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Medicine Oct 2023Medical infrared thermal imaging (IRT) has been applied to research blood flow, breast cancer detection, and human body muscle performance. The benefits of IRT include...
BACKGROUND
Medical infrared thermal imaging (IRT) has been applied to research blood flow, breast cancer detection, and human body muscle performance. The benefits of IRT include the fact that it is noninvasive, quick, dependable, non-contact, capable of creating several recordings in a short period of time, and secure for both patients and medical professionals. We aimed to determine the predictive value of IRT for identifying and evaluating any interventional procedure in patients affected by peripheral artery disease (PAD) of any severity.
METHODS
We searched the Cochrane Library, EMBASE, and PubMed on the topic of IRT and PAD until January 20,2023. We excluded gray literature as it is lacking credibility for not undergoing a peer-reviewed process. The search strategy includes the medical topic headings for "infrared thermal imaging" and "peripheral vascular disorders." The primary outcome of this systematic review was the variation in tissue perfusion in PAD patients. Each technique's technical characteristics and therapeutic use within PAD must be described in each included study.
RESULTS
This systematic review included 2 case reports and 3 observational studies. By comparing the temperatures of PAD patients hands, legs, and feet, IRT might prove to be an unduly valuable tool for treating vascular illnesses, especially in light of the knowledge gained from the temperature distribution maps.
CONCLUSION
This noninvasive method demonstrated encouraging results in the detection of various areas of foot perfusion and the screening of PAD, and it gave good findings in gauging the effects of any type of intervention.
Topics: Humans; Peripheral Arterial Disease; Lower Extremity; Foot; Hemodynamics; Thermography
PubMed: 37904481
DOI: 10.1097/MD.0000000000035639 -
Journal of Controlled Release :... Jul 2024Ultrasound is widely used in the diagnosis and therapy of cancer. Tumors can be treated by thermal or mechanical tissue ablation. Furthermore, tumors can be manipulated... (Meta-Analysis)
Meta-Analysis
Ultrasound is widely used in the diagnosis and therapy of cancer. Tumors can be treated by thermal or mechanical tissue ablation. Furthermore, tumors can be manipulated by hyperthermia, sonodynamic therapy and sonoporation, e.g., by increasing tumor perfusion or the permeability of biological barriers to enhance drug delivery. These treatments induce various immune responses in tumors. However, conflicting data and high heterogeneity between experimental settings make it difficult to generalize the effects of ultrasound on tumor immunity. Therefore, we performed a systematic review to answer the question: "Does ultrasound alter the immune reaction of peripheral solid tumors in humans and animals compared to control conditions without ultrasound?" A systematic literature search was performed in PubMed, EMBASE, and Web of Science and 24,401 potentially relevant publications were identified. Of these, 96 publications were eligible for inclusion in the systematic review. Experiments were performed in humans, rats, and mice and focused on different tumor types, primarily breast and melanoma. We collected data on thermal and non-thermal ultrasound settings, the use of sono-sensitizers or sono-enhancers, and anti-tumor therapies. Six meta-analyses were performed to quantify the effect of ultrasound on tumor infiltration by T cells (cytotoxic, helper, and regulatory T cells) and on blood cytokines (interleukin-6, interferon-γ, tumor necrosis factor-α). We provide robust scientific evidence that ultrasound alters T cell infiltration into tumors and increases blood cytokine concentrations. Furthermore, we identified significant differences in immune cell infiltration based on tumor type, ultrasound settings, and mouse age. Stronger effects were observed using hyperthermia in combination with sono-sensitizers and in young mice. The latter may impair the translational impact of study results as most cancer patients are older. Thus, our results may help refining ultrasound parameters to enhance anti-tumor immune responses for therapeutic use and to minimize immune effects in diagnostic applications.
