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European Review For Medical and... Oct 2023This study aimed to conduct a meta-analysis to compare the effectiveness and safety between titanium mesh cage (TMC) and nano-hydroxyapatite/polyamide 66 cage... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
This study aimed to conduct a meta-analysis to compare the effectiveness and safety between titanium mesh cage (TMC) and nano-hydroxyapatite/polyamide 66 cage (n-HA/PA66) in the surgical treatment of cervical spondylotic myelopathy (CSM) through anterior cervical corpectomy and fusion (ACCF).
MATERIALS AND METHODS
We implemented a comprehensive search strategy across multiple databases, including Wanfang, China Knowledge Network, China Biomedical Literature Database, Wipu, PubMed, Cochran, Embase, and Web of Science. To ensure a thorough examination of available literature, the databases were searched from their inception to January 2023. Two independent researchers evaluated the quality of the included studies by using established criteria. We used RevMan 5.4 (Review Manager Web, The Cochrane Collaboration, Copenhagen, Denmark) to facilitate data extraction and analysis.
RESULTS
This analysis included seven controlled clinical studies. The meta-analysis results showed no statistically significant differences between the two groups in terms of operating time, intraoperative bleeding, preoperative Japanese Orthopedic Association (JOA) score, preoperative visual analog scale (VAS) score, preoperative and final follow-up C2-7 Cobb angles, and intervertebral fusion rate (p > 0.05). However, a significant difference was observed between the two groups in terms of the final follow-up JOA [MD = 0.77, 95% CI (0.58, 0.97), p < 0.00001], VAS [MD = -0.50, 95% CI (-0.71, -0.30), p < 0.00001], and sedimentation rate [RR = 0.30, 95% CI (0.18, 0.48), p < 0.00001].
CONCLUSIONS
The use of n-HA/PA66 in ACCF for treating CSM is safe and effective treatment with positive clinical efficacy. In addition, n-HA/PA66 has both effective clinical efficacy and significantly lower fusion settling rates compared to TMC.
Topics: Humans; Nylons; Durapatite; Spinal Fusion; Spondylosis; Treatment Outcome; Spinal Cord Diseases; Cervical Vertebrae; Retrospective Studies
PubMed: 37916330
DOI: 10.26355/eurrev_202310_34136 -
Asian Journal of Surgery Sep 2023Permanent hypoparathyroidism is a postoperative complication of thyroid and parathyroid surgery and can be cured by cryopreserved parathyroid autotransplantation (CPAT).... (Review)
Review
Permanent hypoparathyroidism is a postoperative complication of thyroid and parathyroid surgery and can be cured by cryopreserved parathyroid autotransplantation (CPAT). However, due to the lack of unified and standardized guidelines, the limited ability of the parathyroid tissue itself to withstand cryopreservation, and some yet-to-be-defined processes or technologies, the success rate of cryopreserved parathyroid autotransplantation varies between institutions; it is low for some institutions and high for others. Due to the sparsity of data, views vary on which factors most influence the success rate of cryopreserved parathyroid autotransplantation. In this review, we analyzed the following probable influencing factors: ischemic period before cryopreservation; processes of cryopreservation and thawing, including freezing medium; freezing and thawing methods; duration of cryopreservation; examination of the graft before transplantation; graft site; mass of transplanted tissue fragments; blood calcium level; and the evaluation criteria for cryopreserved parathyroid autotransplantation success. Although the effects of these factors are debatable, we hypothesized that examining them in the above-given order to determine whether they affect the success rate of cryopreserved parathyroid autotransplantation could be beneficial to maximizing the success rate. Our findings led us to conclude that cryopreserved parathyroid autotransplantation operations should be standardized. Standardized guidelines for cryopreserved parathyroid autotransplantation that include such factors as ischemic period time, freezing and thawing methods, and recipient status should be established based on a comprehensive analysis of these factors.
