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Healthcare (Basel, Switzerland) Oct 2022: Lumbar disc surgery is a common procedure for patients with lower back pain associated with lumbar disc herniation. This study aims to evaluate the impact of active... (Review)
Review
: Lumbar disc surgery is a common procedure for patients with lower back pain associated with lumbar disc herniation. This study aims to evaluate the impact of active physiotherapeutic rehabilitation on global/functional improvement and subjective pain score reduction among patients 1-2 months following lumbar disc surgery. The outcomes of this study are to assess the impact of active physiotherapeutic rehabilitation on functional improvement and subjective improvement in pain behavior post active rehabilitation. The outcomes are measured as pain assessed using the visual analog scale, global measurement of improvement, back pain functional status, and return to work. Databases, including MEDLINE/PubMed (10 June 1996, 2022), Web of Science (10 June 1997, 2022), Scopus (15 March, 10 June 2004, 2022), CINAHL Plus (10 June 1961, 2022), and Cochrane (10 June 1993, 2022) were reviewed without any language restrictions. All studies were systematically screened; however, only randomized controlled trials were eligible against the inclusion/exclusion criteria. All statistical tests were conducted in Review Manager (RevMan) 5.4. The quality of studies was appraised using the grading of recommendations assessment, development, and evaluation (GRADE) approach and the risk-of-bias 2 (RoB 2) tool. Fifteen articles were identified, enrolling a total of 2188 patients, where the majority of active rehabilitation interventions continued for 3 months. All these interventions began 1-2 months postoperatively, and quantitative findings were presented as mean scores. The subjective pain scores were significantly lower in the interventional group, with a mean difference (MD) of -7.01 ( = 0.004). The pain disability score was considerably lower in the interventional group, with an MD of -3.94 ( = 0.002). Global improvement was higher in the interventional group (OR = 1.94, = 0.0001). : This study presents significant improvement in all parameters concerning pain and functionality. Postoperative rehabilitation requires optimization concerning timing, duration, intensity, and associated components to benefit patients post lumbar disc surgery.
PubMed: 36292390
DOI: 10.3390/healthcare10101943 -
Acta Ophthalmologica Mar 2022To evaluate microvascular alterations with optical coherence tomography angiography (OCTA) in eyes with non-arteritic anterior ischaemic optic neuropathy (NAION) and the... (Meta-Analysis)
Meta-Analysis
PURPOSE
To evaluate microvascular alterations with optical coherence tomography angiography (OCTA) in eyes with non-arteritic anterior ischaemic optic neuropathy (NAION) and the unaffected fellow eyes.
DESIGN
Systematic review and meta-analysis.
METHODS
A comprehensive literature search was conducted in the PubMed and Embase databases through 6 September 2020, to identify the studies on NAION and the unaffected fellow eyes using OCTA. Eligible studies and data of interest were extracted and analysed by RevMan Software v. 5.4 and Stata Software v.14.0. The weighted mean differences and 95% confidence intervals were used to assess the strength of the association.
RESULTS
Seventeen observational comparative studies, including 379 eyes with NAION, 175 unaffected contralateral eyes and 470 eyes of healthy controls, were identified. Compared to those of the healthy controls, the perfusion density (PD) of radial peripapillary capillary (RPC) and peripapillary superficial capillary plexus (ppSCP) of NAION were significantly lower. Moreover, the PD of the macular SCP (mSCP) in NAION was significantly reduced in the whole image, superior quadrant and temporal quadrant, while the macular deep capillary plexus (mDCP) showed a decreasing PD only within the whole image. Between unaffected fellow eyes and healthy eyes, significant differences of PD were demonstrated in the whole image and some peripapillary regions of the RPC and ppSCP.
CONCLUSION
Our results suggested that compared to those of healthy controls, the eyes affected by NAION and unaffected fellow eyes demonstrated significant microvascular impairments in different regions. Between acute and non-acute NAION, macular OCTA parameters showed different characteristic patterns.