Topics: Animals; Neoplasms; Humans; Ultrasonic Therapy
PubMed: 38777126
DOI: 10.1016/j.jconrel.2024.05.030 -
Multiple Sclerosis and Related Disorders Oct 2023There is strong evidence for the benefits of exercise for people with Multiple Sclerosis (MS), however, up to 80% of people with MS report experiencing exacerbated... (Review)
Review
BACKGROUND
There is strong evidence for the benefits of exercise for people with Multiple Sclerosis (MS), however, up to 80% of people with MS report experiencing exacerbated symptoms with elevated body temperatures. A range of cooling garments to assist people with MS manage symptoms of heat sensitivity have been investigated. Therefore, the aim of this systematic review was to assess the effect of cooling garments to improve physical function in people with MS, and to determine any associated physiological and perceptual responses.
METHOD
A systematic review adhering to the PRISMA guidelines was performed. The eligibility criteria required investigations to have conducted a randomized controlled trial or cross-over study to assess the effect of a cooling garment to improve physical function, or a related physiological or perceptual measure, in people with MS.
RESULTS
Thirteen empirical studies were identified, compromising of acute cross-over designs (61.5%), longitudinal parallel group designs (23.1%) or a combination of both (15.4%). The studies included 384 participants with MS with an expanded disability status scale range of 1-7.5. Garments included liquid-perfused cooling vests/tops/hoods (50.0%), phase-change cooling vests (38.9%), a cooling thigh-cuff (5.6%) and a palm cooling device (5.6%). The cooling garments were effective at improving walking capacity and functional mobility, and some studies demonstrated improvements in muscular strength and balance, but not manual dexterity. The garments also resulted in improved core temperature, skin temperature, thermal sensation and subjective fatigue. Improvements occurred in temperate and warm conditions, and both with and without an exercise stimulus.
DISCUSSION
Cooling garments can improve physical function for people with MS. Since none of the cooling garments caused harm, and no particular cooling garment could be identified as being superior, people with MS should experiment with different cooling garments to determine their preference, and industry should focus on cooling garments that are effective, accessible and user-friendly.
PubMed: 37499339
DOI: 10.1016/j.msard.2023.104912 -
Biomedicines Mar 2024It is well known that cortical damage may affect cognitive functions, whereas subcortical damage, especially brainstem stroke, would be far less likely to cause... (Review)
Review
It is well known that cortical damage may affect cognitive functions, whereas subcortical damage, especially brainstem stroke, would be far less likely to cause cognitive decline, resulting in this condition being overlooked. Few studies have focused on cognitive dysfunction after a pontine stroke. Here, we begin with describing our nine new case reports of in-depth neuropsychological findings from patients with pontine stroke. The dominant domain of cognitive dysfunction was commonly characterized by executive dysfunction, almost in line with previous studies. The severity was relatively mild. We give an overview of the available literature on cognitive decline following a pontine stroke. This is followed by discussions regarding the prognosis of the cognitive disabilities. Based on previous neuroimaging findings, we would like to get to the core of the neuropathology underlying the cognitive declines in the context of "diaschisis", a phenomenon of a broad range of brain dysfunctions remote from the local lesions. Specifically, our unique paper, with two modalities of neuroimaging techniques, may help us better understand the pathology. SPECT scans yield evidence of frontal and thalamic hyper-perfusion and cerebellar hypo-perfusion in patients with pontine stroke. Functional near-infrared spectroscopy, when focusing on the supplementary motor area (SMA) as one of the hyper-perfusion areas, exhibits that SMA responses may be subject to the severity of cognitive decline due to a pontine stroke and would also be related to the recovery. Finally, we posit that cognitive decline due to pontine stroke could be explained by the failure of hierarchical cognitive processing in the fronto-ponto-cerebellar-thalamic loop.
