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Neurosurgical Review Jul 2023While magnetic resonance imaging (MRI) is the current standard imaging method for diagnosing and localizing corticotropinomas in Cushing disease, it can fail to detect... (Review)
Review
While magnetic resonance imaging (MRI) is the current standard imaging method for diagnosing and localizing corticotropinomas in Cushing disease, it can fail to detect adenomas in up to 40% of cases. Recently, positron emission tomography (PET) has shown promise as a diagnostic tool to detect pituitary adenomas in Cushing disease. We perform a scoping review to characterize the uses of PET in diagnosing Cushing disease, with a focus on describing the types of PET investigated and defining PET-positive disease. A scoping review was conducted following the PRISMA-ScR guidelines. Thirty-one studies fulfilled our inclusion criteria, consisting of 10 prospective studies, 8 retrospective studies, 11 case reports, and 2 illustrative cases with a total of 262 patients identified. The most commonly utilized PET modalities in prospective/retrospective studies were FDG PET (n = 5), MET PET (n = 5), 68 Ga-DOTATATE PET (n = 2), 13N-ammonia PET (n = 2), and 68 Ga-DOTA-CRH PET (n = 2). MRI positivity ranged from 13 to 100%, while PET positivity ranged from 36 to 100%. In MRI-negative disease, PET positivity ranged from 0 to 100%. Five studies reported the sensitivity and specificity of PET, which ranged from 36 to 100% and 50 to 100%, respectively. PET shows promise in detecting corticotropinomas in Cushing disease, including MRI-negative disease. MET PET has been highly investigated and has demonstrated excellent sensitivity and specificity. However, preliminary studies with FET PET and 68 Ga-DOTA-CRH PET show promise for achieving high sensitivity and specificity and warrant further investigation.
Topics: Humans; Pituitary ACTH Hypersecretion; Nitrogen Radioisotopes; Prospective Studies; Retrospective Studies; Positron-Emission Tomography
PubMed: 37393399
DOI: 10.1007/s10143-023-02077-2 -
Critical Care (London, England) May 2021Mortality and other clinical outcomes between culture-negative and culture-positive septic patients have been documented inconsistently and are very controversial. A... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Mortality and other clinical outcomes between culture-negative and culture-positive septic patients have been documented inconsistently and are very controversial. A systematic review and meta-analysis was performed to compare the clinical outcomes of culture-negative and culture-positive sepsis or septic shock.
METHODS
We searched the PubMed, Cochrane and Embase databases for studies from inception to the 1st of January 2021. We included studies involving patients with sepsis or septic shock. All authors reported our primary outcome of all-cause mortality and clearly compared culture-negative versus culture-positive patients with clinically relevant secondary outcomes (ICU length of stay, hospital length of stay, mechanical ventilation requirements, mechanical ventilation duration and renal replacement requirements). Results were expressed as odds ratio (OR) and mean difference (MD) with accompanying 95% confidence interval (CI).
RESULTS
Seven studies including 22,655 patients were included. The primary outcome of this meta-analysis showed that there was no statistically significant difference in the all-cause mortality between two groups (OR = 0.95; 95% CI, 0.88 to 1.01; P = 0.12; Chi- = 30.71; I = 80%). Secondary outcomes demonstrated that there was no statistically significant difference in the ICU length of stay (MD = - 0.19;95% CI, - 0.42 to 0.04; P = 0.10;Chi- = 5.73; I = 48%), mechanical ventilation requirements (OR = 1.02; 95% CI, 0.94 to 1.11; P = 0.61; Chi = 6.32; I = 53%) and renal replacement requirements (OR = 0.82; 95% CI, 0.67 to 1.01; P = 0.06; Chi- = 1.21; I = 0%) between two groups. The hospital length of stay of culture-positive group was longer than that of the culture-negative group (MD = - 3.48;95% CI, - 4.34 to - 2.63; P < 0.00001;Chi- = 1.03; I = 0%). The mechanical ventilation duration of culture-positive group was longer than that of the culture-negative group (MD = - 0.64;95% CI, - 0.88 to - 0.4; P < 0.00001;Chi- = 4.86; I = 38%).
