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Journal of Psychosomatic Research Aug 2024To determine the prevalence and associations between anxiety/depression, and gastrointestinal (GI) symptoms across gastroparesis and functional dyspepsia. (Meta-Analysis)
Meta-Analysis Comparative Study
Comparing the prevalence and association between anxiety, depression and gastrointestinal symptoms in gastroparesis versus functional dyspepsia: A systematic review and meta-analysis.
OBJECTIVE
To determine the prevalence and associations between anxiety/depression, and gastrointestinal (GI) symptoms across gastroparesis and functional dyspepsia.
METHODS
Twenty adult studies were identified through systematic searches of three databases (PubMed, CINAHL and PsycINFO) in September 2023. Meta-analysis was performed to estimate the pooled prevalence rates of anxiety and depression across gastroparesis and functional dyspepsia, and to determine whether the associations of anxiety/depression and gastrointestinal (GI) symptoms differ in gastroparesis versus functional dyspepsia.
RESULTS
The overall pooled prevalence rate for anxiety was similar (χ(1) = 2.45, p = .12) in gastroparesis (49%) and functional dyspepsia (29%). The overall pooled prevalence rate for depression in gastroparesis (39%), and functional dyspepsia (32%) was also similar (χ(1) = 0.81, p = .37). No significant relationship between anxiety and GI symptoms (r = 0.11) or depression and GI symptoms (r = 0.16) was found in gastroparesis, whilst significant, though weak, positive relationships between anxiety and GI symptoms (r = 0.30) and depression and GI symptoms (r = 0.32) were found in functional dyspepsia. The association between GI symptoms and anxiety, but not depression, across gastroparesis and functional dyspepsia was found to be significant (χ(1) = 5.22, p = .02).
CONCLUSION
Contributing to ongoing debate as to whether gastroparesis and functional dyspepsia are interchangeable syndromes, this review found that anxiety and depression prevalence was similar in both conditions. Psychological assessment and the utilisation of effective and holistic care in both conditions is therefore warranted.
Topics: Humans; Gastroparesis; Dyspepsia; Prevalence; Depression; Anxiety; Gastrointestinal Diseases
PubMed: 38896986
DOI: 10.1016/j.jpsychores.2024.111834 -
BioMed Research International 2022Transnasal Humidified Rapid-Insufflation Ventilatory Exchange (THRIVE) has received increasing attention and application as an effective noninvasive mode of ventilation... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Transnasal Humidified Rapid-Insufflation Ventilatory Exchange (THRIVE) has received increasing attention and application as an effective noninvasive mode of ventilation in the treatment of clinical anesthesia and critically ill patients. The conclusions reached in clinical studies of THRIVE and facemask oxygenation are still controversial, and the main objective of this systematic review is to determine the advantages of THRIVE over facemask oxygenation in intensive care units, respiratory medicine, and perioperative preoxygenation.
METHODS
PubMed, Embase, Web of Science, and Cochrane Library have search restrictions. The search library was full of English language articles from the first publication to 15 July 2021. Eligible randomized controlled study designs were included. 245 records were screened, and 5 studies met the inclusion criteria, enrolling a total of 235 patients.
RESULTS
Studying the THRIVE group compared to the facemask group, three studies analyzing intubation time showed that there is no difference in the effect of THRIVE and facemasks (MD -1.22, 95% CI -7.23 to 4.78, and = 0.69 > 0.05). Three studies analyzing apnea showed that there was no difference between the two groups (SMD 1, 95% CI -0.76 to 2.76, and = 0.27 > 0.05). Three studies analyzing PaO after preoxygenation showed that THRIVE is more effective than facemasks (MD 72.58, 95% CI 31.25 to 113.90, = 3.44, and < 0.001). Two studies analyzing oxygen saturation SpO after successful intubation showed that there was no difference in the effectiveness (MD 0.09, 95% CI -1.03 to 1.22, and = 0.87 > 0.05). Two studies analyzing PCO after complete paralysis or intubation preoxygenation showed that there was no difference between the two groups (MD 2.76, 95% CI -1.74 to 7.26, and = 0.23 > 0.05).