Topics: Adult; Aged; Aged, 80 and over; Female; Humans; Male; Middle Aged; Observational Studies as Topic; Optic Disk; Optic Neuropathy, Ischemic; Retinal Vessels; Tomography, Optical Coherence
PubMed: 34155823
DOI: 10.1111/aos.14930 -
Ophthalmic Research 2024Anterior ischemic optic neuropathy (AION) can mimic glaucoma and consequently cause difficulties in differential diagnosis. The purpose of this paper was to summarize... (Review)
Review
INTRODUCTION
Anterior ischemic optic neuropathy (AION) can mimic glaucoma and consequently cause difficulties in differential diagnosis. The purpose of this paper was to summarize differences in diagnostic tests that can help perform a correct diagnosis.
METHODS
The search strategy was performed according to the PRISMA 2009 guidelines, and four databases were used: MEDLINE, Embase, Web of Science, and Cochrane. Totally, 772 references were eligible; 39 were included after screening with respect to inclusion criteria that included English language and published in the 20 years before search date.
RESULTS
Ninety percent (n = 35) of included studies used optical coherence tomography (OCT). Glaucomatous eyes had a significantly greater cup area, volume and depth, cup-to-disk ratio, a lower rim volume and area, and a thinner Bruch's membrane opening-minimum rim width. Retinal nerve fiber layer (RNFL) thinning in glaucomatous eyes occurred primarily at the superotemporal, inferotemporal, and inferonasal sectors, while AION eyes demonstrated mostly superonasal thinning. Glaucoma eyes showed greater macular ganglion cell layer thickness, except at the inferotemporal sector. OCT angiography measurements demonstrated a significant decrease in superficial and deep macular vessel density (VD) in glaucoma compared to AION with similar degree of visual field damage; the parapapillary choroidal VD was spared in AION eyes compared to glaucomatous eyes.
CONCLUSION
By use of OCT imaging, optic nerve head parameters seem most informative to distinguish between glaucoma and AION. Although both diseases affect the RNFL thickness, it seems to do so in different sectors. Differences in structure and vascularity of the macula can also help in making the differential diagnosis.
Topics: Humans; Optic Neuropathy, Ischemic; Diagnosis, Differential; Tomography, Optical Coherence; Nerve Fibers; Retinal Ganglion Cells; Optic Disk; Glaucoma; Visual Fields; Intraocular Pressure
PubMed: 38262372
DOI: 10.1159/000535568 -
BMC Pediatrics Nov 2023Spondylodiscitis (SD), a rare disease in children, poses diagnostic challenges due to non-specific presenting symptoms, scarcity in incidence, and difficulty expressing...
BACKGROUND
Spondylodiscitis (SD), a rare disease in children, poses diagnostic challenges due to non-specific presenting symptoms, scarcity in incidence, and difficulty expressing pain in non-verbal children.
METHOD
A comprehensive search was conducted on three databases, including PubMed/Medline, Web of Science, and Scopus until March 2023. The inclusion criteria were studies that investigated the clinical characteristics, treatment, and complications of children's spondylodiscitis. Full text of cross-sectional and cohort studies were added. The quality assessment of cohort studies was conducted using the Newcastle-Ottawa Quality Assessment Scale. The search, screening, and data extraction were performed by two researchers independently.
RESULT
Clinical manifestations of discitis in children are nonspecific, such as back pain, fever, reduced ability or inability to walk or sit, limping, and reduced range of movements. The mean delay in the time of diagnosis was 4.8 weeks. The most affected site of all the studies was the lumbar spine. 94% of studies reported increased inflammatory markers such as white blood cell count, C-reactive protein, and erythrocyte sedimentation rate. Less than 30% of patients had positive blood cultures and biopsy findings. The most common microbiological results (64%) were Staphylococcus Aureus and Kingella kingae. In radiographic evaluation, intervertebral disk narrowing, lumbar lordosis reduction, loss of disk height, and destruction of the vertebral body have been reported. In all studies, antibiotic therapy was initiated; in 52% immobilization was employed, and 29% of studies reported surgery was performed, and the follow-up period differed from 1.5 months to 156 months. 94% of studies reported complications such as vertebral body destruction, back pain, kyphosis, reduced range of movement, scoliosis, and neurological complications.
CONCLUSION
Spondylodiscitis is an uncommon, heterogeneous, multifactorial disease with resulting difficult and delayed diagnosis. Due to its morbidity, it is essential to investigate children with refusal to walk, gait disturbances, or back pain, particularly when associated with elevated inflammatory markers.
