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Journal of Clinical Medicine Jun 2023Allograft urolithiasis is an uncommon, challenging, and potentially dangerous clinical problem. Treatment of allograft stones includes external shockwave lithotripsy... (Review)
Review
BACKGROUND
Allograft urolithiasis is an uncommon, challenging, and potentially dangerous clinical problem. Treatment of allograft stones includes external shockwave lithotripsy (SWL), flexible ureteroscopy and lasertripsy (fURSL), or percutaneous nephrolithotomy (PCNL). A gap in the literature and guidelines exists regarding the treatment of patients in this setting. The aim of this systematic review was to collect preoperative and treatment characteristics and evaluate the outcomes of post-transplant SWL for stone disease.
METHODS
A systematic search in the literature was performed, including articles up to March 2023. Only original English articles were selected.
RESULTS
Eight articles (81 patients) were included in the review. Patients were mainly male, with a mean age of 41.9 years (±7.07). The mean stone size was 13.18 mm (±2.28 mm). Stones were predominantly located in the kidney ( = 18, 62%). The overall stone-free rate and complication rates were 81% (range: 50-100%) and 17.2% (14/81), respectively, with only one major complication reported. A pre-operative drainage was placed in eleven (13.5%) patients. Five patients (6.71%) required a second treatment for residual fragments.
CONCLUSIONS
SWL is a safe and effective option to treat de novo stones after transplantation. Larger studies are needed to better address allograft urolithiasis management.
PubMed: 37445423
DOI: 10.3390/jcm12134389 -
Epilepsy & Behavior : E&B Sep 2022Psychiatric comorbidities, including depression and suicide, contribute substantially to the illness burden of patients with refractory temporal lobe epilepsy (TLE). The... (Review)
Review
Psychiatric comorbidities, including depression and suicide, contribute substantially to the illness burden of patients with refractory temporal lobe epilepsy (TLE). The aim of this systematic review was to synthesize the existing literature assessing the effect of TLE surgery on (1) depression prevalence and (2) severity, and estimating the incidence of (3) de novo depression and (4) attempted and completed suicide following TLE surgery. A literature search was performed using Ovid Medline, Embase, Clarivate Web of Science, Cochrane Library, and ProQuest Dissertations and Theses. Studies of patients with TLE who underwent TLE surgery and reported estimates of at least one of the following outcomes were included: pre- and postoperative depression prevalence or severity, the incidence of postoperative de novo depression, or attempted or completed suicide. The search yielded 2,127 citations related to TLE surgery and postoperative depression or suicide. After a full-text review of 98 articles, 18 met the final eligibility criteria. Most studies reported a reduced or similar prevalence (n = 12) and severity of depression (n = 5) postoperatively, compared with the preoperative period. Eleven studies reported the incidence of postoperative de novo depression, which ranged from 0 % to 38 % over follow-up periods of three months to nine years. Four studies assessed the incidence of postoperative attempted or completed suicide, with completed suicide incidence ranging from 0 % to 3 % over follow-up periods of one to four years. Overall, the effect of TLE surgery on depression and suicide remains unclear, as many studies did not assess the statistical significance of depression prevalence or severity changes following TLE surgery. Therefore, timely psychosocial follow-up for patients after TLE surgery should be considered. Future longitudinal studies with consistent measures are needed to elucidate the effect of TLE surgery on the prevalence and severity of depression and estimate the incidence of de novo depression and suicide following surgery.