CONCLUSIONS
THRIVE does not have a greater advantage over a facemask in improving apnea time, oxygenation time, PCO, and SpO, but it has an advantage in improving arterial partial pressure of oxygen (PaO) after preoxygenation, which can improve PaO well. This trial is registered with the protocol registration number CRD42021268143.
Topics: Apnea; Humans; Insufflation; Masks; Oxygen; Oxygen Inhalation Therapy; Partial Pressure
PubMed: 35872871
DOI: 10.1155/2022/9858820 -
European Annals of Otorhinolaryngology,... Dec 2020AQFThe authors present the guidelines of the French Society of ENT and Head and Neck Surgery (SFORL) regarding the management of Bell's palsy in adults. After a...
AQFThe authors present the guidelines of the French Society of ENT and Head and Neck Surgery (SFORL) regarding the management of Bell's palsy in adults. After a literature review by a multidisciplinary workgroup, guidelines were drawn up based on retrieved articles and group-members' experience, then read over by an independent group to edit the final version. Guidelines were graded A, B, C or "expert opinion" according to decreasing level of evidence. Thorough ENT and neurological clinical examination is recommended in all patients presenting with peripheral facial palsy to confirm diagnosis of Bell's palsy. MRI with gadolinium enhancement should explore the entire course of the facial nerve, if possible within the first month. ENMG should be performed to assess prognosis for recovery. In confirmed Bell's palsy, corticosteroid therapy should be implemented as early as possible (ideally within 72h) at a dose of 1mg/kg/day for 7-10 days. Antiviral therapy should be associated to steroids in patients with severe and early-onset disease and in Ramsay-Hunt syndrome. Isolated antiviral therapy is not recommended. To date, there is no evidence that surgical facial nerve decompression provides benefit.
Topics: Acute Disease; Adrenal Cortex Hormones; Antiviral Agents; Bell Palsy; Contrast Media; Decompression, Surgical; Drug Administration Schedule; Drug Therapy, Combination; Facial Nerve; Facial Paralysis; France; Gadolinium; Herpes Zoster Oticus; Humans; Hyperbaric Oxygenation; Magnetic Resonance Imaging; Neurologic Examination; Otolaryngology; Physical Therapy Modalities; Prognosis; Recovery of Function; Societies, Medical
PubMed: 32636146
DOI: 10.1016/j.anorl.2020.06.004 -
JPRAS Open Sep 2022Facial paralysis has a debilitating impact on facial function, especially the eyebrow. Static procedures have long been the standard treatment strategy, but in more... (Review)
Review
BACKGROUND
Facial paralysis has a debilitating impact on facial function, especially the eyebrow. Static procedures have long been the standard treatment strategy, but in more recent years, dynamic procedures are being developed. To reconstruct the upper branches of the facial nerve (temporal and zygomatic branches), the deep temporal nerve (DTN) and its branches, with its close proximity to the eyebrow, can be used as a possible donor nerve for reinnervation. This systematic review provides an overview of the DTN anatomy and possible surgical treatment strategies.
MATERIALS AND METHODS
A PubMed systematic literature search was performed in October 2021. Studies on cadavers and clinical studies providing anatomical or surgical information on the dissection of the DTN as well as surgical treatment strategies using the DTN were included.
RESULTS
The literature search produced 311 results, including 36 duplicates. After screening on title and abstract, 11 studies were found possibly relevant and underwent a full-text critical appraisal, resulting in 4 exclusions. In total seven studies were included. The data gathered were used to adequately describe the DTN anatomy, surgical approaches and landmarks used during surgery.
CONCLUSION
The DTN and its branches prove to be a viable donor for the reconstruction of facial nerve branches, since the location and anatomical consistency can be relied upon through a multitude of studies, especially of the middle branch. Our study describes anatomy and nerve characteristics for its use in facial reanimation.
