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Burns & Trauma 2024Laser therapy has emerged to play a valuable role in the treatment of paediatric burn scars; however, there is heterogeneity in the literature, particularly concerning...
BACKGROUND
Laser therapy has emerged to play a valuable role in the treatment of paediatric burn scars; however, there is heterogeneity in the literature, particularly concerning optimal timing for initiation of laser therapy. This study aims to investigate the effect of factors such as scar age, type of laser and laser treatment interval on burn scar outcomes in children by meta-analysis of previous studies.
METHODS
A literature search was conducted across seven databases in May 2022 to understand the effects of laser therapy on burn scar outcomes in paediatric patients by metanalysis of standardized mean difference (SMD) between pre- and post-laser intervention. Meta-analyses were performed using the Comprehensive Meta-Analysis software version 4.0. Fixed models were selected when there was no significant heterogeneity, and the random effects model was selected for analysis when significant heterogeneity was identified. For all analyses, a -value < 0.05 was considered significant.
RESULTS
Seven studies were included in the meta-analysis with a total of 467 patients. Laser therapy significantly improved Vancouver Scar Scale (VSS)/Total Patient and Observer Scar Assessment Scale (Total POSAS), vascularity, pliability, pigmentation and scar height of burn scars. Significant heterogeneity was found between the studies and thus subgroup analyses were performed. Early laser therapy (<12 months post-injury) significantly improved VSS/POSAS scores compared to latent therapy (>12 months post-injury) {SMD -1.97 [95% confidence interval (CI) = -3.08; -0.87], < 0.001 -0.59 [95%CI = -1.10; -0.07], = 0.03} as well as vascularity {SMD -3.95 [95%CI = -4.38; -3.53], < 0.001 -0.48 [95%CI = -0.66; -0.30], < 0.001}. Non-ablative laser was most effective, significantly reducing VSS/POSAS, vascularity, pliability and scar height outcomes compared to ablative, pulse dye laser and a combination of ablative and pulse dye laser. Shorter treatment intervals of <4 weeks significantly reduced VSS/POSAS and scar height outcomes compared to intervals of 4 to 6 weeks.
CONCLUSIONS
Efficacy of laser therapy in the paediatric population is influenced by scar age, type of laser and interval between laser therapy application. The result of this study particularly challenges the currently accepted initiation time for laser treatment. Significant heterogeneity was observed within the studies, which suggests the need to explore other confounding factors influencing burn scar outcomes after laser therapy.
PubMed: 38312741
DOI: 10.1093/burnst/tkad046 -
BMJ Open Ophthalmology Oct 2023The rising prevalence of myopia is a concern in ophthalmology, with myopic choroidal neovascularisation (m-CNV) significantly affecting vision. However, long-term...
INTRODUCTION
The rising prevalence of myopia is a concern in ophthalmology, with myopic choroidal neovascularisation (m-CNV) significantly affecting vision. However, long-term outcomes of m-CNV management have been unsatisfactory, leading to high recurrence rates. These studies aim to identify risk factors for m-CNV recurrence.
METHODS
Comprehensive review followed a pre-registered plan in the International Prospective Register of Systematic Reviews (PROSPERO). The search strategy used various databases including PubMed, Cochrane Library, Embase, Scopus and ScienceDirect using the keywords 'Myopic Choroidal Neovascularization', 'Recurrence' and 'Risk'. Eligible studies were identified and analysed based on predetermined criteria. This study was registered on PROSPERO (CRD4202343461).
RESULTS
The systematic review included three retrospective studies investigating risk factors associated with m-CNV recurrence. These factors are: (1) requiring three or more injections for initial disease control, (2) older age, (3) larger myopic macular neovascularisation, (4) juxtafoveal CNV, (5) larger height of hyper-reflective foci (HRF) and (6) destruction or absence of the ellipsoid zone (EZ) and retinal pigment epithelium (RPE).
CONCLUSION
Risk factors for m-CNV recurrence include a greater number of required injections, older age, large macular CNV, juxtafoveal location, increased HRF height and changes in EZ and RPE structure. Understanding these factors can inform personalised treatment approaches and improve patient outcomes by identifying individuals at higher risk of recurrence and implementing proactive measures to mitigate the impact of m-CNV recurrence and progression. Further investigation is needed to enhance our understanding of the underlying mechanisms and develop innovative therapeutic approaches for effective m-CNV management.
PROSPERO REGISTRATION NUMBER
CRD4202343461.
Topics: Humans; Choroidal Neovascularization; Myopia, Degenerative; Retrospective Studies
PubMed: 37816549
DOI: 10.1136/bmjophth-2023-001396 -
Skin Health and Disease Dec 2023Pigmented skin lesions in human adults can present with several different visible features that may indicate signs of malignancy, particularly melanoma. Patient and...
BACKGROUND
Pigmented skin lesions in human adults can present with several different visible features that may indicate signs of malignancy, particularly melanoma. Patient and clinician awareness of these features can aid the early recognition and melanoma diagnosis improving patient outcomes. The seven-point checklist (7PCL) is a clinical prediction rule advocated by the National Institute for Health Care Excellence to aid the assessment of pigmented skin lesions in primary care to indicate referral for specialist opinion.
OBJECTIVES
Assess the current evidence to establish which features of the 7PC present more frequently, so public education and clinician assessment can be focused to maximise early diagnosis and minimise referrals of benign lesions.
METHODS
A systematic review of published evidence identified studies that assessed the seven features of the 7PCL in histologically proven melanomas. Two independent reviewers screened eligible studies and independently extracted data and assessed quality.
RESULTS
112 studies were screened, 20 were assessed in full, seven met the inclusion criteria. 1184 histologically diagnosed melanomas were assessed using the 7PCL. Four studies involved patients assessing 335 melanomas, and three involved clinicians who assessed 849 melanomas. The most common feature identified was a change in size of the lesion, and the least common was inflammation.
