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British Medical Bulletin Jun 2023Chronic low back pain, common from the sixth decade, negatively impacts the quality of life of patients and health care systems. Recently, mesenchymal stem cells (MSCs)...
BACKGROUND
Chronic low back pain, common from the sixth decade, negatively impacts the quality of life of patients and health care systems. Recently, mesenchymal stem cells (MSCs) have been introduced in the management of degenerative discogenic pain. The present study summarizes the current knowledge on the effectiveness of MSCs in patients with discogenic back pain.
SOURCES OF DATA
We performed a systematic review of the literature following the PRISMA guidelines. We searched PubMed and Google Scholar database, and identified 14 articles about management of chronic low back pain with MSCs injection therapy. We recorded information on type of stem cells employed, culture medium, clinical scores and MRI outcomes.
AREAS OF AGREEMENT
We identified a total of 303 patients. Ten studies used bone marrow stem cells. In the other four studies, different stem cells were used (of adipose, umbilical, or chondrocytic origin and a pre-packaged product). The most commonly used scores were Visual Analogue Scale and Oswestry Disability Index.
AREAS OF CONTROVERSY
There are few studies with many missing data.
GROWING POINTS
The studies analysed demonstrate that intradiscal injections of MSCs are effective on discogenic low-back pain. This effect may result from inhibition of nociceptors, reduction of catabolism and repair of injured or degenerated tissues.
AREAS TIMELY FOR DEVELOPING RESEARCH
Further research should define the most effective procedure, trying to standardize a single method.
Topics: Humans; Low Back Pain; Quality of Life; Treatment Outcome; Mesenchymal Stem Cells; Magnetic Resonance Imaging
PubMed: 37164906
DOI: 10.1093/bmb/ldad008 -
PloS One 2016The main purpose of the present meta-analysis was to examine the criterion-related validity of the distance- and time-based walk/run tests for estimating... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
The main purpose of the present meta-analysis was to examine the criterion-related validity of the distance- and time-based walk/run tests for estimating cardiorespiratory fitness among apparently healthy children and adults.
MATERIALS AND METHODS
Relevant studies were searched from seven electronic bibliographic databases up to August 2015 and through other sources. The Hunter-Schmidt's psychometric meta-analysis approach was conducted to estimate the population criterion-related validity of the following walk/run tests: 5,000 m, 3 miles, 2 miles, 3,000 m, 1.5 miles, 1 mile, 1,000 m, ½ mile, 600 m, 600 yd, ¼ mile, 15 min, 12 min, 9 min, and 6 min.
RESULTS
From the 123 included studies, a total of 200 correlation values were analyzed. The overall results showed that the criterion-related validity of the walk/run tests for estimating maximum oxygen uptake ranged from low to moderate (rp = 0.42-0.79), with the 1.5 mile (rp = 0.79, 0.73-0.85) and 12 min walk/run tests (rp = 0.78, 0.72-0.83) having the higher criterion-related validity for distance- and time-based field tests, respectively. The present meta-analysis also showed that sex, age and maximum oxygen uptake level do not seem to affect the criterion-related validity of the walk/run tests.
CONCLUSIONS
When the evaluation of an individual's maximum oxygen uptake attained during a laboratory test is not feasible, the 1.5 mile and 12 min walk/run tests represent useful alternatives for estimating cardiorespiratory fitness. As in the assessment with any physical fitness field test, evaluators must be aware that the performance score of the walk/run field tests is simply an estimation and not a direct measure of cardiorespiratory fitness.
Topics: Adult; Child; Exercise Test; Health Status; Humans; Oxygen Consumption; Physical Fitness; Running; Walking
PubMed: 26987118
DOI: 10.1371/journal.pone.0151671 -
British Medical Bulletin Mar 2021In osteonecrosis of the femoral head (ONFH), blood supply is insufficient for the metabolic requirements of the bone. The initial management is conservative, and, in...
BACKGROUND
In osteonecrosis of the femoral head (ONFH), blood supply is insufficient for the metabolic requirements of the bone. The initial management is conservative, and, in case of failure, surgery is indicated. Osteotomies aim to change the spatial position of the necrotic portion of the femoral head. This systematic review evaluates the effectiveness and safety of osteotomies for ONFH.
SOURCE OF DATA
The systematic review, organized, conducted and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, was performed on PubMed and Google Scholar. We analysed outcomes in term of Harris Hip Score, leg shortening, secondary collapse and blood loss. We also verified the percentage of patients who required total hip replacement (THR) after osteotomy for ONFH.
AREAS OF AGREEMENT
A total of 16 articles were selected, including 775 patients and 852 osteotomies [curved varus osteotomy in 369 (43.3%) patients; transtrochanteric rotational osteotomy in 435 (51.05%) patients; half wedge osteotomy in 48 (5.6%) patients]. There was an overall THR conversion rate of 31.5% (268 hips on 852 osteotomies).
