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Global Spine Journal Oct 2022Systematic Review and Meta-Analysis. (Review)
Review
STUDY DESIGN
Systematic Review and Meta-Analysis.
OBJECTIVES
Various minimally invasive surgical techniques have been developed as alternatives to conventional surgery. According to recent studies, endoscopic spinal surgery (ESS) (biportal ESS [BESS] or uniportal ESS [UESS]) is more favorable compared with microscopic spinal surgery (MSS). This systematic review and meta-analysis aimed to assess the latest evidence on the use of ESS compared with MSS in lumbar spinal stenosis.
METHODS
A systematic electronic search using PubMed, Embase, Cochrane Central Database, and Korea Med was performed until December 2019 to identify studies that compared ESS and MSS in patients with lumbar spinal stenosis.
RESULTS
Overall, 1167 patients were included from three randomized controlled trials, six retrospective cohorts, and two prospective case-control studies. This review only presented 3 direct comparative studies. The study had inherent limitations specifically in terms of the study design. Meta-analysis of hospital stay (days) showed significant difference between BESS and MSS, UESS and MSS, BESS +UESS, and MSS at the final follow-up (95% confidence interval [CI]: -3.66 to -.77; P = .003; I = 97%, 95% CI: -2.95 to -1.22; P <.00001; I = 90%, and 95% CI: -2.89 to -1.48; P <.00001; I = 96%, respectively). However, meta-analysis showed no significant difference in other results.
CONCLUSIONS
Although a shorter duration of hospital stay was observed in ESS, there were no significant differences in efficacy and safety between ESS and MSS. Further studies are required to validate these results.
PubMed: 35333105
DOI: 10.1177/21925682221083271 -
BioMed Research International 2023Schistosomiasis is causing high morbidity and significant mortality in endemic areas. Kato-Katz stool examination and urine filtration techniques are the conventional... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
Schistosomiasis is causing high morbidity and significant mortality in endemic areas. Kato-Katz stool examination and urine filtration techniques are the conventional methods for the detection of intestinal and urinary schistosomiasis. The most appropriate diagnostic tools for the detection of schistosomiasis especially in low-prevalence settings should be used. Therefore, this study is aimed at investigating the diagnostic accuracy of and diagnostic tools in sub-Saharan Africa.
METHODS
Electronic databases such as PubMed, PubMed Central/Medline, HINARI, Scopus, EMBASE, Science Direct, Google Scholar, and Cochrane Library were reviewed. The pooled estimates and heterogeneity were determined using Midas in Stata 14.0. The diagnostic accuracy of index tests was compared using the hierarchical summary of the receiver operating characteristic (HSROC) curve in Stata 14.0.
RESULTS
Twenty-four studies consisting of 12,370 individuals were tested to evaluate the accuracy of antigen, antibody, and molecular test methods for the detection of and . The pooled estimate of sensitivity and specificity of CCA was 88% (95% CI: 83-92) and 72 (95% CI: 62-80), respectively, when it is compared with parasitological stool examination for detection. On the other hand, ELISA showed a pooled estimate of sensitivity and specificity of 95% (95% CI: 93-96) and 35% (95% CI: 21-52), respectively, for the examination of using stool examination as a reference test. With regard to , the pooled estimate of sensitivity and specificity of polymerase chain reaction was 97% (95% CI: 78-100) and 94% (95% CI: 74-99), respectively. Moreover, the sensitivity and specificity of urine CCA vary between 41-80% and 55-91%, respectively, compared to urine microscopy.
CONCLUSION
The effort of schistosomiasis elimination requires accurate case identification especially in low-intensity infections. This study showed that CCA had the highest sensitivity and moderate specificity for the diagnosis of . Similarly, the sensitivity of ELISA was excellent, but its specificity was low. The diagnostic accuracy of PCR for the detection of was excellent compared to urine microscopic examination.
Topics: Humans; Animals; Microscopy; Schistosoma mansoni; Urinalysis; Africa South of the Sahara; Diagnostic Tests, Routine
PubMed: 37621699
DOI: 10.1155/2023/3769931 -
Journal of Clinical Medicine May 2022Objective: In this study, we aimed to evaluate the worldwide incidence and prevalence of ANCA-associated vasculitis (AAV). Methods: A systematic search of Medline and...