Topics: Humans; Transplantation, Autologous; Parathyroid Glands; Hypoparathyroidism; Cryopreservation; Postoperative Complications
PubMed: 37105818
DOI: 10.1016/j.asjsur.2023.04.032 -
Tissue Engineering. Part B, Reviews Aug 2023Surgical outcomes of pelvic organ prolapse (POP) surgery are poor, resulting in a 20% recurrence risk. Following the hypothesis that impaired wound healing is the main... (Meta-Analysis)
Meta-Analysis Review
Surgical outcomes of pelvic organ prolapse (POP) surgery are poor, resulting in a 20% recurrence risk. Following the hypothesis that impaired wound healing is the main determinant of recurrent POP, growth factors have the potential to promote wound healing and may improve surgical outcomes. In this study, we systematically reviewed the effect of growth factors on vaginal wound healing in both and animal studies. For each independent comparison, the standardized mean difference and 95% CI were calculated using the Hedges' g correction. Of the 3858 retrieved studies, seven studies were included, of which six were included in meta-analysis (three studies and four studies). , basic fibroblast growth factor (bFGF) promotes proliferation, differentiation, and collagen types I and III production. Epidermal growth factor stimulates proliferation and connective tissue growth factor promotes Tenascin-C expression. These effects, however, are less pronounced ; only bFGF slightly promotes collagen production. The review shows that growth factors, particularly bFGF, are able to promote vaginal wound healing . The uncertain findings suggest that preclinical models should be improved. The ultimate goal is to develop effective growth factor-supplemented therapies that improve surgical outcomes for POP.
Topics: Animals; Female; Wound Healing; Collagen
PubMed: 37051705
DOI: 10.1089/ten.TEB.2022.0225 -
Joint Diseases and Related Surgery Jan 2024The study aimed to compare the efficacy and safety of percutaneous kyphoplasty (PKP) and vertebral body stenting (VBS) in the treatment of osteoporotic vertebral... (Meta-Analysis)
Meta-Analysis
Comparison of clinical and radiological outcomes of vertebral body stenting versus percutaneous kyphoplasty for the treatment of osteoporotic vertebral compression fracture: A systematic review and meta-analysis.
OBJECTIVES
The study aimed to compare the efficacy and safety of percutaneous kyphoplasty (PKP) and vertebral body stenting (VBS) in the treatment of osteoporotic vertebral compression fractures (OVCFs) and evaluate the clinical efficacy, Cobb angle correction, and cement leakage associated with both methods for OVCFs.
PATIENTS AND METHODS
A systematic search was conducted in PubMed, EMBASE, Cochrane Library, Medline, China National Knowledge, and Wanfang Data for clinical studies comparing VBS with PKP for OVCF up to May 2023. The meta-analysis was performed using Review Manager 5.3, with a focus on evaluating clinical and radiologic outcomes.
RESULTS
A total of eight eligible clinical studies were included in this meta-analysis. In terms of clinical outcomes, VBS was found to have a longer surgical time compared to PKP (standard mean difference [SMD]=1.06 min; 95% confidence interval [CI]: 0.20, 1.92; p=0.02). However, VBS demonstrated comparable blood loss to PKP (SMD =0.00 mL; 95% CI: -0.45, 0.45; p=0.99). Additionally, VBS showed slight superiority in alleviating back pain as measured by the Visual Analog Scale (VAS) (SMD=-0.38; 95% CI: -0.63, -0.12; p=0.004), as well as in improving functional disability based on the Oswestry Disability Index (ODI) (SMD= -0.28; 95% CI: -0.54, -0.03; p=0.03). Radiographically, VBS achieved better Cobb angle correction compared to PKP (SMD= -1.00; 95% CI: -1.48, -0.51; p<0.0001), while there was no significant difference in cement leakage between VBS and PKP (odds ratio=0.81; 95% CI: 0.21, 3.14; p=0.76).