AREAS OF CONTROVERSY
There were no prospective randomized trials, and the outcome measures employed were often heterogeneous.
GROWING POINTS
Approximately one-third of the osteotomies performed in cases of ONFH are converted to THR over a period of ~7 years. In older patients, primary THR should be considered, especially as the conversion to THR after osteotomy is technically demanding.
AREAS TIMELY FOR DEVELOPING RESEARCH
Randomized clinical studies should be conducted in order to define the parameters of the patient that can direct towards the most suitable osteotomic technique.
Topics: Aged; Arthroplasty, Replacement, Hip; Femur Head; Femur Head Necrosis; Humans; Osteotomy; Treatment Outcome
PubMed: 33454780
DOI: 10.1093/bmb/ldaa044 -
British Medical Bulletin 2015Theoretical advantages of endoscopic cubital tunnel release are the short incision, lower risk of nerve damage, reduced manipulation of the nerve and possible faster... (Review)
Review
INTRODUCTION
Theoretical advantages of endoscopic cubital tunnel release are the short incision, lower risk of nerve damage, reduced manipulation of the nerve and possible faster recovery.
SOURCES OF DATA
We systematically searched Medline (PubMed), Web of Science and Scopus databases using the following keywords: 'endoscopic ulnar nerve', 'endoscopic cubital nerve', 'endoscopic ulnar compression' and 'endoscopic ulnar neuropathy'. Twenty-one studies were included in this review. The quality of the studies was assessed using the Coleman Methodological Score.
AREAS OF AGREEMENT
Endoscopic release is effective for cubital tunnel entrapment and allows adequate visualization of the site of entrapment. There is a negative association between the severity of the compression and reported outcomes. Injury to the medial branch of the antebrachial cutaneous nerve is less frequent thanks to the limited dissection. The most frequent complication is the development of a hematoma.
AREAS OF CONTROVERSY
It is unclear whether ulnar nerve instability is a contraindication to simple decompression.
GROWING POINTS
The shorter time to return to work and the cosmetic appearance of the scar can be considered advantages of the endoscopic technique.
AREAS TIMELY FOR DEVELOPING RESEARCH
There is a need to perform randomized clinical trials with common and validated scoring system with a longer duration of follow-up. The literature pertinent to endoscopic cubital tunnel release is lacking in the evaluation of the learning curve. Further investigations are necessary to assess the role of ulnar nerve instability.
Topics: Cubital Tunnel Syndrome; Decompression, Surgical; Humans; Neuroendoscopy; Neurosurgical Procedures; Treatment Outcome
PubMed: 26608457
DOI: 10.1093/bmb/ldv049 -
International Journal of Environmental... Jun 2023Currently, a high percentage of children globally fail to meet the World Health Organisation's (WHO) recommended daily physical activity (PA) guidelines. The Daily Mile... (Review)
Review
Currently, a high percentage of children globally fail to meet the World Health Organisation's (WHO) recommended daily physical activity (PA) guidelines. The Daily Mile (TDM) is a school-based PA initiative, designed to improve primary school children's PA behaviour. The purpose of this review was to evaluate the extant TDM implementation process and identify its impact on health-related metrics. Three databases were used to search for articles from the time TDM originated in 2012 until February 2022. The identification and screening process of articles for their ability to meet this review's eligibility criteria were facilitated by use of PRISMA and Rayyan. Sixteen articles from the initial search (n = 202) were deemed eligible for inclusion. An analysis of these articles identified five common outcome categories that permeated throughout the research articles: (1) cardiorespiratory fitness (CRF); (2) anthropometry and body composition; (3) PA; (4) cognition; and (5) process evaluation. Results presented from the included articles suggests TDM positively impacts markers of a variety of health-related metrics, namely CRF and PA. However, implementation barriers including TDM's repetitive nature, time constraints associated with competing curriculum demands and inadequate facilities regularly necessitate the adaptation and development of the original TDM format by schools and teachers.
Topics: Child; Humans; Child Health; School Health Services; Exercise; Motor Activity; Cognition
PubMed: 37444051
DOI: 10.3390/ijerph20136203 -
International Journal of Infectious... Aug 2018Historically, semi-closed populations have had high rates of meningococcal carriage and have experienced recurrent outbreaks. As such, these high-risk groups are... (Review)
Review
BACKGROUND
Historically, semi-closed populations have had high rates of meningococcal carriage and have experienced recurrent outbreaks. As such, these high-risk groups are recommended for targeted vaccination in many countries.
METHODS
A systematic review of eight databases and Google Scholar forward citations was conducted to characterize serogroup-specific meningococcal carriage in university students, military personnel, and Hajj pilgrims from 2007 to 2016.