Objective: In this study, we aimed to evaluate the worldwide incidence and prevalence of ANCA-associated vasculitis (AAV). Methods: A systematic search of Medline and Embase was conducted until June 2020 for studies that analyzed the incidence and prevalence of patients aged >16 years diagnosed with AAV in different geographical areas. A meta-analysis was undertaken to estimate the pooled incidence per million person-years and prevalence per million persons in AAV overall and for each subtype of AAV: granulomatosis with polyangiitis (GPA), microscopic polyangiitis (MPA), and eosinophilic granulomatosis with polyangiitis (EGPA). The 95% confidence interval (CI) and I2 for heterogeneity were calculated. Results: The meta-analysis included 25 studies that met the inclusion criteria and covered a total of 4547 patients with AAV. Frequency increased over time. The global pooled incidence (95% CI) was 17.2 per million person-years (13.3−21.6) and the global pooled prevalence (95% CI) was 198.0 per million persons (187.0−210.0). The pooled incidence per million person-years for each AAV subtype varied from highest to lowest, as follows: GPA, 9.0; MPA, 5.9; and EGPA, 1.7. The individual pooled prevalence per million persons was, as follows: GPA, 96.8; MPA, 39.2; and EGPA, 15.6. AAV was more predominant in the northern hemisphere. By continent, a higher incidence in America and pooled prevalence of AAV was observed in America and Europe. Conclusion: The pooled incidence and prevalence of AAV seem to be increasing over time and are higher in the case of GPA. AAV was generally more frequent (incidence and prevalence) in the northern hemisphere.
PubMed: 35566698
DOI: 10.3390/jcm11092573 -
Medicina (Kaunas, Lithuania) Jun 2023Endoscopes are increasingly being used in middle ear surgery as an adjunct to or replacement for the operative microscope. The superior visualization of hidden areas and... (Review)
Review
Endoscopes are increasingly being used in middle ear surgery as an adjunct to or replacement for the operative microscope. The superior visualization of hidden areas and a minimally invasive transcanal approach to the pathology are some of the endoscope's advantages. The aim of this review is to compare the surgical outcomes of a totally endoscopic transcanal approach with a conventional microscopic approach for type 1 tympanoplasty in patients with chronic otitis media (COM) in order to establish if endoscopic myringoplasty (EM) could be a better alternative to microscopic myringoplasty (MM). A literature review was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis recommendations. The selected articles were identified by searching PubMed Central, PubMed, MEDLINE and Embase databases for the relevant publications. Only studies where the same surgeon in the department performed both endoscopic and microscopic myringoplasty have been included in the review. The results suggest that with an endoscopic approach, minimally invasive myringoplasty can be achieved with a similar graft success rate and postoperative air-bone gap (ABG) improvement, a shorter operative time and less postoperative complications compared to a microscopic approach.
Topics: Humans; Myringoplasty; Tympanic Membrane Perforation; Treatment Outcome; Endoscopy; Otitis Media; Chronic Disease; Retrospective Studies
PubMed: 37374278
DOI: 10.3390/medicina59061074 -
Medicina Oral, Patologia Oral Y Cirugia... May 2020The primordial odontogenic tumor (POT) is a recently described benign entity with histopathological and immunohistochemical features suggesting its origin during early...
BACKGROUND
The primordial odontogenic tumor (POT) is a recently described benign entity with histopathological and immunohistochemical features suggesting its origin during early odontogenesis.
AIM
To integrate the available data published on POT into a comprehensive analysis to better define its clinicopathological and molecular features.
MATERIAL AND METHODS
An electronic systematic review was performed up to September 2019 in multiple databases.
RESULTS
A total of 13 publications were included, representing 16 reported cases and 3 molecular studies. The mean age of the affected patients was 11.6 years (range 2-19), with a slight predominance in males (56.25%). The posterior mandible was the main location (87.5%), with only two cases affecting the posterior maxilla. All cases appeared as a radiolucent lesion in close relationship to an unerupted tooth. Recurrences have not been reported to date. Microscopically, POT comprises fibromyxoid tissue with variable cellularity surrounded by a cuboidal to columnar odontogenic epithelium but without unequivocal dental hard tissue formation. A delicate fibrous capsule surrounds (at least partially) the tumor. The epithelial component shows immunohistochemical positivity for amelogenin, CK19, and CK14, and variable expression of Glut-1, Galectin-3 and Caveolin-1, Vimentin, p-53, PITX2, Bcl-2, Bax and Survivin; the mesenchymal tissue is positive for Vimentin, CD90, p-53, PITX2, Bcl-2, Bax, and Survivin, and the subepithelial region exhibits the strong expression of Syndecan-1 and CD34. The Ki-67 index is low (<5%). The negative or weak expression of dentinogenesis-associated genes could explain the inhibition of dentin and subsequent enamel formation in this neoplasm.