Topics: Anterior Temporal Lobectomy; Depression; Depressive Disorder; Epilepsy, Temporal Lobe; Humans; Postoperative Complications; Suicide
PubMed: 35905516
DOI: 10.1016/j.yebeh.2022.108853 -
Neurogenetics Oct 2022C-terminal binding proteins (CtBP1/2) are transcriptional coregulators that play a significant role during vertebrate neurodevelopment. This systematic review aims to... (Review)
Review
C-terminal binding proteins (CtBP1/2) are transcriptional coregulators that play a significant role during vertebrate neurodevelopment. This systematic review aims to identify case reports with genetic variants in CTBP1 and CTBP2 associated with brain development syndromes.We screened different databases (PubMed, Scopus, Google Scholar, LILACS) by systematically searching journals and checking reference lists and citations of background papers. We found fourteen cases (10 males) from five papers carrying two pathogenic, heterozygous variants in the CTBP1 gene (13 individuals carried the missense mutation c.991C T, p.Arg342Trp, and one subject carrying the 2-base pair deletion c.1315_1316delCA, p.Gln439ValfsTer84). These mutations were de novo in 13 cases and one case of maternal germinal mosaicism. Two variants are in the same domain of the protein: Pro-Leu-Asp-Leu-Ser (PLDLS) C terminal. Patients with these mutations exhibit a phenotype with intellectual disability, HADDTS syndrome (hypotonia, ataxia, developmental delay, and tooth enamel defects), and cerebellar volume loss. We did not identify reported cases associated with homozygous mutations harbored in CTBP1. We did not identify any report of neurodevelopment phenotypes associated with heterozygous or homozygous CTBP2 mutations. Due to CTBP2/RIBEYE being a gene with dual function, identifying and interpreting the potential pathogenic variants is challenging.Further, homozygous mutations in the CTBP2 gene may be lethal. The mechanisms involved in the pathogenesis of neurodevelopment due to variants of these proteins have not yet been elucidated, despite some functional evidence. Further studies should be conducted to understand these transcription factors and their interaction with each other and their partners.
Topics: Humans; Alcohol Oxidoreductases; Ataxia; Co-Repressor Proteins; Muscle Hypotonia; Mutation; Mutation, Missense; Transcription Factors
PubMed: 36331689
DOI: 10.1007/s10048-022-00700-w -
East Asian Archives of Psychiatry :... Jun 2023Clozapine is a potent antipsychotic medication with a complex receptor profile. It is reserved for treatment-resistant schizophrenia. We systematically reviewed studies...
OBJECTIVE
Clozapine is a potent antipsychotic medication with a complex receptor profile. It is reserved for treatment-resistant schizophrenia. We systematically reviewed studies of non-psychosis symptoms of clozapine withdrawal.
METHODS
CINAHL, Medline, PsycINFO, PubMed, and the Cochrane Database of Systematic Reviews were searched using the keywords 'clozapine,' and 'withdrawal,' or 'supersensitivity,' 'cessation,' 'rebound,' or 'discontinuation'. Studies related to non-psychosis symptoms after clozapine withdrawal were included.
RESULTS
Five original studies and 63 case reports / series were included in analysis. In 195 patients included in the five original studies, approximately 20% experienced non-psychosis symptoms following discontinuation of clozapine. In 89 patients in four of the studies, 27 experienced cholinergic rebound, 13 exhibited extrapyramidal symptoms (including tardive dyskinesia), and three had catatonia. In 63 case reports / series included, 72 patients with non-psychosis symptoms were reported, which were catatonia (n=30), dystonia or dyskinesia (n=17), cholinergic rebound (n=11), serotonin syndrome (n=4), mania (n=3), insomnia (n=3), neuroleptic malignant syndrome (NMS) [n=3, one of them had both catatonia and NMS], and de novo obsessive compulsive symptoms (n=2). Restarting clozapine appeared to be the most effective treatment.
CONCLUSIONS
Non-psychosis symptoms following clozapine withdrawal have important clinical implications. Clinicians should be aware of the possible presentations of symptoms to ensure early recognition and management. Further research is warranted to better characterise the prevalence, risk factors, prognosis, and optimal drug dosing for each withdrawal symptom.