RESULTS
A total of 7014 records were identified and 22 studies were included. Overall carriage ranged from 0.0% to 27.4% in Hajj pilgrims, from 1.5% to 71.1% in university students, and from 4.2% to 15.2% in military personnel. Among serogroups A, B, C, W, X, and Y, serogroup B was most prevalent in Hajj pilgrims, B and Y in university students, and B, C, and Y in military personnel. 'Other' serogroups were more prevalent in university students than Hajj pilgrims or military personnel. Risk factors for carriage varied by setting. Among Hajj pilgrims, a high endemicity in the country of origin increased the risk of carriage, while smoking, male sex, and frequently attending parties increased the carriage risk for university students. Similarly, smoking increased the carriage risk for professional soldiers. Data gaps remain for many regions.
CONCLUSIONS
Preventative vaccination policies for high-risk groups should be based on current disease data in individual countries, supplemented by carriage data. Meningococcal carriage studies and disease surveillance are critical for determining the local epidemiology, populations responsible for disease transmission, and the need for targeted vaccination.
Topics: Carrier State; Female; Humans; Male; Meningococcal Infections; Military Personnel; Prevalence; Vaccination
PubMed: 29997031
DOI: 10.1016/j.ijid.2018.05.022 -
The Surgeon : Journal of the Royal... Oct 2021The knowledge of the anatomy and biomechanics of patellar stabilizers is mandatory to achieve good clinical results with surgical reconstructive procedures. Few articles... (Review)
Review
BACKGROUND
The knowledge of the anatomy and biomechanics of patellar stabilizers is mandatory to achieve good clinical results with surgical reconstructive procedures. Few articles provide clear anatomical and biomechanical picture of medial patello-tibial ligament (MPTL).
METHODS
After a systematic review of the literature we selected in vivo or ex vivo studies providing anatomical or biomechanical measurements. We included 7 studies about MPTL anatomy for a total of 96 knees and 4 biomechanical studies.
RESULTS
The MPTL is a true ligament and important component of the medial patellar stabilizers, together with the medial patello-femoral ligament (MPFL) and medial patello-meniscal ligament. The contribution of MPTL on restriction forces of the patello-femoral joint is still unclear. Quadriceps, patellar, semitendinous and gracilis tendons are adequate grafts for surgical MPTL reconstruction.
CONCLUSIONS
MPTL is a well defined anathomical structure and histologically can be considered a ligament. It plays an important role in patellar stability especially it has a main role on patellar rotation and tilt instead on shift.
Topics: Biomechanical Phenomena; Humans; Joint Instability; Ligaments, Articular; Patella; Patellar Dislocation; Plastic Surgery Procedures
PubMed: 33121878
DOI: 10.1016/j.surge.2020.09.005 -
Cardiovascular and Interventional... May 2016Subclavian artery occlusive disease (SAOD) is often associated with cerebrovascular symptoms such as subclavian steal syndrome and stroke. We conducted a systematic... (Comparative Study)
Comparative Study Meta-Analysis Review
BACKGROUND AND PURPOSE
Subclavian artery occlusive disease (SAOD) is often associated with cerebrovascular symptoms such as subclavian steal syndrome and stroke. We conducted a systematic review and meta-analysis to compare percutaneous transluminal angioplasty (PTA) and stent placement for the treatment of SAOD.
MATERIALS AND METHODS
We searched Medline, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and Scopus through October 16, 2014. From each study, we abstracted baseline patient characteristics, study design variables, and outcome data including rates of technical success, primary patency (≤2 and >2 years follow-up), symptom resolution, and complications. Meta-analysis was performed using a random-effects model.
RESULTS
A total of 35 non-comparative studies with 1726 patients were included. Technical success rate was significantly higher in the stent group than the PTA group (92.8 vs 86.8%, p = 0.007). Long-term primary patency rates (76.9 vs 79.6%, p = 0.729) and symptom resolution rates (82.2 vs 73.0%, p = 0.327) were not statistically different. There was no statistically significant difference in the rates of stroke or death.
CONCLUSION
Stent placement for treatment of SAOD may be associated with higher rates of technical success but similar rates of symptom resolution and long-term outcomes. The confidence in the available estimates is low. Further comparative studies are needed to guide patients and clinicians in shared decision making.
Topics: Angioplasty; Arterial Occlusive Diseases; Blood Vessel Prosthesis Implantation; Humans; Stents; Stroke; Subclavian Artery; Subclavian Steal Syndrome
PubMed: 26630966
DOI: 10.1007/s00270-015-1250-9 -
The Surgeon : Journal of the Royal... Oct 2022The present systematic review investigated return to sport, patient reported outcome measures (PROMs), complications and subsequent progression to total hip arthroplasty... (Review)
Review
BACKGROUND
The present systematic review investigated return to sport, patient reported outcome measures (PROMs), complications and subsequent progression to total hip arthroplasty (THA) in patients undergoing arthroscopic labral repair for FAI.