CONCLUSION
POT is an entity with a well-defined clinicopathological, immunohistochemical and molecular profile that must be properly diagnosed and differentiated from other odontogenic lesions and treated consequently.
Topics: Adolescent; Adult; Child; Child, Preschool; Epithelium; Humans; Male; Mandible; Neoplasm Recurrence, Local; Odontogenesis; Odontogenic Tumors; Young Adult
PubMed: 32040459
DOI: 10.4317/medoral.23432 -
International Journal of Environmental... Aug 2022Increasing evidence relate anti-SARS-CoV-2 vaccinations to orofacial adverse reactions, therefore, the present systematic review aimed to evaluate primary oral lesions... (Review)
Review
Increasing evidence relate anti-SARS-CoV-2 vaccinations to orofacial adverse reactions, therefore, the present systematic review aimed to evaluate primary oral lesions diagnosed in adult subjects, following the WHO Emergency Use Listing approved and EMA authorized vaccines, also in relation to cases' age, gender, comorbidities, and history of COVID-19, and in relation to vaccine type and doses. The study protocol, registered on PROSPERO (CRD42022339032) and compliant with the PRISMA statement, included an electronic search across Scopus, MEDLINE/PubMed, BioMed Central databases, and PROSPERO, ended on 18 June 2022 and succeeded by a manual search, an independent data extraction, and arisk of bias evaluation through ROBINS-I tool. Qualitatively synthesized data from the 13studies included showed an overall low prevalence (16 cases), though higher in females (68.8%), of oral lesions, mainly erosions and ulcers (34.5%). Nine cases were diagnosed following Pfizer-BioNTech, two Moderna, and one AstraZeneca, Serum Institute of India, Sinopharm, and Johnson&Johnson vaccines, respectively; specifically, eight after the first dose and seven after the second. In one case, vaccine type and dose were not specified. Considering newly developing vaccines, presented findings may be updated and further studies needed to highlight factors affecting oral lesion occurrence and specific macro-microscopic phenotypes in relation to cases' and vaccines' characteristics.
Topics: COVID-19; COVID-19 Vaccines; Data Management; Female; Humans; India; Vaccination; Vaccines
PubMed: 36011863
DOI: 10.3390/ijerph191610228 -
Digestive Diseases (Basel, Switzerland) 2023Microscopic colitis (MC) is a chronic inflammatory bowel disease characterized by watery diarrhoea and a normal radiological and endoscopic appearance. Concern regarding... (Meta-Analysis)
Meta-Analysis
BACKGROUND AND OBJECTIVES
Microscopic colitis (MC) is a chronic inflammatory bowel disease characterized by watery diarrhoea and a normal radiological and endoscopic appearance. Concern regarding a potential association between drug exposure and MC has recently emerged. We sought to systematically review and summarize the evidence for the potential association.
METHODS
A systematic review and meta-analysis were performed to evaluate the incidence of MC associated with exposure to drug. The PubMed and Embase databases were searched to identify potential studies for inclusion.
RESULTS
Twelve case-control studies were included in the meta-analysis. The results showed exposure to NSAID (OR, 1.64; 95% CI: 1.14-2.37; p < 0.001), PPI (OR, 2.36; 95% CI: 1.59-3.52; p < 0.001), SSRI (OR, 2.16; 95% CI: 1.5-3.13; p < 0.001), or aspirin (OR, 2.84; 95% CI: 1.4-5.76; p < 0.001) was related to the incidence of MC; however, such relationships in PPI and SSRI may be modulated by the selection of controls. Furthermore, we did not found a positive association with other drug exposure and MC.
CONCLUSION
This meta-analysis indicated that NSAID, PPI, SSRI, or aspirin consumption may increase the risk for MC. Further studies exploring drug-induced microscopic colitis should include control groups with diarrhoea and not only healthy controls.