Topics: Humans; Child; Discitis; Cross-Sectional Studies; Lumbar Vertebrae; Staphylococcal Infections; Back Pain; Retrospective Studies
PubMed: 37980513
DOI: 10.1186/s12887-023-04395-2 -
Clinical Oral Investigations Nov 2022To identify the antifungal susceptibility profile of Candida spp. isolated from the human oral cavity was assessed with meta-analyses of observational studies that... (Meta-Analysis)
Meta-Analysis Review
AIM
To identify the antifungal susceptibility profile of Candida spp. isolated from the human oral cavity was assessed with meta-analyses of observational studies that collected samples from the oral cavity of human subjects.
MATERIAL AND METHODS
Isolated Candida albicans tested by E-test®; disk diffusion test; microdilution and macrodilution; Sensititre YeastOne; and/or FungiTest. Search strategies were conducted on the MEDLINE, Embase, CINAHL, Dentistry, and Oral Sciences, Central, Scopus, and LILACS databases, and gray literature sources. Articles were initially screened by title and then their abstracts. Articles that met the conditions for inclusion were read in full, followed by data extraction. A descriptive analysis was conducted of each study, and the data were tabulated. A first meta-analysis was conducted to assess the resistance of antifungals regardless of systemic comorbidities. An additional stratified analysis was conducted by systemic comorbidity groups for the outcome "resistance" to the antifungals.
RESULTS
When not grouping Candida albicans isolates by systemic conditions, the lowest resistance rates to the antifungals tested were observed for amphotericin B, nystatin, flucytosine, and caspofungin. In contrast, the highest resistance rates were observed for miconazole and econazole. There was a high degree of heterogeneity and low resistance in general in all analyses, except for the "several associated comorbidities" group, which had high resistance rates.
CONCLUSIONS
Clinical C. albicans isolates had low antifungal resistance.
CLINICAL RELEVANCE
The presence of concomitant systemic comorbidities appears to be an essential factor that should be considered when evaluating resistance to antifungals for oral isolates.
Topics: Humans; Antifungal Agents; Candida albicans; Candidiasis; Microbial Sensitivity Tests; Drug Resistance, Fungal; Mouth
PubMed: 36167858
DOI: 10.1007/s00784-022-04716-2 -
The Nigerian Postgraduate Medical... 2023Carbapenem antibiotics are considered one of the most effective and the last-resort antibiotics for the treatment of infections caused by multidrug-resistant... (Review)
Review
Carbapenem antibiotics are considered one of the most effective and the last-resort antibiotics for the treatment of infections caused by multidrug-resistant Gram-negative bacteria. However, with the advent of carbapenem resistance, it becomes obvious that quality health-care delivery will be hampered if adequate measure is not put in place. This review assessed the prevalence of carbapenem-resistant Gram-negative bacteria (CR-GNB) and also provided an up-to-date position on carbapenem resistance (CR) in Nigeria. Three electronic databases (Google Scholar, PubMed and African Journal online) were searched for relevant literatures, and 38 articles published between January 2013 and June 2022 that met the criteria for inclusion were recruited into the study. The mean prevalence of CR in Nigeria stands at 21.3%, with the southern and northern regions documenting a mean prevalence of 22.0% and 20.9%, respectively. Most of the reviewed articles were from clinical settings (81.6%), with urine samples (38.7%) constituting the most prevalent clinical sample in which CR-GNB were detected. The preponderance of phenotypic methods (55.3%) over molecular method (44.7%), particularly the use of disk diffusion test breakpoint and Modified Hodge test was documented. The most prevalent carbapenem-resistant bacteria were Escherichia coli (50.0%) and Klebsiella pneumoniae (26.3%). The blaNDM and blaVIM were the major reported carbapenemase-encoded genes, particularly among E. coli, K. pneumoniae and Pseudomonas species. This systematic review revealed a mean prevalence of CR-GNB in Nigeria that required urgent attention. Furthermore, the detection of clinically and epidemiologically important carbapenemase coding genes is of public health importance.
Topics: Humans; Anti-Bacterial Agents; Bacterial Proteins; Carbapenems; Escherichia coli; Gram-Negative Bacteria; Klebsiella pneumoniae; Microbial Sensitivity Tests; Nigeria; Public Health; Drug Resistance, Bacterial
PubMed: 36814157
DOI: 10.4103/npmj.npmj_240_22 -
European Journal of Medical Research Jan 2023This study aimed to assess the survival outcomes among patients with out-of-hospital cardiac arrest (CA) who received cardiopulmonary resuscitation (CPR) in China. (Meta-Analysis)
Meta-Analysis
BACKGROUND
This study aimed to assess the survival outcomes among patients with out-of-hospital cardiac arrest (CA) who received cardiopulmonary resuscitation (CPR) in China.