MATERIAL AND METHODS
Following the PRISMA statement, the literature search was performed in February 2021. The outcomes of interest were: rate of return to sport, modified Harris Hip Score (mHHS), the subscales Activities of Daily Living and Sport-Specific Subscale of the Hip Outcome Score (HOS-ADL and HOS-SSS, respectively). Complications, revision surgeries and progression to total hip arthroplasty were recorded.
RESULTS
Data from 210 procedures were retrieved. The mean follow-up was 34.0 (24.0-42.5) months. The mean age of the patients was 32.0 (20.0-47.0) years, while the mean BMI was 20.9 (20.1-21.7) kg/m. 52.8% (111 of 210 patients) were women. At 24-month follow-up, 100% of the patients had returned to sport. At a mean of 34 months follow-up, the mean mHHS increased by 25.5% (P = 0.02), the mean HOS-ADL by 23.0% (P = 0.03), the mean HOS-SSS by 32.8% (P = 0.001). No complications were observed. The rate of revision was 4.3% (9 of 210 procedures). At a mean of 37.9 ± 7.5 months, 1.9% of patients (4/210) underwent THA.
CONCLUSION
Arthroscopic labral refixation for FAI yields reliably positive clinical outcomes, with a low rate of revision and conversion to THA.
Topics: Activities of Daily Living; Adult; Arthroscopy; Female; Femoracetabular Impingement; Follow-Up Studies; Hip Joint; Humans; Male; Middle Aged; Treatment Outcome
PubMed: 33820729
DOI: 10.1016/j.surge.2021.02.013 -
Sports Medicine (Auckland, N.Z.) Dec 2016Sports-related groin pain (SRGP) is a common entity in rotational sports such as football, rugby and hockey, accounting for 12-18 % of injuries each year, with high... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Sports-related groin pain (SRGP) is a common entity in rotational sports such as football, rugby and hockey, accounting for 12-18 % of injuries each year, with high recurrence rates and often prolonged time away from sport.
OBJECTIVE
This systematic review synthesises movement and muscle function findings to better understand deficits and guide rehabilitation.
STUDY SELECTION
Prospective and retrospective cross-sectional studies investigating muscle strength, flexibility, cross-sectional area, electromyographic activation onset and magnitude in patients with SRGP were included.
SEARCH METHODS
Four databases (MEDLINE, Web of Knowledge, EBSCOhost and EMBASE) were searched in June 2014. Studies were critiqued using a modified version of the Downs and Black Quality Index, and a meta-analysis was performed.
RESULTS
Seventeen studies (14 high quality, 3 low quality; 8 prospective and 9 retrospective) were identified. Prospective findings: moderate evidence indicated decreased hip abduction flexibility as a risk factor for SRGP. Limited or very limited evidence suggested that decreased hip adduction strength during isokinetic testing at ~119°/s was a risk factor for SRGP, but no associations were found at ~30°/s or ~210°/s, or with peak torque angle. Decreased hip abductor strength in angular velocity in ~30°/s but not in ~119°/s and ~210°/s was found as a risk factor for SRGP. No relationships were found with hip internal or external rotation range of movement, nor isokinetic knee extension strength. Decreased isokinetic knee flexion strength also was a potential risk factor for SRGP, at a speed ~60°/s. Retrospective findings: there was strong evidence of decreased hip adductor muscle strength during a squeeze test at 45°, and decreased total hip external rotation range of movement (sum of both legs) being associated with SRGP. There was strong evidence of no relationship to abductor muscle strength nor unilateral hip internal and external rotation range of movement. Moderate evidence suggested that increased abduction flexibility and no change in total hip internal rotation range of movement (sum of both legs) were retrospectively associated with SRGP. Limited or very limited evidence (significant findings only) indicated decreased hip adductor muscle strength during 0° and 30° squeeze tests and during an eccentric hip adduction test, but a decrease in the isometric adductors-to-abductors strength ratio at speed 120°/s; decreased abductors-to-adductors activation ratio in the early phase in the moving leg as well as in all three phases in the weight-bearing leg during standing hip flexion; and increased hip flexors strength during isokinetic and decrease in transversus abdominis muscle resting thickness associated with SRGP.
CONCLUSIONS
There were a number of significant movement and muscle function associations observed in athletes both prior to and following the onset of SRGP. The strength of findings was hampered by the lack of consistent terminology and diagnostic criteria, with there being clear guides for future research. Nonetheless, these findings should be considered in rehabilitation and prevention planning.
Topics: Abdominal Pain; Arthralgia; Groin; Hip Joint; Humans; Muscle, Skeletal; Pain; Range of Motion, Articular
PubMed: 27142535
DOI: 10.1007/s40279-016-0523-z