CONCLUSIONS
Culture positivity or negativity was not associated with mortality of sepsis or septic shock patients. Furthermore, culture-positive septic patients had similar ICU length of stay, mechanical ventilation requirements and renal replacement requirements as those culture-negative patients. The hospital length of stay and mechanical ventilation duration of culture-positive septic patients were both longer than that of the culture-negative patients. Further large-scale studies are still required to confirm these results.
Topics: Blood Culture; Humans; Sepsis
PubMed: 33964934
DOI: 10.1186/s13054-021-03592-8 -
Annals of Medicine and Surgery (2012) Jul 2022Aggressive angiomyxoma is a rare benign mesenchymal tumor and occurs rarely in males. This study aimed to review all the cases of AAM in men in the English literature up... (Review)
Review
INTRODUCTION
Aggressive angiomyxoma is a rare benign mesenchymal tumor and occurs rarely in males. This study aimed to review all the cases of AAM in men in the English literature up to September 2020 and investigate the clinical, histochemical, and radiological characteristics of AAM and discuss the best treatment choices according to available data.
METHODS
A comprehensive search of the PubMed, Google Scholar, and Embase databases up to September 2020 was performed looking for reported cases of male patients with AAM. The search excluded articles in languages other than English, reported female cases, and superficial angiomyxoma cases.
RESULTS
Among the 97 patients, the mean age was 48.2 years with an incidence peak between 40 and 60 years. The sites commonly involved were the scrotum (42.3%). On ultrasound, the tumor was hypoechoic (85.7%) with a well-defined margin (100%), whereas on MRI, most cases were isointense on T1-weighted images (53.8%), and hyperintense on T2-weighted images (85.7%). Immunohistochemistry revealed that the tumor tended to be positive for vimentin (100%), CD34 (63.4%), ER (50%), and PR (53.3%) while S-100 showed 91% negativity. Wide and complete surgical excision was conducted in most cases (72%), and follow-up duration ranged from 1 month to 144 months with a recurrence rate of 11.8%.
CONCLUSION
Although the occurrence of AAM is rare in men, consideration should be taken in the differential diagnosis of a mass in the genitourinary region. According to our review, the most decisive immunohistochemistry profile is the positivity of Vimentin and CD34 with the negativity of S-100. Although hormonal treatment is controversial, we suggest a novel algorithm for the management of aggressive angiomyxoma.
PubMed: 35860056
DOI: 10.1016/j.amsu.2022.103880 -
Journal of Obstetrics and Gynaecology :... 2016Thyroid antibody positivity is relatively common in women. While many epidemiological studies have investigated the links between thyroid antibodies and pregnancy... (Review)
Review
Thyroid antibody positivity is relatively common in women. While many epidemiological studies have investigated the links between thyroid antibodies and pregnancy complications, evidence regarding the effect of Levothyroxine treatment of euthyroid pregnant women with autoimmune thyroid disease on pregnancy outcome is limited. The objective of this paper is to provide a review on the impact of treatment of euthyroid thyroid antibody-positive pregnant women on adverse pregnancy outcome. This systematic review was conducted with a prospective protocol. PubMed, Science direct, Google scholar, Embase and the Cochrane Library databases were searched through January 2014 to identify studies that met pre-stated inclusion criteria. The search was limited to English manuscripts. We found that there is inadequate data regarding both the adverse effect of thyroid antibody positivity in euthyroid women on pregnancy outcomes and the effects Levothyroxine on these women. It seems that the results of most studies indicate adverse effects of thyroid antibody positivity in euthyroid women on pregnancy outcomes. Further randomised clinical trials are needed to investigate the effects of treating pregnant euthyroid women with positive thyroid antibodies on the maternal and early/late neonatal outcomes.