Topics: Humans; Antipsychotic Agents; Catatonia; Cholinergic Agents; Clozapine; Schizophrenia; Substance Withdrawal Syndrome
PubMed: 37400227
DOI: 10.12809/eaap2261 -
Human Reproduction Update Aug 2021In the decade following the introduction of ICSI, a higher prevalence of de novo chromosome abnormalities, in particular sex chromosome and autosomal structural... (Meta-Analysis)
Meta-Analysis
BACKGROUND
In the decade following the introduction of ICSI, a higher prevalence of de novo chromosome abnormalities, in particular sex chromosome and autosomal structural abnormalities, as well as inherited abnormalities was described in children conceived by ICSI compared to both naturally conceived (NC) children and children conceived by standard IVF. The explanation for the observed increase in prevalence is not clear and has been suggested to reflect parental factors (e.g. age or sperm quality) or to be a result of the ICSI procedure itself. Over the years, the procedure, as well as the patient group, and indications for ICSI treatment have changed.
OBJECTIVE AND RATIONALE
The objective of this systematic review and meta-analysis was to assess the prevalence of chromosome abnormalities in ICSI pregnancies and children and to examine any potentially increased risk compared to standard IVF and NC.
SEARCH METHODS
Pubmed, Embase, Cochrane Libraries and Web of Science up to October 2020 were searched. Primary outcome measures were overall chromosome abnormalities and de novo abnormalities (including sex chromosome abnormalities and autosomal abnormalities). The secondary outcome was inherited abnormalities. We followed the PRISMA guidelines and relevant meta-analyses were performed.
OUTCOMES
The search included 4648 articles, out of which 27 met the inclusion criteria, and 19 were included in quantitative synthesis (meta-analyses). The prevalence of chromosome abnormalities varied considerably between studies, possibly explained by large differences in sample size and patient demographics. Only five studies were eligible for pooled analyses on adjusted data. All studies had a critical risk of bias. Results from pooled adjusted data showed no evidence of an increased risk of overall chromosome abnormalities when comparing ICSI to either standard IVF (aOR 0.75 (95% CI 0.41-1.38)) or NC (aOR 1.29 (95% CI 0.69-2.43)). In contrast, meta-analyses on unadjusted data showed an increased risk of overall chromosome abnormalities in ICSI compared to both standard IVF (OR 1.42 (95% CI 1.09-1.85)) and NC (OR 2.46 (95% CI 1.52-3.99)) and an increased risk of de novo abnormalities in ICSI compared to NC (OR 2.62 (95% CI 2.07-3.31)). Yet, based on a very low certainty of evidence, the conclusion remains, that no indication of an increased risk of chromosome abnormalities in ICSI offspring could be found. If an increased risk of chromosome abnormalities in selected ICSI offspring should exist, the absolute risk continues to be small.
WIDER IMPLICATIONS
This review provides an extensive overview of the existing evidence on the relationship between ICSI and chromosome abnormalities in the offspring. We highlight the need for well-designed large, prospective, controlled studies with systematic cytogenetic testing. Existing data are limited and, in many cases, marred by critical levels of bias.
Topics: Child; Chromosome Aberrations; Female; Fertilization; Fertilization in Vitro; Humans; Pregnancy; Prospective Studies; Sperm Injections, Intracytoplasmic
PubMed: 33956940
DOI: 10.1093/humupd/dmab005 -
BJUI Compass May 2023Neuroendocrine prostate cancer (NEPC) is a lethal subtype of prostate cancer. We performed a systematic review and meta-analysis to evaluate the prevalence of genomic... (Review)
Review
BACKGROUND
Neuroendocrine prostate cancer (NEPC) is a lethal subtype of prostate cancer. We performed a systematic review and meta-analysis to evaluate the prevalence of genomic alterations in NEPC and better understand its molecular features to potentially inform precision medicine.
METHODS
EMBASE, PubMed, and Cochrane Central Register of Controlled Trials databases were searched for eligible studies until March 2022. Study qualities were assessed using the Q-genie tool. The prevalence of gene mutations and copy number alterations (CNAs) were extracted, and meta-analysis was performed using R Studio with package.
RESULTS
A total of 14 studies with 449 NEPC patients were included in this meta-analysis. The most frequently mutated gene in NEPC was (49.8%), and the prevalence of deleterious mutations in was 16.8%. Common CNAs in NEPC included loss (58.3%), loss (42.8%), loss (37.0%), amplification (28.2%), and amplification (22.9%). alterations and concurrent and alterations were remarkably common in NEPC, with a prevalence of 83.8% and 43.9%, respectively. Comparative analyses indicated that the prevalence of (concurrent) alterations was significantly higher in de novo NEPC than in treatment-emergent NEPC (t-NEPC).