METHODS
Relevant studies, published between January 1, 2010 and September 5, 2022, were retrieved from databases, including EMBASE, PubMed, Cochrane Library, the China Biology Medicine disk, China National Knowledge Infrastructure, and Wanfang databases. We included clinical studies in which all patients were diagnosed with CA and underwent out-of-hospital CPR, and the outcome variables were at least one of the following: return of spontaneous circulation (ROSC), survival to admission, survival to hospital discharge, 1-month survival, achieved good neurological outcomes, and 1-year survival. Two investigators independently extracted the study data and assessed its quality using a modified Newcastle-Ottawa Scale tool. The data were pooled using random-effects models.
RESULTS
Of the 3620 identified studies, 49 (63,378 patients) were included in the meta-analysis. The pooled ROSC rate was 9.0% (95% confidence interval [CI] 7.5-10.5%, I = 97%), the pooled survival to admission rate was 5.0% (95% CI 2.7-8.0%, I = 98%), and the pooled survival to discharge rate was 1.8% (95% CI 1.2-2.5%, I = 95%). Additionally, the ROSC rate of patients with bystander CPR was significantly higher than that of those without bystander CPR, and the pooled odds ratio (OR) was 7.92 (95% CI 4.32-14.53, I = 85%). The ROSC rate of participants who started CPR within 5 min was significantly higher than that of those who started CPR after 5 min, and the pooled OR was 5.92 (95% CI 1.92-18.26, I = 85%). The ROSC rate of participants with defibrillation was significantly higher than that of those without defibrillation, and the pooled OR was 8.52 (95% CI 3.72-19.52, I = 77%).
CONCLUSION
The survival outcomes of out-of-hospital CPR in China are far below the world average. Therefore, the policy of providing automated external defibrillators (AEDs) in public places and strengthening CPR training for healthcare providers and public personnel should be encouraged and disseminated nationwide. Trial registration This study was registered in PROSPERO (CRD42022326165) on 29 April 2022.
Topics: Humans; Cardiopulmonary Resuscitation; Out-of-Hospital Cardiac Arrest; Emergency Medical Services; Hospitalization; China
PubMed: 36600249
DOI: 10.1186/s40001-022-00955-x -
Journal of the American Academy of... May 2023Primary spinal infections (PSIs) are a group of infectious diseases characterized by inflammation of the end plate-disk unit or its surroundings. PSI is considered more...
PURPOSE
Primary spinal infections (PSIs) are a group of infectious diseases characterized by inflammation of the end plate-disk unit or its surroundings. PSI is considered more prevalent and aggressive among patients with chronic immunocompromised states. Association of PSIs, immunocompromising cancers, and hemoglobinopathies has not been systematically analyzed. We conducted a systematic review to study characteristics, clinical presentation, and mortality of patients with PSI in the setting of hematologic disease.
METHODS
A systematic literature search in PubMed, Web of Science, and Scopus was conducted in April 2022 in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We included retrospective case series and individual case reports.
RESULTS
On careful review, 28 articles published between 1970 and 2022 were selected. These studies featured 29 patients who met inclusion criteria (mean age 29 years, age range 1.5 to 67 years; 63.3% male). Lumbar infection was the most common location (65.5%), with Salmonella (24.1%) as the main causative microorganism. Neurologic compromise was present in 41% of patients, and surgical intervention occurred in 48.3%. Average antibiotic duration was 13 weeks. The postoperative complication rate was 21.4%, with a mortality of 6.9%.
CONCLUSION
PSI in patients with hematologic disease, while having shorter periods to diagnosis, presents increased rates of neurologic deficit, surgical intervention, and complications.