Topics: Autoantibodies; Autoimmune Diseases; Female; Humans; Pregnancy; Pregnancy Complications; Pregnancy Outcome; Thyroid Diseases; Thyroxine
PubMed: 26203920
DOI: 10.3109/01443615.2014.968110 -
Developmental Psychobiology Mar 2023Oxytocin (OT) plays a pivotal role in early parent-child relationship formation and bonding that is critical for the social, cognitive, and emotional development of the... (Review)
Review
Oxytocin (OT) plays a pivotal role in early parent-child relationship formation and bonding that is critical for the social, cognitive, and emotional development of the child. Therefore, this systematic review aims to consolidate all available evidence regarding the associations of parental OT concentration levels with parenting behavior and bonding within the past 20 years. A systematic search was conducted in five databases from 2002 to May 2022, and 33 studies were finalized and included. Due to the heterogeneity of the data, findings were presented narratively based on the type of OT and parenting outcomes. Current evidence strongly suggests that parental OT levels are positively related to parental touch and parental gaze and affect synchrony and observer-coded parent-infant bonding. No gender difference in OT levels was observed between fathers and mothers, but OT strengthens affectionate parenting in mothers and stimulatory parenting in fathers. Child OT levels were also positively associated with parental OT levels. Family and healthcare providers could encourage more positive touch and interactive play between parent and child to strengthen parent-child relationships.
Topics: Infant; Female; Humans; Parenting; Oxytocin; Parent-Child Relations; Parents; Mothers
PubMed: 36811366
DOI: 10.1002/dev.22359 -
Clinical Microbiology and Infection :... Apr 2024Centor and McIsaac scores are clinical prediction rules for diagnosing group A streptococcus (GAS) infection in patients with pharyngitis. Their recommended thresholds... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Centor and McIsaac scores are clinical prediction rules for diagnosing group A streptococcus (GAS) infection in patients with pharyngitis. Their recommended thresholds vary between guidelines.
OBJECTIVES
To estimate the sensitivity and specificity of the McIsaac and Centor scores to diagnose GAS pharyngitis and evaluate their impact on antibiotic prescribing at each threshold in patients presenting to secondary care.
DATA SOURCES
MEDLINE, Embase, and Web of Science were searched from inception to September 2022.
STUDY ELIGIBILITY CRITERIA
Studies of patients presenting with acute pharyngitis to emergency or outpatient clinics that estimated the accuracy of McIsaac or Centor scores against throat cultures and/or rapid antigen detection tests (RADT) as reference standards.
TESTS
Centor or McIsaac score.
REFERENCE STANDARD
Throat cultures and/or RADT.
ASSESSMENT OF RISK OF BIAS
Quality Assessment of Diagnostic Accuracy Studies.
METHODS OF DATA SYNTHESIS
The sensitivities and specificities of the McIsaac and Centor scores were pooled at each threshold using bivariate random effects meta-analysis.
RESULTS
Fourteen studies were included (eight McIsaac and six Centor scores). Eight studies had unclear and six had a high risk of bias. The McIsaac score had higher estimated sensitivity and lower specificity relative to Centor scores at equivalent thresholds but with wide and overlapping confidence regions. Using either score as a triage to RADT to decide antibiotic treatment would reduce antibiotic prescription to patients with non-GAS pharyngitis relative to RADT test for everyone, but also reduce antibiotic prescription to patients with GAS.
DISCUSSION
Centor and McIsaac scores are equally ineffective at triaging patients who need antibiotics presenting with pharyngitis at hospitals. At high thresholds, too many true positive cases are missed, whereas at low thresholds, too many false positives are treated, leading to the over prescription of antibiotics. The former may be compensated by adequate safety netting by clinicians, ensuring that patients can seek help if symptoms worsen.