PubMed: 35812354
DOI: 10.1016/j.jpra.2022.05.007 -
Journal of Rehabilitation Medicine Aug 2023Post-stroke shoulder pain is a serious challenge for stroke survivors. The aim of this meta-analysis was to review the literature to confirm information on structural... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
Post-stroke shoulder pain is a serious challenge for stroke survivors. The aim of this meta-analysis was to review the literature to confirm information on structural changes in post-stroke shoulders detected by ultrasound examination.
METHODS
PubMed, Embase, Web of Science and ClinicalTrials.gov were searched until 7 December 2022, for studies describing shoulder sonographic findings in stroke patients. Two independent authors selected the studies, extracted the data, and performed the critical appraisal.
RESULTS
A total of 23 clinical studies were included. The most prevalent pathologies in hemiplegic shoulders pertained to the biceps long head tendon (41.4%), followed by the supraspinatus tendon (33.2%), subdeltoid bursa (29.3%), acromioclavicular joint (15.0%), and subscapularis tendon (9.2%). The common pathological findings encompassed bicipital peritendinous effusion (39.2%), biceps tendinopathy (35.5%), subdeltoid bursitis (29.3%) and supraspinatus tendinopathy (24.6%). Biceps long head tendon and supraspinatus tendon abnormalities were observed significantly more in the hemiplegic (vs contralateral) shoulders, with odds ratios of 3.814 (95% confidence interval 2.044-7.117) and 2.101 (95% confidence interval 1.257-3.512), respectively. No correlation was observed between motor function and shoulder pathology.
CONCLUSION
Ultrasonography enabled the identification of common shoulder pathologies after stroke. Further research is needed to establish the association between these changes and the clinical course of stroke patients.
Topics: Humans; Shoulder; Hemiplegia; Rotator Cuff; Tendons; Bursitis; Pain
PubMed: 37615388
DOI: 10.2340/jrm.v55.13432 -
Drugs in R&D Mar 2023Dopamine antagonists are the main pharmacological options to treat gastroparesis. The aim of this study was to conduct a systematic literature review (SLR) to evaluate... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Dopamine antagonists are the main pharmacological options to treat gastroparesis. The aim of this study was to conduct a systematic literature review (SLR) to evaluate the profile of adverse events (AEs) of dopamine antagonists used in the treatment of children and adults with gastroparesis.
METHODS
We searched EMBASE and MEDLINE up to March 25, 2021, for relevant clinical trials and observational studies. We conducted a proportional meta-analysis to estimate the pooled occurrence of AEs (%), with 95% confidence interval (CI), from arm-level data across studies and the comparative occurrence of AEs from placebo-controlled clinical trials (odds ratio [OR] with 95% CI).
RESULTS
We identified 28 studies assessing AEs experienced by patients treated for gastroparesis with domperidone and metoclopramide; 22 studies contributed data to the meta-analyses. Cardiovascular, neurological, and endocrine AEs were commonly observed, with point incidences varying from 1 to > 50%. Clinically important AEs, such as QTc prolongation, occurred in 5% of patients treated with domperidone (95% CI: 3.32-8.62). Restlessness, an extrapyramidal AE, occurred in 15% of patients (95% CI: 7.48-26.61) treated with metoclopramide, with a 7-fold increase compared with patients receiving placebo (OR: 7.72; 95% CI: 1.27-47.05). Variation in terminology to describe extrapyramidal events precluded further pooled analyses. Additional meta-analyses were not feasible due to discrepancies in the assessment and reporting of the AEs.
CONCLUSIONS
The evidence confirms concerns of cardiovascular, extrapyramidal, and endocrine AEs in patients with gastroparesis treated with domperidone and metoclopramide. Imprecise AE reporting limits firm interpretation and conclusions.
REGISTRATION
PROSPERO international prospective register of systematic reviews (registration number: CRD42021248888).
