identify studies that compared ESS and MSS in patients with lumbar spinal stenosis.
RESULTS
Overall, 1167 patients were included from three randomized controlled trials, six retrospective cohorts, and two prospective case-control studies. This review only presented 3 direct comparative studies. The study had inherent limitations specifically in terms of the study design. Meta-analysis of hospital stay (days) showed significant difference between BESS and MSS, UESS and MSS, BESS +UESS, and MSS at the final follow-up (95% confidence interval [CI]: -3.66 to -.77; P = .003; I = 97%, 95% CI: -2.95 to -1.22; P <.00001; I = 90%, and 95% CI: -2.89 to -1.48; P <.00001; I = 96%, respectively). However, meta-analysis showed no significant difference in other results.
CONCLUSIONS
Although a shorter duration of hospital stay was observed in ESS, there were no significant differences in efficacy and safety between ESS and MSS. Further studies are required to validate these results.
PubMed: 35333105
DOI: 10.1177/21925682221083271 -
Nephrology, Dialysis, Transplantation :... Jun 2016Studies in anti-neutrophil cytoplasm antibody (ANCA)-associated vasculitis (AAV) have revealed promising biomarkers. The aim of our study was to validate the most... (Review)
Review
BACKGROUND
Studies in anti-neutrophil cytoplasm antibody (ANCA)-associated vasculitis (AAV) have revealed promising biomarkers. The aim of our study was to validate the most encouraging markers of granulomatosis with polyangiitis and microscopic polyangiitis identified by literature search and to create biomarker panels.
METHODS
A systematic literature review was performed and we identified 161 marker molecules that were ranked by their quantitative differential expression between active and inactive disease. Enzyme-linked immunosorbent assays were used to validate the results in a cross-sectional cohort of patients with renal involvement. Active vasculitis as assessed by the Birmingham Vasculitis Score version 3 (BVAS v3) was defined as BVAS v3 ≥1 and inactive disease as BVAS v3 = 0. Statistical analysis was performed with SPSS version 21 and the Salford Predictive Modeler 7.0 was used to generate a predictive biomarker panel.
RESULTS
The review indicated abundant expression of sC5bC9, C3a, C5a and monocyte chemotactic protein (MCP)-1 in urine, whereas granulocyte macrophage colony-stimulating factor, C-reactive protein (CRP), soluble fms-like tyrosine kinase-1, interleukin-17A (IL-17A), C5a, hyaluronan, C3a and interleukin-18 binding protein (IL-18BP) were identified to be highly diverse in active and inactive disease in blood samples. Our cross-sectional analysis revealed significant up-regulation of CRP, C5a, C3a, IL-18BP in blood and C5a and MCP-1 in urine samples during active AAV (all P < 0.05). Creation of a biomarker panel comprising CRP and urinary MCP-1 yielded a sensitivity and specificity of 76% (area under the curve 0.89).
CONCLUSIONS
We identified promising biomarkers in a literature-based review that were in part corroborated as has been shown for CRP, C3a, C5a, IL-18BP in blood and MCP-1 and C5a in urine samples. Moreover, we propose a biomarker panel comprising CRP and urinary MCP-1 in patients with AAV and renal involvement. Further investigations to confirm our preliminary results are clearly warranted, including the reliability to predict disease relapses.
Topics: Biomarkers; Enzyme-Linked Immunosorbent Assay; Granulomatosis with Polyangiitis; Humans; Interleukin-17; Kidney; Microscopic Polyangiitis
PubMed: 26410887
DOI: 10.1093/ndt/gfv336 -
International Journal of Molecular... Apr 2023Believed to be a rare cause of chronic diarrhoea, microscopic colitis (MC) is a condition with rising incidence. Many prevalent risk factors and the unknown pathogenesis... (Review)
Review
Believed to be a rare cause of chronic diarrhoea, microscopic colitis (MC) is a condition with rising incidence. Many prevalent risk factors and the unknown pathogenesis of MC rationalise the need for studies on microbiota composition. PubMed, Scopus, Web of Science and Embase were searched. Eight case-control studies were included. The risk of bias was assessed with the Newcastle-Ottawa Scale. Clinical details on the study population and MC were poor. The most consistent result among the studies was a decreased genus in faecal samples. Other results were inconsistent due to the different taxonomic levels of the outcomes. Possible changes in different taxa were observed in patients who suffered from MC compared to healthy controls. The alpha diversity compared between MC and the diarrhoea control may suggest potential similarities. The beta diversity in MC compared to healthy and diarrhoeal populations showed no significant outcomes. The microbiome composition in MC possibly differed from the healthy control, but no agreement regarding taxa was made. It might be relevant to focus on possible factors influencing the microbiome composition and its relationship with other diarrhoeal diseases.
Topics: Humans; Colitis, Microscopic; Diarrhea; Microbiota; Case-Control Studies; Risk Factors
PubMed: 37108189
DOI: 10.3390/ijms24087026