Topics: Humans; Colitis, Microscopic; Colitis; Diarrhea; Anti-Inflammatory Agents, Non-Steroidal; Aspirin
PubMed: 36067746
DOI: 10.1159/000526809 -
International Journal of Molecular... Apr 2023Believed to be a rare cause of chronic diarrhoea, microscopic colitis (MC) is a condition with rising incidence. Many prevalent risk factors and the unknown pathogenesis... (Review)
Review
Believed to be a rare cause of chronic diarrhoea, microscopic colitis (MC) is a condition with rising incidence. Many prevalent risk factors and the unknown pathogenesis of MC rationalise the need for studies on microbiota composition. PubMed, Scopus, Web of Science and Embase were searched. Eight case-control studies were included. The risk of bias was assessed with the Newcastle-Ottawa Scale. Clinical details on the study population and MC were poor. The most consistent result among the studies was a decreased genus in faecal samples. Other results were inconsistent due to the different taxonomic levels of the outcomes. Possible changes in different taxa were observed in patients who suffered from MC compared to healthy controls. The alpha diversity compared between MC and the diarrhoea control may suggest potential similarities. The beta diversity in MC compared to healthy and diarrhoeal populations showed no significant outcomes. The microbiome composition in MC possibly differed from the healthy control, but no agreement regarding taxa was made. It might be relevant to focus on possible factors influencing the microbiome composition and its relationship with other diarrhoeal diseases.
Topics: Humans; Colitis, Microscopic; Diarrhea; Microbiota; Case-Control Studies; Risk Factors
PubMed: 37108189
DOI: 10.3390/ijms24087026 -
Toxics Aug 2023Persistent Organic Pollutants (POPs) such as dichlorodimethyltrichloroethane (DDT) are present and ubiquitous in the environment due to their resilient nature. DDT is a... (Review)
Review
Persistent Organic Pollutants (POPs) such as dichlorodimethyltrichloroethane (DDT) are present and ubiquitous in the environment due to their resilient nature. DDT is a prevalent endocrine disruptor still found in detectable amounts in organisms and the environment even after its use was banned in the 1970s. Medline and Google Scholar were systematically searched to detect all relevant animal and human studies published in the last 20 years (January 2003 to February 2023) in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. In total, 38 studies were included for qualitative synthesis. This systematic search and review indicated that exposure to DDT is associated with female reproductive health issues, such as reduced fecundability; increased risk of preterm/premature deliveries; increased periods of gestation; alterations in the synthesis of crucial reproductive hormones (Progesterone and Oxytocin) through ion imbalances and changes in prostaglandin synthesis, myometrial and stromal hypertrophy, and edema; and variations in uterine contractions through increased uterine wet weight. There was also limited evidence indicating DDT as a carcinogen sufficient to instigate reproductive cancers. However, this review only takes into account the in vitro studies that have established a possible pathway to understand how DDT impacts female infertility and leads to reproductive cancers. Links between the pathways described in various studies have been developed in this review to produce a summarized picture of how one event might lead to another. Additionally, epidemiological studies that specifically targeted the exposure to DDT of females belonging to various ethnicities have been reviewed to develop an overall picture of prevailing female reproductive health concerns in different nations.
PubMed: 37755736
DOI: 10.3390/toxics11090725 -
European Archives of... May 2024To analyze and compare the available data about the outcomes of endoscopic and microscopic type I tympanoplasty. (Meta-Analysis)
Meta-Analysis
OBJECTIVES
To analyze and compare the available data about the outcomes of endoscopic and microscopic type I tympanoplasty.
DATA SOURCES
PubMed, Cochrane library Ovid, Scopus, Google scholar, and ClinicalTrials.
METHODS
We conducted a meta-analysis in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. We included comparative studies describing type I tympanoplasty, and comparing surgical outcomes of the endoscope with the microscope in terms of efficacy and safety.
RESULTS
Our systematic search yielded 22 studies meeting the inclusion criteria and eligible for analysis. The pooled graft uptake rates and audiological results of endoscopic and microscopic tympanoplasty demonstrated non-significant differences. In contrast, endoscopic type I tympanoplasty outperforms microscopic tympanoplasty regarding a highly significant decrease not only in pooled mean operative time but also in the pooled complications rate.
CONCLUSIONS
Based on our meta-analysis, the surgical outcomes of endoscope-assisted and microscope-assisted type I tympanoplasty in terms of postoperative hearing outcomes and the graft uptake rate were comparable. On the contrary, operative time and complications rate proved to be significantly reduced with endoscopy compared to microscopy. Hence, the endoscope is as efficient as the microscope in type I tympanoplasty but less invasive, fewer in complications and shorter in operative time.
Topics: Humans; Tympanoplasty; Microscopy; Treatment Outcome; Myringoplasty; Endoscopy; Endoscopes; Tympanic Membrane Perforation; Retrospective Studies
PubMed: 37966540
DOI: 10.1007/s00405-023-08305-1