CONCLUSIONS
This study presents the comprehensive prevalence of common genomic alterations and potentially actionable targets in NEPC and reveals the genomic differences between de novo NEPC and t-NEPC. Our findings highlight the importance of genomic testing in patients for precision medicine and provide insights into future studies exploring different NEPC subtypes.
PubMed: 37025467
DOI: 10.1002/bco2.212 -
Annals of Indian Academy of Neurology 2023COVID-19 infection is associated with neurological manifestations, including various types of movement disorders (MD). A thorough review of individual patients with...
BACKGROUND
COVID-19 infection is associated with neurological manifestations, including various types of movement disorders (MD). A thorough review of individual patients with COVID-19-induced MD would help in better understanding the clinical profile and outcome of these patients and in prognostication.
OBJECTIVE
We conducted an individual patient-systematic review to study the clinical and imaging profile and outcomes of patients with COVID-19-associated MD.
METHODS
A systematic literature search of PubMed, EMBASE, and Cochrane databases was conducted by two independent reviewers. Individual patient data COVID from case reports and case series on COVID-19-associated MD, published between December 2019 and December 2022, were extracted and analyzed.
RESULTS
Data of 133 patients with COVID-19-associated MD from 82 studies were analyzed. Mean age was 55 ± 18 years and 77% were males. A mixed movement disorder was most commonly seen (41%); myoclonus-ataxia was the most frequent (44.4%). Myoclonus significantly correlated with age (odds ratio (OR) 1.02 = 0.03, CI 1-1.04). Tremor had the longest latency to develop after SARS-CoV-2 infection [median (IQR) 21 (10-40) days, = 0.009, CI 1.01-1.05]. At short-term follow-up, myoclonus improved (OR 14.35, value = 0.01, CI 1.71-120.65), whereas parkinsonism (OR 0.09, value = 0.002, CI 0.19-0.41) and tremor (OR 0.16, value = 0.016, CI 0.04-0.71) persisted.
CONCLUSION
Myoclonus-ataxia was the most common movement disorder after COVID-19 infection. Myoclonus was seen in older individuals and usually improved. Tremor and parkinsonism developed after a long latency and did not improve in the short-term.
PubMed: 38022478
DOI: 10.4103/aian.aian_572_23 -
World Neurosurgery Aug 2023The optimal treatment algorithm for patients with degenerative lumbar spondylolisthesis has not been clarified. Part of the reason for this is that the natural history... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
The optimal treatment algorithm for patients with degenerative lumbar spondylolisthesis has not been clarified. Part of the reason for this is that the natural history of degenerative spondylolisthesis (DS) has not been sufficiently studied. Comprehension of the natural history is essential for surgical decision making. We aimed to determine 1) the proportion of patients that develop de novo DS during follow-up; and 2) the proportion of patients with progression of preexistent DS by conducting a systematic review and meta-analysis of the literature.
METHODS
This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Ovid, EMBASE, and the Cochrane Library were searched from their inception through April 2022. Demographic values of the study populations, grade of slip, rate of slippage before and after the follow-up period, and percentage of patients with slip in the populations at baseline and after follow-up were the extracted parameters.
RESULTS
Of the 1909 screened records, eventually 10 studies were included. Of these studies, 5 reported the development of de novo DS and 9 reported on the progression of preexistent DS. Proportions of patients developing de novo DS ranged from 12% to 20% over a period ranging from 4 to 25 years. The proportion of patients with progression of DS ranged from 12% to 34% over a period ranging from 4 to 25 years.
CONCLUSIONS
Systematic review and metanalysis of DS on the basis of radiologic parameters revealed both an increasing incidence over time and an increasing progression of the slip rate in up to a third of the patients older than 25 years, which is important for counseling patients and surgical decision making. Importantly, two thirds of patients did not experience slip progression.