PubMed: 38540236
DOI: 10.3390/biomedicines12030623 -
Scientific Reports Apr 2024Optical coherence tomography angiography (OCTA) is widely used for non-invasive retinal vascular imaging, but the OCTA methods used to assess retinal perfusion vary. We... (Meta-Analysis)
Meta-Analysis
Optical coherence tomography angiography (OCTA) is widely used for non-invasive retinal vascular imaging, but the OCTA methods used to assess retinal perfusion vary. We evaluated the different methods used to assess retinal perfusion between OCTA studies. MEDLINE and Embase were searched from 2014 to August 2021. We included prospective studies including ≥ 50 participants using OCTA to assess retinal perfusion in either global retinal or systemic disorders. Risk of bias was assessed using the National Institute of Health quality assessment tool for observational cohort and cross-sectional studies. Heterogeneity of data was assessed by Q statistics, Chi-square test, and I index. Of the 5974 studies identified, 191 studies were included in this evaluation. The selected studies employed seven OCTA devices, six macula volume dimensions, four macula subregions, nine perfusion analyses, and five vessel layer definitions, totalling 197 distinct methods of assessing macula perfusion and over 7000 possible combinations. Meta-analysis was performed on 88 studies reporting vessel density and foveal avascular zone area, showing lower retinal perfusion in patients with diabetes mellitus than in healthy controls, but with high heterogeneity. Heterogeneity was lowest and reported vascular effects strongest in superficial capillary plexus assessments. Systematic review of OCTA studies revealed massive heterogeneity in the methods employed to assess retinal perfusion, supporting calls for standardisation of methodology.
Topics: Tomography, Optical Coherence; Humans; Retinal Vessels; Fluorescein Angiography; Angiography
PubMed: 38670997
DOI: 10.1038/s41598-024-54306-3 -
BMC Neurology Oct 2023Dementia is generally caused by neurodegenerative diseases affecting the brain, which leads to a progressive neurocognitive decline characterized by inability to perform... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Dementia is generally caused by neurodegenerative diseases affecting the brain, which leads to a progressive neurocognitive decline characterized by inability to perform major higher functioning tasks. Fluorodeoxyglucose-positron emission tomography (FDG-PET) scan is one of the main imaging tests performed for diagnostic purposes. However, with FDG-PET being quite expensive and not widely available, an attempt to find an alternative is set. Arterial-spin-labelling magnetic resonance imaging (ASL-MRI) is an increasingly investigated substitute to FDG-PET for the diagnosis of dementia. Thereby, the main purpose of this systematic review and meta-analysis is to compare the diagnostic ability of FDG-PET and ASL-MRI in detecting dementia.
METHODS
PRISMA checklist for diagnostic test accuracy was employed in outlining this paper. A literature search was done using several search engines including PubMed, Core, and Cochrane. Two researchers (HH and SH) extracted the essential information from all included articles. Risk of bias was evaluated by the Quality Assessment of Diagnostic Accuracy Studies tool, version 2 (QUADAS-2). A qualitative analysis and summary of studies' results were provided. In addition, a meta-analysis was executed based on the studies which involved sensitivity and specificity measures of diagnostic accuracy.
RESULTS
Fourteen total studies were included in the given review. Qualitative analysis of the articles showed that nine studies demonstrated an overlap between metabolic and perfused brain maps as derived by FDG-PET and ASL-MRI respectively, while the remaining five studies registered significant differences across both modalities, with superiority to FDG-PET. As for the meta-analysis implemented, summary ROC-curve analysis revealed that FDG-PET performed better than ASL-MRI, with pooled sensitivity being significantly higher for FDG-PET.
CONCLUSIONS
Comparing the diagnostic value of FDG-PET and ASL-MRI, the results of this systematic review and meta-analysis indicate that FDG-PET still has an advantage over ASL-MRI. Such implication could be related to the technical differences relating to both modalities, with ASL-MRI having lower temporal resolution. It's worth mentioning that specificity was rather quite similar among both modalities and some studies found an overridden metabolic and perfused images. These findings call for future research to focus their scope of investigation while exploring the diagnostic value of ASL-MRI.
Topics: Humans; Fluorodeoxyglucose F18; Spin Labels; Positron-Emission Tomography; Sensitivity and Specificity; Magnetic Resonance Imaging; Dementia; Radiopharmaceuticals
PubMed: 37875879
DOI: 10.1186/s12883-023-03432-y -
PloS One 2024Wound healing monitoring for abnormality identification and intervention is crucial to securing a successful surgical outcome. Indices have been used to summarize the...