CONCLUSIONS
The most frequently occurring features of melanoma involve shape, size and colour, however focussing on changes in features, rather than irregularity, is more likely to identify early melanoma and increase the accuracy of referrals.
PubMed: 38047248
DOI: 10.1002/ski2.295 -
Current Nutrition Reports Dec 2023Dietary patterns that include polyphenols may help manage cardiometabolic risk factors. Pigmented rice contains phenolic acids and flavonoids that contribute to its...
PURPOSE OF REVIEW
Dietary patterns that include polyphenols may help manage cardiometabolic risk factors. Pigmented rice contains phenolic acids and flavonoids that contribute to its antioxidant properties. This review examined the effect of polyphenol-containing pigmented rice on antioxidant status, lipid profile, glucose/insulin, blood pressure, and weight among adults. Four electronic databases including PubMed, ProQuest, EBSCOhost, and Google Scholar were systematically searched for relevant articles published in English since 2000, using PRISMA guidelines (PROSPERO registration: CRD42022358132). Two-staged screening resulted in the inclusion of seventeen (seven acute, ten chronic) randomized controlled trials. A random effects model was conducted on cardiometabolic outcomes reported in at least three studies.
RECENT FINDINGS
Acute intake increased plasma antioxidant activity and lowered postprandial glucose and insulin levels. Chronic consumption was associated with reductions in fasting glucose (WMD: -1.60 mg/dL; 95% CI:-3.05,-0.14, p = 0.03, k = 5, n = 349), weight (WMD: -0.23 kg, 95% CI: -0.44, -0.02, p = 0.03, k = 3, n = 182), and diastolic blood pressure (WMD: -1.39 mmHg, 95% CI: -2.21, -0.56, p = 0.001, k = 3, n = 185). No effect on total cholesterol, low-density lipoprotein, high-density lipoprotein, triglycerides, body mass index, and systolic blood pressure was found. The consumption of pigmented rice may improve cardiometabolic risk factors. However, the small number of studies and differences in study design, including participants' health status, form of rice utilized, and duration of intervention, support the need for more high-quality trials to further investigate these findings.
Topics: Adult; Humans; Antioxidants; Cardiovascular Diseases; Glucose; Insulins; Oryza; Randomized Controlled Trials as Topic
PubMed: 37676476
DOI: 10.1007/s13668-023-00496-7 -
Journal of Racial and Ethnic Health... Dec 2023Wearable consumer technology allows for the collection of a growing amount of personal health data. Through the analysis of reflected LED light on the skin, heart rate...
BACKGROUND
Wearable consumer technology allows for the collection of a growing amount of personal health data. Through the analysis of reflected LED light on the skin, heart rate measurement and arrhythmia detection can be performed. Given that melanin alters skin light absorption, this study seeks to summarize the accuracy of cardiac data from wrist-worn wearable devices for participants of varying skin tones.
METHODS
We conducted a systematic review, searching Embase, MEDLINE, CINAHL, and Cochrane for original studies that stratified heart rate and rhythm data for consumer wearable technology according to participant race and/or skin tone.
RESULTS
A total of 10 studies involving 469 participants met inclusion criteria. The frequency-weighted Fitzpatrick score for skin tone was reported in six studies (n = 293), with a mean participant score of 3.5 (range 1-6). Overall, four of the ten studies reported a significant reduction in accuracy of heart rate measurement with wearable devices in darker-skinned individuals, compared to participants with lighter skin tones. Four studies noted no effect of user skin tone on accuracy. The remaining two studies showed mixed results.
CONCLUSIONS
Preliminary evidence is inconclusive, but some studies suggest that wearable devices may be less accurate for detecting heart rate in participants with darker skin tones. Higher quality evidence is necessary, with larger sample sizes and more objective stratification of participants by skin tone, in order to characterize potential racial bias in consumer devices.
Topics: Humans; Wrist; Heart Rate; Skin Pigmentation; Wearable Electronic Devices
PubMed: 36376641
DOI: 10.1007/s40615-022-01446-9 -
Archives of Dermatological Research Mar 2024The objectives are to determine the frequency that skin color is reported in randomized controlled trials (RCTs) involving squamous cell carcinoma (SCC) detection and...
The objectives are to determine the frequency that skin color is reported in randomized controlled trials (RCTs) involving squamous cell carcinoma (SCC) detection and treatment in leading dermatology journals. A systematic review of RCTs involving SCC was conducted among the top ten most impactful dermatology journals from inception to July 10th, 2023. Studies were included if they reviewed the treatment, prevention, or detection of SCC, involved patients directly and were classified as traditional RCTs. Studies were considered positive for reporting SOC if there was any demographic data in the methods or results of the following terms: Fitzpatrick scale, race, ethnicity, sunburn tendency, or skin of color. Of the 39 studies which were identified, 23 reported data related to skin color data (59.0%). White individuals were the most reported in these studies (56.5%). Subgroup analysis was conducted, and no statistical significance was found for study location, year of publication, or funding source. Skin color impacts skin cancer detection, predominant location of tumors, and recurrence. Less than 60% of high-quality RCTs related to SCC in top global dermatology journals included skin color among the demographic traits of study participants. Subgroup analysis demonstrated no improvement in reporting over the past 2 decades. Further research is needed to understand the reason for low skin color reporting rates among SCC-related RCTs and the impact this has on society.
Topics: Humans; Carcinoma, Squamous Cell; Dermatology; Periodicals as Topic; Randomized Controlled Trials as Topic; Skin Pigmentation; Racial Groups
PubMed: 38554241
DOI: 10.1007/s00403-024-02843-2