CONCLUSION
The findings suggest that VBS has a comparable clinical outcome to PKP based on operation time, intraoperative blood loss, VAS, and ODI. Furthermore, VBS showed slightly better maintenance of Cobb angle correction, whereas VBS did not demonstrate a significant advantage over PKP in terms of cement leakage.
Topics: Humans; Kyphoplasty; Fractures, Compression; Spinal Fractures; Vertebral Body; Osteoporotic Fractures; Bone Cements
PubMed: 38108184
DOI: 10.52312/jdrs.2023.1356 -
The Science of the Total Environment Sep 2023Microplastics have been reported in wastewater treatment works across the world. The majority of microplastics are removed during the wastewater treatment process, with... (Review)
Review
Microplastics have been reported in wastewater treatment works across the world. The majority of microplastics are removed during the wastewater treatment process, with removal efficiencies between 57 % to 99 %. What happens to the microplastics removed from the wastewater, and how they accumulate in sewage sludge and biosolids (by-products of the wastewater treatment process), remains a topic of high interest. Here we systematically reviewed the current state of knowledge on the presence, concentration, and characteristics of microplastics in sewage sludge and biosolids globally to understand how biosolids may act as a pathway for microplastic pollution to soils. A systematic search was performed on the Web of Science and Science Direct databases. Sixty-five studies reporting on microplastic pollution in sewage sludge and biosolid products were identified, spanning twenty-five countries. Reported microplastic concentrations varied considerably from 0.193 microplastics/g to 1.69 × 10 microplastics/g with a median microplastic concentration of 22.41 microplastics/g, illustrating how many microplastics are captured during the wastewater treatment process, and retained in the sewage sludge. The extent to which biosolid recycling pollutes the terrestrial environment was compared between countries. High numbers of microplastics were estimated to reach fields via biosolid application with a wide variation of 8.2 × 10 to 1.29 × 10 microplastics/year between sixteen countries, although there was no significant difference in microplastic concentration between fields with a history of biosolid applications and control fields. The comparative risk this delivery of approx. 0.4 to 6430 tonnes of microplastics poses compared to the environmental benefits of nutrient and carbon recycling associated with biosolids reuse, or compared to other sources of microplastic pollution remains a global research imperative. The next step in scientific research needs to focus on solutions to the biosolid and circular economy conundrum - biosolids are a valuable source of nutrients but contain high concentrations of microplastics, which are ultimately entering the terrestrial environment.
Topics: Microplastics; Sewage; Plastics; Biosolids; Wastewater
PubMed: 37236476
DOI: 10.1016/j.scitotenv.2023.164068 -
Toxicology Reports Jun 2024PAE and PC polymers, such as BPA, are utilized to make water bottles. Due to the lack of polymer-chemical interaction, PAE can enter drinking bottles during production,... (Review)
Review
PAE and PC polymers, such as BPA, are utilized to make water bottles. Due to the lack of polymer-chemical interaction, PAE can enter drinking bottles during production, wrapping, and keeping. Phthalates can transfer from the bottle to the water depending on keeping conditions (temperature, time, sunlight intensity), pH, and bottle capacity. Since there haven't been previous studies published on the subject, the aim of this meta-analysis and systematic review research is to determine the level of phthalates in drinking water consumed in Iranian cities. Web of Science, Science of Direct, Scopus, and PubMed, databases have been used in this study. Eight studies were selected from 556 initial publications after screening for duplication and irrelevant information. Articles from January 1, 2000, to February 10, 2024, were found in the mentioned databases. Among the types of phthalates, the concentration of DEHP was reported higher than the others Because its concentration has been reported in seven out of eight studies. The highest concentration of DEHP was reported by Mehraie(2.22 µg/l), Zare Jeddi (0.8 µg/l), Yousefi (0.77 µg/l), Abtahi (0.76 µg/l), Zare Jeddi (0.42 µg/l), Abdolahnejad(0.15 µg/l), and Pourzamani (0.08 µg/l). The highest concentration of DEP, DBP, BBP, and PA was reported by Abtahi (0.77 µg/l) and Esteki (2.25 µg/l), Mehraie(0.93 µg/l), and Pourzamani (0.83 µg/l). The results of this study showed that the most important phthalates measured in drinking water include DEP, DEHP, DBP, BBP, and PA. According to the results of the present studies, the most important factor in the increase of phthalates is the storage conditions of drinking water (temperature, sunlight, and the type of pipe or bottle).