UNLABELLED
Wound healing monitoring for abnormality identification and intervention is crucial to securing a successful surgical outcome. Indices have been used to summarize the degree of healing. Given the increasing frequency of regenerative procedures which preserve dentition and implant stability, and the higher esthetic demands, an appraisal of the available indices is needed to identify the current knowledge gap. This study aimed to systematically review published oral wound healing indices and scores.
MATERIALS AND METHODS
A complete literature electronic search in 5 databases was conducted by two reviewers. A combination of keywords related to oral wound healing was used.
RESULTS
A total of 11 articles were included in the evaluation of various procedures (conventional periodontal procedures, guided tissue regeneration, soft tissue reconstruction procedures, and tooth extractions), at different time points (1 day to 12 weeks), with a focus on diverse clinical signs and symptoms. Frequently evaluated parameters included wound dehiscence/epithelialization (91%), tissue color (redness) (73%), suppuration (55%), swelling/edema (55%), and hemostasis (55%). Other less commonly used parameters include esthetics-related and patient-centered outcomes.
CONCLUSION
The available indices evaluate a diverse group of subjective clinical signs and symptoms to estimate the underlying biological healing events and assess the degree of clinical success. The majority of the included indices are not validated. Quantitative and objective subclinical parameters including blood perfusion, biomaterial stability, and completeness of epithelialization, are needed for customized wound healing care and better outcome prediction.
Topics: Humans; Wound Healing; Plastic Surgery Procedures; Tooth; Biocompatible Materials
PubMed: 38330054
DOI: 10.1371/journal.pone.0290050 -
Journal of Medical Radiation Sciences Jun 2024Brain metastases (BMs) are common in lung cancer (LC) and are associated with poor prognosis. Magnetic resonance imaging (MRI) plays a vital role in the detection,... (Review)
Review
INTRODUCTION
Brain metastases (BMs) are common in lung cancer (LC) and are associated with poor prognosis. Magnetic resonance imaging (MRI) plays a vital role in the detection, diagnosis and management of BMs. This review summarises recent advances in MRI techniques for BMs from LC.
METHODS
This systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive literature search was conducted in three electronic databases: PubMed, Scopus and the Web of Science. The search was limited to studies published between January 2000 and March 2023. The quality of the included studies was evaluated using appropriate tools for different study designs. A narrative synthesis was carried out to describe the key findings of the included studies.
RESULTS
Sixty-five studies were included. Standard MRI sequences such as T1-weighted (T1w), T2-weighted (T2w) and fluid-attenuated inversion recovery (FLAIR) were commonly used. Advanced techniques included perfusion-weighted imaging (PWI), diffusion-weighted imaging (DWI) and radiomics analysis. DWI and PWI parameters could distinguish tumour recurrence from radiation necrosis. Radiomics models predicted genetic mutations and the risk of BMs. Diagnostic accuracy was improved with deep learning (DL) approaches. Prognostic factors such as performance status and concurrent chemotherapy impacted survival.
CONCLUSION
Advanced MRI techniques and specialised MRI methods have emerging roles in managing BMs from LC. PWI and DWI improve diagnostic accuracy in treated BMs. Radiomics and DL facilitate personalised prognosis and treatment. Magnetic resonance imaging plays a key role in the continuum of care for BMs of patients with LC, from screening to treatment monitoring.
Topics: Humans; Brain Neoplasms; Lung Neoplasms; Magnetic Resonance Imaging; Neuroimaging
PubMed: 38234262
DOI: 10.1002/jmrs.756 -
Journal of Medical Economics 2024This systematic literature review (SLR) consolidated economic and healthcare resource utilization (HCRU) evidence for positron emission tomography (PET) and...
Economic and healthcare resource utilization assessments of PET imaging in Coronary Artery Disease diagnosis: a systematic review and discussion of opportunities for future economic evaluations.