Topics: Adult; Child; Humans; Domperidone; Metoclopramide; Gastroparesis; Dopamine Antagonists
PubMed: 36749528
DOI: 10.1007/s40268-023-00413-x -
Frontiers in Neuroscience 2016Conversion (functional) limb weakness or paralysis (FW) can be a debilitating condition, and often causes significant distress or impairment in social, occupational, or... (Review)
Review
Conversion (functional) limb weakness or paralysis (FW) can be a debilitating condition, and often causes significant distress or impairment in social, occupational, or other important areas of functioning. Most treatment concepts are multi-disciplinary, containing a behavioral approach combined with a motor learning program. Non-invasive brain stimulation (NIBS) methods, such as electroconvulsive therapy (ECT), and transcranial magnetic stimulation (TMS) have been used in the past few decades to treat FW. In order to identify all published studies that used NIBS methods such as ECT, TMS and transcranial direct current stimulation (tDCS) for treating FW patients a systematic review of the literature was conducted in PubMed and Web of Science. In a second step, narratives were used to retrospectively determine nominal CGI-I (Clinical Global Impression scale-Improvement) scores to describe approximate changes of FW symptoms. We identified two articles (case reports) with ECT used for treatment of FW, five with TMS with a total of 86 patients, and none with tDCS. In 75 out of 86 patients treated with repetitive (r)TMS a nominal CGI-I score could be estimated, showing a satisfactory short-term improvement. Fifty-four out of seventy-five identified patients (72%) had a CGI-I score of 1 (very much improved), 13 (17%) a score of 2 (much improved), 5 (7%) a score of 3 (minimally improved), and 3 (5%) remained unchanged (CGI-I = 4). In no case did patients worsen after rTMS treatment, and no severe adverse effects were reported. At follow-up, symptom improvement was not quantifiable in terms of CGI-I for the majority of the cases. Patients treated with ECT showed a satisfactory short-term response (CGI-I = 2), but deterioration of FW symptoms at follow-up. Despite the predominantly positive results presented in the identified studies and satisfactory levels of efficacy measured with retrospectively calculated nominal CGI-I scores, any assumption of a beneficial effect of NIBS in FW has to be seen with caution, as only few articles could be retrieved and their quality was mostly poor. This article elucidates how NIBS might help in FW and gives recommendations for future study designs using NIBS in this condition.
PubMed: 27065796
DOI: 10.3389/fnins.2016.00140 -
The Egyptian Journal of Neurology,... 2021The COVID-19 pandemic has drastically affected everyone in a hit or miss manner. Since it began, evidence of the neuro-invasive potential of the virus has been... (Review)
Review
BACKGROUND
The COVID-19 pandemic has drastically affected everyone in a hit or miss manner. Since it began, evidence of the neuro-invasive potential of the virus has been intensifying significantly. Several pathways have been hypothesized to elucidate the neurotropic nature of SARS-CoV2. It is the need of the hour to collect vital information.
OBJECTIVE
To evaluate and correlate the neuro-radiological and neurological manifestations in patients diagnosed with SARS-CoV2.To identify neuro-invasive pathways of COVID infection.
METHODS
Relevant studies were identified through four databases-the Cochrane Library, PubMed, Science Direct, and Web of Science. These were searched using relevant keywords-"COVID-19," "SARS-CoV2," "neurological manifestations," "neuroimaging," "CT," and "MRI." Relevant articles were screened according to a pre-defined inclusion and exclusion criteria from December 2019 to August 2020.
RESULTS
Our review included a total of 63 full text publications with 584 patients, composed mainly of observational studies, case reports, and case series. The most common neurological manifestations associated with COVID-19 were altered mental status, stroke, and paralysis. About 17.85% patients who underwent neuroimaging were found to be having ischemic changes suggestive of a stroke. This was followed by hemorrhagic changes as the second most common finding. The most commonly involved vessel was the Middle Cerebral Artery. Besides stroke, we found that SARS-CoV2 could be the cause for new-onset seizures, Guillain-Barre Syndrome, encephalitis, and many other severe neurological diseases.
CONCLUSION
The information that we have obtained so far will prove dynamic to healthcare providers working against the COVID-19 pandemic. It is necessary to be aware of these atypical neurological findings for the early diagnosis and treatment of COVID-19 infected patients. However, to completely understand the connection between SARS-CoV2 and the nervous system, further research is necessary.