PubMed: 38495472
DOI: 10.1016/j.toxrep.2024.02.009 -
International Journal of Pharmaceutics:... Dec 2023Electrospun chitosan nanofibers (QSNFs) enhance the healing process by mimicking skin structure and function. The aim of this study was to analyze the therapeutic... (Review)
Review
Electrospun chitosan nanofibers (QSNFs) enhance the healing process by mimicking skin structure and function. The aim of this study was to analyze the therapeutic effects of QSNFs application on animal skin wounds to identify a potential direction for translational research in dermatology. The PRISMA methodology and the PICO scheme were used. A random effects model and mean difference analysis were applied for the meta-analysis. A meta-regression model was constructed, risk of bias was determined, and methodological quality assessment was performed. Of the 2370 articles collected, 54 studies were selected based on the inclusion and exclusion criteria. The wound healing area was used for building models on the 3rd, 7th, and 14th days of follow-up; the results were - 10.4% (95% CI, -18.2% to -2.6%, = 0.001), -21.0% (95% CI, -27.3% to -14.7%, p = 0.001), and - 14.0% (95% CI, -19.1 to -8.8%, p = 0.001), respectively. Antioxidants and synthetic polymers combined with QSNFs further reduced skin wound areas ( < 0.05). The results show a more efficient reduction in wound area percentages in experimental groups than in control groups, so QSNFs could potentially be applied in translational human medicine research.
PubMed: 36950662
DOI: 10.1016/j.ijpx.2023.100175 -
In Vivo (Athens, Greece) 2023Silicone implants or tissue expanders placed under the pectoralis major (PM) muscle are often used for breast reconstruction. However, the disruption of PM insertions,... (Review)
Review
Silicone implants or tissue expanders placed under the pectoralis major (PM) muscle are often used for breast reconstruction. However, the disruption of PM insertions, which is often an inevitable part of the surgical procedure, is known to cause PM morbidity and, subsequently, problems with the use of the ipsilateral arm. In this systematic review, we present current knowledge regarding the effect of submuscular silicone-based breast reconstruction on the function of PM and the ipsilateral arm. A search of the relevant English literature was performed through PubMed and ten eligible studies were identified. Articles reporting breast augmentation were accepted as the techniques of implant insertion are similar to reconstruction. Questionnaires reporting the status of the arm, analysis of the range of motion of the shoulder with 3-D video, isometric or isokinetic dynamometry, ultrasound shear-wave elastography, volumetric MRI, electromyography and light and electron microscopy of the PM fibers were used for the assessment of PM and arm status. The insertion of implants under the PM, especially when combined with dissection of some of its insertions, seems to be associated with measurable abnormal microscopic, imaging, and dynamometric findings. However, the intact part of the muscle and possibly other nearby muscular structures are able to compensate for the lost part of PM. Thus, the insertion of implants fully or partially under the PM seems to have no or little effect on the function of the ipsilateral upper limb in daily life.