AIMS
This systematic literature review (SLR) consolidated economic and healthcare resource utilization (HCRU) evidence for positron emission tomography (PET) and single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) to inform future economic evaluations.
MATERIALS AND METHODS
An electronic search was conducted in MEDLINE, Embase, and Cochrane databases from 2012-2022. Economic and HCRU studies in adults who underwent PET- or SPECT-MPI for coronary artery disease (CAD) diagnosis were eligible. A qualitative methodological assessment of existing economic evaluations, HCRU, and downstream cardiac outcomes was completed. Exploratory meta-analyses of clinical outcomes were performed.
RESULTS
The search yielded 13,439 results, with 71 records included. Economic evaluations and comparative clinical trials were limited in number and outcome types (HCRU, downstream cardiac outcomes, and diagnostic performance) assessed. No studies included all outcome types and only one economic evaluation linked diagnostic performance to HCRU. The meta-analyses of comparative studies demonstrated significantly higher rates of early- and late-invasive coronary angiography and revascularization for PET- compared to SPECT-MPI; however, the rate of repeat testing was lower with PET-MPI. The rate of acute myocardial infarction was lower, albeit non-significant with PET- vs. SPECT-MPI.
LIMITATIONS AND CONCLUSIONS
This SLR identified economic and HCRU evaluations following PET- and SPECT-MPI for CAD diagnosis and determined that existing studies do not capture all pertinent outcome parameters or link diagnostic performance to downstream HCRU and cardiac outcomes, thus, resulting in simplified assessments of CAD burden. A limitation of this work relates to heterogeneity in study designs, patient populations, and follow-up times of existing studies. Resultingly, it was challenging to pool data in meta-analyses. Overall, this work provides a foundation for the development of comprehensive economic models for PET- and SPECT-MPI in CAD diagnosis, which should link diagnostic outcomes to HCRU and downstream cardiac events to capture the full CAD scope.
Topics: Humans; Coronary Artery Disease; Positron-Emission Tomography; Tomography, Emission-Computed, Single-Photon; Cost-Benefit Analysis; Myocardial Perfusion Imaging; Patient Acceptance of Health Care
PubMed: 38650543
DOI: 10.1080/13696998.2024.2345507 -
BMJ Neurology Open 2024We conducted a systematic review and meta-analysis to assess the incidence of acute kidney injury (AKI) in patients undergoing CT angiography (CTA) and CT perfusion...
BACKGROUND AND PURPOSE
We conducted a systematic review and meta-analysis to assess the incidence of acute kidney injury (AKI) in patients undergoing CT angiography (CTA) and CT perfusion (CTP) for acute ischaemic stroke (AIS). Concerns over contrast-induced nephropathy (CIN) often lead medical centres to mandate pre-imaging serum creatinine level assessments, causing unnecessary delays. We aim to confirm further the practice of conducting CTA/CTP without first testing creatinine.
METHODS
We searched PubMed, Cochrane Central and Scopus from inception until March 2023 for studies reporting on AKI in patients with AIS receiving CTA/CTP. Outcomes of interest were (1) the odds of AKI in patients receiving CTA/CTP versus non-contrast CT and (2) the overall incidence of AKI and haemodialysis in patients with AIS undergoing CTA/CTP.
RESULTS
Results were pooled using a random effects model. 13 studies were included (5 cohort and 8 single-arm studies) with 5104 patients in total, out of which 4347 patients received CTA/CTP and 757 patients received no contrast. In case-control studies, 4.8% (OR=0.66, 95% CI 0.35 to 1.22, Z=1.32, p=0.19) of patients who received CTA/CTP developed AKI, compared with 7.7% of patients in the control group. Temporary haemodialysis was required for two patients in the analysed studies.
CONCLUSIONS
Non-randomised evidence suggests that CTA/CTP is not associated with a statistically significant increase in the risk of AKI in patients with stroke. Further well-designed prospective studies are required to explore potential risk factors of CIN in specific patient populations such as diabetes mellitus and chronic kidney disease.
PubMed: 38685917
DOI: 10.1136/bmjno-2023-000558