Topics: Humans; Male; Infant; Child, Preschool; Child; Adolescent; Young Adult; Adult; Middle Aged; Aged; Female; Retrospective Studies; Aggression; Anti-Bacterial Agents; Bone Plates; Hemoglobinopathies
PubMed: 37159278
DOI: 10.5435/JAAOSGlobal-D-22-00178 -
BMC Ophthalmology Feb 2022β-Zone parapapillary atrophy (β-PPA) is a common sign in patients with open-angle glaucoma (OAG). Some studies have suggested that β-PPA can aid in the diagnosis of... (Meta-Analysis)
Meta-Analysis
BACKGROUND
β-Zone parapapillary atrophy (β-PPA) is a common sign in patients with open-angle glaucoma (OAG). Some studies have suggested that β-PPA can aid in the diagnosis of OAG. We performed a systematic review and meta-analysis of the prevalence and diagnostic ability of β-PPA in OAG.
METHODS
We performed a literature search in PubMed, Web of Science, Embase and Google Scholar from inception to 1st November, 2021. Both hospital-based and population-based studies that reported details of β-PPA in OAG were included.
RESULTS
We screened 1404 articles from these databases and ultimately included 24 articles in our meta-analysis. The prevalence of β-PPA in OAG was 0.73 (95% CI 0.67 to 0.78). The results of subgroup analysis by country revealed prevalence rates of 0.83 (95% CI 0.78 to 0.88) in Japan, 0.85 (95% CI 0.64 to 0.97) in Korea, 0.64 (95% CI 0.55 to 0.73) in the USA, 0.61 (95% CI 0.58 to 0.63) in Germany and 0.57 (95% CI 0.39 to 0.74) in China. Fundus photography, Heidelberg retina tomography (HRT), Heidelberg retina angiography (HRA) + indocyanine green angiography (ICGA), Spectral domain optical coherence tomography (SD-OCT)and Swept source optical coherence tomography(SS-OCT) values were 0.65 (95% CI 0.58 to 0.71), 0.70 (95% CI 0.50 to 0.86), 0.78 (95% CI 0.61 to 0.91), 0.77 (95% CI 0.65 to 0.88) and 0.99(95% CI 0.87 to 1.00) respectively. The sensitivity and specificity of β-PPA as a diagnostic marker were 0.78 (95% CI 0.68 to 0.85) and 0.63 (95% CI 0.51 to 0.73), respectively.
CONCLUSIONS
β-PPA is a potential diagnostic marker for OAG. However, a more detailed understanding of β-PPA characteristics is needed to improve the ability to predict OAG.
Topics: Atrophy; Glaucoma, Open-Angle; Humans; Intraocular Pressure; Optic Atrophy; Optic Disk; Prevalence; Tomography, Optical Coherence
PubMed: 35151269
DOI: 10.1186/s12886-022-02282-5 -
Scientific Reports Jul 2019The function of connective tissues depends on the physical and biochemical properties of their extracellular matrix (ECM), which are in turn dictated by ECM protein... (Meta-Analysis)
Meta-Analysis
The function of connective tissues depends on the physical and biochemical properties of their extracellular matrix (ECM), which are in turn dictated by ECM protein composition. With the primary objective of obtaining quantitative estimates for absolute and relative amounts of ECM proteins, we performed a systematic review of papers reporting protein composition of human connective tissues. Articles were included in meta-analysis if they contained absolute or relative quantification of proteins found in the ECM of human bone, adipose tissue, tendon, ligament, cartilage and skeletal muscle. We generated absolute quantitative estimates for collagen in articular cartilage, intervertebral disk (IVD), skeletal muscle, tendon, and adipose tissue. In addition, sulfated glycosaminoglycans were quantified in articular cartilage, tendon and skeletal muscle; total proteoglycans in IVD and articular cartilage, fibronectin in tendon, ligament and articular cartilage, and elastin in tendon and IVD cartilage. We identified significant increases in collagen content in the annulus fibrosus of degenerating IVD and osteoarthritic articular cartilage, and in elastin content in degenerating disc. In contrast, collagen content was decreased in the scoliotic IVD. Finally, we built quantitative whole-tissue component breakdowns. Quantitative estimates improve our understanding of composition of human connective tissues, providing insights into their function in physiology and pathology.
Topics: Cartilage, Articular; Collagen; Connective Tissue; Elastin; Extracellular Matrix; Extracellular Matrix Proteins; Fibronectins; Glycosaminoglycans; Humans; Intervertebral Disc; Proteoglycans; Tissue Distribution
PubMed: 31332239
DOI: 10.1038/s41598-019-46896-0