Topics: Humans; Secondary Care; Streptococcal Infections; Pharyngitis; Streptococcus pyogenes; Anti-Bacterial Agents; Sensitivity and Specificity
PubMed: 38182052
DOI: 10.1016/j.cmi.2023.12.025 -
International Journal of Cancer Mar 2024We intended to update human papillomavirus (HPV) prevalence and p16 positivity in oropharyngeal squamous cell carcinomars (SCC), and calculate HPV attributable fraction... (Meta-Analysis)
Meta-Analysis
We intended to update human papillomavirus (HPV) prevalence and p16 positivity in oropharyngeal squamous cell carcinomars (SCC), and calculate HPV attributable fraction (AF) for oropharyngeal SCC by geographic region. We searched Medline, Embase, and the Cochrane Library to identify published studies of HPV prevalence and p16 positivity alone or together in oropharyngeal SCC before December 28, 2021. Studies that reported type-specific HPV DNA prevalence using broad-spectrum PCR-based testing methods were included. We estimated pooled HPV prevalence, type-specific HPV prevalence, and p16 positivity. AF of HPV was calculated by geographic region. One hundred and thirty-four studies including 12 139 cases were included in our analysis. The pooled HPV prevalence estimate for oropharyngeal SCC was 48.1% (95% confidence interval [CI] 43.2-53.0). HPV prevalence varied significantly by geographic region, and the highest HPV prevalence in oropharyngeal SCC was noted in North America (72.6%, 95% CI 63.8-80.6). Among HPV positive cases, HPV 16 was the most common type with a prevalence of 40.2% (95% CI 35.7-44.7). The pooled p16 positivity in HPV positive and HPV16 positive oropharyngeal SCC cases was 87.2% (95% CI 81.6-91.2) and 91.7% (84.3-97.2). The highest AFs of HPV and HPV16 were noted in North America at 69.6% (95% CI 53.0-91.5) and 63.0% (48.0-82.7). [Correction added on 31 October 2023, after first online publication: the percentage symbol (%) was missing and has been added to 63.0% (48.0-82.7) in the Abstract and Conclusion.] A significant proportion of oropharyngeal SCC was attributable to HPV. HPV16 accounts for the majority of HPV positive oropharyngeal SCC cases. These findings highlight the importance of HPV vaccination in the prevention of a substantial proportion of oropharyngeal SCC cases.
Topics: Humans; Carcinoma, Squamous Cell; Cyclin-Dependent Kinase Inhibitor p16; DNA, Viral; Head and Neck Neoplasms; Human papillomavirus 16; Human Papillomavirus Viruses; Oropharyngeal Neoplasms; Papillomaviridae; Papillomavirus Infections; Squamous Cell Carcinoma of Head and Neck
PubMed: 37861207
DOI: 10.1002/ijc.34763 -
The Gerontologist Sep 2021During past years, gamification has become a major trend in technology, and promising results of its effectiveness have been reported. However, prior research has...
BACKGROUND AND OBJECTIVES
During past years, gamification has become a major trend in technology, and promising results of its effectiveness have been reported. However, prior research has predominantly focused on examining the effects of gamification among young adults, while other demographic groups such as older adults have received less attention. In this review, we synthesize existing scholarly work on the impact of gamification for older adults.
RESEARCH DESIGN AND METHODS
A systematic search was conducted using 4 academic databases from inception through January 2019. A rigorous selection process was followed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
RESULTS
Twelve empirical peer-reviewed studies written in English, focusing on older adults aged ≥55, including a gameful intervention, and assessing subjective or objective outcomes were identified. Eleven of the 12 studies were conducted in the health domain. Randomized controlled study settings were reported in 8 studies. Positively oriented results were reported in 10 of 12 studies on visual attention rehabilitation, diabetes control, increasing positive emotions for patients with subthreshold depression, cognitive training and memory tests, engagement in training program, perceptions of self-efficacy, motivation and positive emotions of social gameplay conditions, increased physical activity and balancing ability, and increased learning performance and autonomy experiences. The results are, however, mostly weak indications of positive effects.