Topics: Humans; Spondylolisthesis; Treatment Outcome; Decompression, Surgical; Spinal Fusion; Lumbar Vertebrae
PubMed: 37271258
DOI: 10.1016/j.wneu.2023.05.112 -
Cancers Mar 2021Immunosuppressive therapy after solid organ transplantation leads to the development of cancer in many recipients. Analysis of the occurrence of different types of de... (Review)
Review
Immunosuppressive therapy after solid organ transplantation leads to the development of cancer in many recipients. Analysis of the occurrence of different types of de novo carcinomas in relation to specific immunosuppressive drugs may give insight into their carcinogenic process and carcinogenesis in general. Therefore, a systematic search was performed in Embase and PubMed. Studies describing over five de novo carcinomas in patients using immunosuppressive drugs after solid organ transplantation were included. Incidence per 1000 person-years was calculated with DerSimonian-Laird random effects model and odds ratio for developing carcinomas with the Mantel-Haenszel test. Following review of 5606 papers by title and abstract, a meta-analysis was conducted of 82 studies. The incidence rate of de novo carcinomas was 8.41. Patients receiving cyclosporine developed more de novo carcinomas compared to tacrolimus (OR1.56, 95%CI 1.00-2.44) and mycophenolate (OR1.26, 95%CI 1.03-1.56). Patients receiving azathioprine had higher odds to develop de novo carcinomas compared to mycophenolate (OR3.34, 95%CI 1.29-8.65) and head and neck carcinoma compared to tacrolimus (OR3.78, 95%CI 1.11-12.83). To conclude, patients receiving immunosuppressive drugs after solid organ transplantation have almost a 20-fold increased likelihood of developing carcinomas, with the highest likelihood for patients receiving cyclosporine A and azathioprine. Looking into altered immune pathways affected by immunosuppressive drugs might lead to better understanding of carcinogenesis in general.
PubMed: 33807849
DOI: 10.3390/cancers13051122 -
European Spine Journal : Official... Dec 2020Primary degenerative scoliosis represents a new scoliosis developing in patients with no prior history of spinal curvature. Researchers sought to determine the... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
Primary degenerative scoliosis represents a new scoliosis developing in patients with no prior history of spinal curvature. Researchers sought to determine the prevalence of this type of scoliosis.
METHODS
MEDLINE, Embase, CINAHL, Web of Science and PubMed were searched from inception to 28th March, 2018. Studies that assessed adults from the general population for scoliosis using imaging techniques were included. Studies were included only if the study authors had excluded participants with previously diagnosed scoliosis and/or spinal disorders. Mixed-effects logistic-regression was used to establish an overall prevalence estimate with 95% confidence intervals (primary outcome) and to examine the effect of age and sex (secondary outcomes).
RESULTS
Four cross-sectional studies and one cohort study, involving 4069 participants (66.6% Female), aged between 41 and 94 years, were eligible for inclusion. Reported prevalence figures ranged from 13 to 68%. The pooled prevalence estimate from the mixed-effects logistic regression analysis was 37.6% (95% CI 18.7-61.8). Females were more likely to suffer from scoliosis compared with males (p < 0.001), with prevalence figures of 41.2% (95% CI 20.7-65.8) versus 27.5% (95% CI 12.2-51.1), respectively. Individuals aged < 60 years had a prevalence of 13% (95% CI 5.2-30.2), whereas the prevalence estimates were substantially higher in the > 60 age group [36% (95% CI 17.4-60.6)].
CONCLUSION
Primary degenerative scoliosis is a highly prevalent condition, especially in females. Further research targeting this type of scoliosis is required to obtain more precise global prevalence estimates and to understand the influence of age and sex.
Topics: Adult; Aged; Aged, 80 and over; Cohort Studies; Cross-Sectional Studies; Female; Humans; Logistic Models; Male; Middle Aged; Prevalence; Scoliosis
PubMed: 32440771
DOI: 10.1007/s00586-020-06453-0