Topics: Pectoralis Muscles; Silicones; Mammaplasty; Prostheses and Implants; Magnetic Resonance Imaging; Breast Implants
PubMed: 37652471
DOI: 10.21873/invivo.13289 -
Journal of Hazardous Materials Sep 2023In recent years, the number of publications on nano- and microplastic particles (NMPs) effects on freshwater organisms has increased rapidly. Freshwater crustaceans of... (Meta-Analysis)
Meta-Analysis Review
In recent years, the number of publications on nano- and microplastic particles (NMPs) effects on freshwater organisms has increased rapidly. Freshwater crustaceans of the genus Daphnia are widely used in ecotoxicological research as model organisms for assessing the impact of NMPs. However, the diversity of experimental designs in these studies makes conclusions about the general impact of NMPs on Daphnia challenging. To approach this, we systematically reviewed the literature on NMP effects on Daphnia and summarized the diversity of test organisms, experimental conditions, NMP properties and measured endpoints to identify gaps in our knowledge of NMP effects on Daphnia. We use a meta-analysis on mortality and immobilization rates extracted from the compiled literature to illustrate how NMP properties, study parameters and the biology of Daphnia can impact outcomes in toxicity bioassays. In addition, we investigate the extent to which the available data can be used to predict the toxicity of untested NMPs based on the extracted parameters. Based on our results, we argue that focusing on a more diverse set of NMP properties combined with a more detailed characterization of the particles in future studies will help to fill current research gaps, improve predictive models and allow the identification of NMP properties linked to toxicity.
Topics: Animals; Plastics; Microplastics; Water Pollutants, Chemical; Daphnia; Fresh Water; Ecotoxicology
PubMed: 37348369
DOI: 10.1016/j.jhazmat.2023.131839 -
Neurology(R) Neuroimmunology &... Sep 2023Glial fibrillary acidic protein (GFAP) antibodies can associate with an astrocytopathy often presenting as a meningoencephalitis. Visual involvement has been reported...
BACKGROUND AND OBJECTIVES
Glial fibrillary acidic protein (GFAP) antibodies can associate with an astrocytopathy often presenting as a meningoencephalitis. Visual involvement has been reported but scarcely defined. We describe 2 cases of GFAP astrocytopathy with predominant visual symptoms and present a systematic review of the literature.
METHODS
We describe 2 patients with GFAP astrocytopathy from our neurology department. We performed a systematic review of the literature according to PRISMA guidelines, including all patients with this disease and available clinical data, focusing on visual involvement.
RESULTS
Patient 1 presented with bilateral optic disc edema and severe sudden bilateral loss of vision poorly responsive to therapy. Patient 2 showed bilateral optic disc edema, headache, and mild visual loss with complete recovery after steroids. We screened 275 records and included 84 articles (62 case reports and 22 case series) for a total of 592 patients. Visual involvement was reported in 149/592 (25%), with either clinical symptoms or paraclinical test-restricted abnormalities. Bilateral optic disc edema was found in 80/159 (50%) of patients investigated with fundoscopy, among which 49/80 (61%) were asymptomatic. One hundred (100/592, 17%) reported visual symptoms, often described as blurred vision or transient visual obscurations. Optic neuritis was rare and diagnosed in only 6% of all patients with GFAP astrocytopathy, often without consistent clinical and paraclinical evidence to support the diagnosis. Four patients (including patient 1) manifested a severe, bilateral optic neuritis with poor treatment response. In patients with follow-up information, a relapsing disease course was more frequently observed in those with vs without visual involvement (35% vs 11%, = 0.0035, OR 3.6 [CI 1.44-8.88]).
DISCUSSION
Visual system involvement in GFAP astrocytopathy is common and heterogeneous, ranging from asymptomatic bilateral optic disc edema to severe bilateral loss of vision, but optic neuritis is rare. GFAP CSF antibody testing should be considered in patients with encephalitis/meningoencephalitis or myelitis and bilateral optic disc edema, even without visual symptoms, and in patients with severe bilateral optic neuritis, especially when AQP4 antibodies are negative. Visual symptoms might associate with a higher relapse risk and help to identify patients who may require chronic immunosuppression.
Topics: Humans; Papilledema; Glial Fibrillary Acidic Protein; Meningoencephalitis; Optic Neuritis; Antibodies
PubMed: 37582612
DOI: 10.1212/NXI.0000000000200146