PubMed: 34093004
DOI: 10.1186/s41983-021-00322-3 -
Journal of Clinical Medicine Nov 2021Recurrent laryngeal nerve injury is an important complication following thyroid and parathyroid surgery. Recently, Transcutaneous laryngeal ultrasound (TLUSG) has... (Review)
Review
Recurrent laryngeal nerve injury is an important complication following thyroid and parathyroid surgery. Recently, Transcutaneous laryngeal ultrasound (TLUSG) has emerged as a non-invasive alternative to laryngoscopic examination for vocal cord (VC) assessment. The aim of the systematic review and meta-analysis was to determine its diagnostic accuracy in reference to laryngoscopy. It was conducted in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. MEDLINE, Scopus, Cochrane library and Web of Science databases were searched to identify relevant articles. Sixteen studies were included in the review. Pooled diagnostic accuracy was calculated based on weighted arithmetic mean and plotting forest plot. The pooled visualization rate was 86.28% and 94.13% preoperatively and postoperatively, respectively. The respective pooled sensitivity and specificity was 78.48% and 98.28%, and 83.96% (CI 95%: 77.24-88.50%) and 96.15% (CI 95%: 95.24-96.88%). The diagnostic accuracy improved if transverse and lateral approaches, and valsalva maneuver were utilized. Male gender and older age were the most crucial risk factors for VC non-visualization. TLUSG is an efficacious screening tool for vocal cord palsy due to its high sensitivity. It is likely to prevent unnecessary laryngoscopic examination in around 80% of patients, with the potential for becoming a gold standard for specific (female/young) patient cohort through assimilative modifications use, increasing expertise and development of objective measurements in the future.
PubMed: 34830675
DOI: 10.3390/jcm10225393 -
International Journal of Surgery... Jul 2023Thyroid disease is a common endocrine disorder, and thyroid surgeries and postoperative complications have increased recently. This study aimed to explore the... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Thyroid disease is a common endocrine disorder, and thyroid surgeries and postoperative complications have increased recently. This study aimed to explore the effectiveness of intraoperative nerve monitoring (IONM) in endoscopic thyroid surgery using subgroup analysis and determine confounding factors.
MATERIALS AND METHODS
Two researchers individually searched for relevant studies published till November 2022 in the PubMed, Embase, Web of Science and Cochrane Library databases. Eventually, eight studies met the inclusion criteria. Heterogeneity was assessed using the Cochran's Q test, and a funnel plot was implemented to evaluate publication bias. The odds ratio or risk difference were calculated using fixed-effects models. The weighted mean difference of continuous variables was calculated. Subgroup analysis was performed according to the disease type.
RESULTS
Eight eligible papers included 915 patients and 1242 exposed nerves. The frequencies of transient, permanent and total recurrent laryngeal nerve (RLN) palsy were 2.64, 0.19 and 2.83%, respectively, in the IONM group and 6.15, 0.75 and 6.90%, respectively, in the conventional exposure group. In addition, analysis of the secondary outcome indicators for the average total length of surgery, localisation time of the RLN, recognition rate of the superior laryngeal nerve and length of incision revealed that IONM reduced the localisation time of the RLN and increased the identification rate of the superior laryngeal nerve. Subgroup analysis showed that IONM significantly reduced the incidence of RLN palsy in patients with malignancies.
CONCLUSIONS
The use of IONM significantly reduced the incidence of transient RLN palsy during endoscopic thyroid surgery, but it did not significantly reduce the incidence of permanent RLN palsy. However, the reduction in the total RLN palsy was statistically significant. In addition, IONM can effectively reduce the location time of the RLN and increase the recognition rate of the superior laryngeal nerve. Therefore, the application of IONM for malignant tumours is recommended.
Topics: Humans; Thyroid Gland; Thyroidectomy; Recurrent Laryngeal Nerve; Monitoring, Intraoperative; Recurrent Laryngeal Nerve Injuries; Vocal Cord Paralysis
PubMed: 37318897
DOI: 10.1097/JS9.0000000000000393