DISCUSSION AND IMPLICATIONS
Overall, the studies on gameful interventions for older adults suggest that senior users may benefit from gamification and game-based interventions, especially in the health domain. However, due to methodological shortcomings and limited amount of research available, further work in the area is called for.
Topics: Aged; Cognition; Humans; Motivation
PubMed: 32530026
DOI: 10.1093/geront/gnaa047 -
Scientific Reports Jun 2023In recent years, the prevalence of allergic diseases has increased significantly, causing great concern, and wheat, as one of the top 8 food allergens, is a common... (Meta-Analysis)
Meta-Analysis
In recent years, the prevalence of allergic diseases has increased significantly, causing great concern, and wheat, as one of the top 8 food allergens, is a common allergy trigger. Nevertheless, reliable estimates of the positivity rate of wheat allergens in the allergic population in China are still lacking. The systematic review and meta-analysis aims to evaluate the positive detection rate of wheat allergens in the Chinese allergic population and further provide a reference for the prevention of allergy. CNKI, CQVIP, WAN-FANG DATA, Sino Med, PubMed, Web of Science, Cochrane Library, and Embase databases were retrieved. Related research and case reports about the positive rate of wheat allergen in the Chinese allergic population published from inception to June 30, 2022, were searched, and meta-analysis was performed using Stata software. The pooled positive rate of wheat allergens and 95% confidence interval were calculated by random effect models, and the publication bias was evaluated using Egger's test. A total of 13 articles were included for the final meta-analysis, in which wheat allergen detection methods involved only serum sIgE testing and SPT assessment. The results showed that the wheat allergen positivity detection rate in Chinese allergic patients was 7.30% (95% CI 5.68-8.92%). Subgroup analysis showed that the positivity rate of wheat allergens was influenced by region, but hardly by age and assessment method. The positive rates of wheat allergy in the population with allergic diseases were 2.74% (95% CI 0.90-4.58%) and 11.47% (95% CI 7.08-15.87%) in southern and northern China, respectively. In particular, the positive rates of wheat allergens were greater than 10% in Shaanxi, Henan and Nei Mongol, all of which belong to the northern region. These results suggest that wheat allergens are an important cause of sensitization in allergic populations from northern China, and therefore attention should be paid to early prevention in high-risk populations.
Topics: Humans; Allergens; Asian People; East Asian People; Ethnicity; Hypersensitivity; Triticum; China
PubMed: 37386279
DOI: 10.1038/s41598-023-37648-2 -
JMIR Perioperative Medicine Jun 2022Mindfulness-based cognitive therapy and isometric exercise training (IET) interventions are relatively new approaches to maintain physical functioning, alleviate pain,... (Review)
Review
BACKGROUND
Mindfulness-based cognitive therapy and isometric exercise training (IET) interventions are relatively new approaches to maintain physical functioning, alleviate pain, prevent joint stiffness and muscular atrophy, and positively influence other postoperative care outcomes.
OBJECTIVE
The aim of this review was to identify the impacts of mindfulness-based interventions (MBIs) and IET and, more specifically, their combination, which have not previously been assessed to our knowledge.
METHODS
Studies were identified by searching the PubMed and Cochrane databases within the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) algorithm format and using relevant keyword combinations, which resulted in 39 studies meeting the inclusion criteria.
RESULTS
In general, MBI was shown to positively impact both pain relief and physical functioning, while IET positively impacted physical functioning. Numerous other benefits, including improved quality of life and decreased postoperative opioid use, were also described from both interventions; however, further research is needed to confirm these findings as well as to determine other possible benefits. No studies were found that combined MBI and IET.
CONCLUSIONS
Despite many positive results from each individual intervention, there is a lack of information about how the combination of MBI and IET might impact postoperative care. The combination of these two interventions might prove to be more effective than each individual intervention alone, and the findings from this review show that they could even be complementary. Going forward, research should be expanded to study the possible benefits of the combination of MBI and IET in postoperative care routines as well as other possible combinations.
PubMed: 35687415
DOI: 10.2196/34651