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American Journal of Otolaryngology 2022To assess the feasibility and effectiveness of indocyanine green (ICG) for image-guided resection of head and neck cancer (HNC). (Review)
Review
OBJECTIVE
To assess the feasibility and effectiveness of indocyanine green (ICG) for image-guided resection of head and neck cancer (HNC).
DATA SOURCES
PubMed, Embase, and Scopus databases.
REVIEW METHODS
Searches were conducted from database inception to February 2022. Patient and study characteristics, imaging parameters, and imaging efficacy data were extracted from each study.
RESULTS
Nine studies met inclusion criteria, representing 103 head and neck tumors. Weighted mean ICG dose and imaging time were 1.27 mg/kg and 11.77 h, respectively. Among the five studies that provided quantitative metrics of imaging efficacy, average ICG tumor-to-background ratio (TBR) was 1.56 and weighted mean ONM-100 TBR was 3.64. Pooled sensitivity and specificity across the five studies were 91.7 % and 71.9 %, respectively.
CONCLUSION
FGS with ICG may facilitate real-time tumor-margin delineation to improve margin clearance rates and progression-free survival. Future studies with validated, quantitative metrics of imaging success are necessary to further evaluate the prognostic benefit of these techniques.
Topics: Head and Neck Neoplasms; Humans; Indocyanine Green; Margins of Excision; Optical Imaging; Surgery, Computer-Assisted
PubMed: 35939987
DOI: 10.1016/j.amjoto.2022.103570 -
Langenbeck's Archives of Surgery May 2023This review aims to explore and summarise current knowledge of indocyanine green (ICG) fluorescence application in metabolic and bariatric surgery (MBS) and assess its... (Review)
Review
PURPOSE
This review aims to explore and summarise current knowledge of indocyanine green (ICG) fluorescence application in metabolic and bariatric surgery (MBS) and assess its potential in improving patient safety.
METHODS
The review was prepared according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. Evidence from PubMed, ScienceDirect and Ovid MEDLINE databases was independently screened in October 2022. The primary information and outcomes were the type of fluorescence application with potential patient benefit and the complication rate. The secondary outcomes consisted of the kind of dye, the application protocol, and the equipment used.
RESULTS
Thirteen publications were included, with six prospective observational studies, five case reports and two retrospective cohort studies and involved a total of 424 patients. The publications were categorized into four groups based on the method of fluorescence application. Sixty-six percent of the cases used fluorescence for LSG, 32.3% used it for RYGB, 1.2% for revisional surgery, 0.2% during removal of an adjustable gastric band, and 0.2% for LSG combined with Rossetti fundoplication. ICG was used on its own in the majority of studies, although in one case, it was used in combination with methylene blue. ICG administration protocols varied significantly. Complications occurred in three patients (0.71%): leaks were diagnosed in two cases, and one patient required a blood transfusion.
CONCLUSION
The most popular type of use is intraoperative assessment of the blood supply. ICG application may reduce the risk of complications, with potential benefits in detecting ischemia and leaks, searching for bleeding in areas inaccessible to endoscopy, and non-invasive hepatopathy evaluation.
Topics: Humans; Retrospective Studies; Bariatric Surgery; Indocyanine Green; Prospective Studies; Observational Studies as Topic
PubMed: 37249703
DOI: 10.1007/s00423-023-02955-9 -
EClinicalMedicine Sep 2020Infantile hemangioma (IH) is common in children, which may bring about cosmetically disfiguring, functional impairment, and exhibiting complications. There had been...
BACKGROUND
Infantile hemangioma (IH) is common in children, which may bring about cosmetically disfiguring, functional impairment, and exhibiting complications. There had been various therapies and we aimed to assess the efficacy and adverse effects of different therapies through network meta-analysis.
METHODS
We searched PubMed, Embase, Cochrane Library and Web of Science (from database inception to April 11, 2020) for studies assessing the efficacy, success rate and adverse effects. Direct pairwise comparison and a network meta-analysis under random effects were performed. We also assessed the ranking probability.
FINDINGS
A total of 30 randomized clinical trials with more than 20 different therapeutic regimens were identified. Treatment combined propranolol orally with laser could improve the curative effect than monotherapy. Laser with topical β blockers showed more efficiency than others whether in children under 6 months or not. The long-pulsed dye laser might be the best laser therapy. A higher dose and a longer treatment duration of propranolol orally achieved a higher success rate and increased side effects. Plus pulse dye laser with propranolol had the lowest incidence of adverse reactions, such as ulcer, color sink and color reduction.
INTERPRETATION
A combination of β blockers and laser might be the first-line treatment of IHs and a longer pulsed dye laser is preferred.
FUNDING
No funding was received.
PubMed: 33089121
DOI: 10.1016/j.eclinm.2020.100506 -
Journal of Gastrointestinal and Liver... Sep 2013The pathological condition of inguinal lymph nodes is an independent prognostic factor in predicting tumor recurrence and overall survival in anal canal cancer. Sentinel... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND & AIMS
The pathological condition of inguinal lymph nodes is an independent prognostic factor in predicting tumor recurrence and overall survival in anal canal cancer. Sentinel node mapping is a non-invasive method for the detection of inguinal lymph node involvement in anal cancer. In the current study, we conducted a comprehensive search of literature in this regard and then interpreted the final results in a systematic review and meta-analysis format.
METHODS
Medline, SCOPUS, and ISI Web of Knowledge were searched with the following search terms: (anal OR anus) AND sentinel. Outcomes of interest were inguinal detection rate and inguinal recurrence in patients receiving inguinal sparing radiotherapy due to pathologically negative inguinal sentinel nodes (false negative cases).
RESULTS
Overall 16 studies (323 patients) were included in the meta-analysis. Pooled inguinal detection rate was 86.2%: 73.4-93.4%: for studies using both blue dye and radiotracer it was 90.1% [78.7-95.8] and for studies using radiotracer alone it was 72.4% [46.3-88.9]. Pooled sensitivity was 90% [79-97%].
CONCLUSIONS
Sentinel node biopsy is a promising method for inguinal lymph node staging in anal cancer. Combined blue dye and radiotracer technique can maximize the inguinal detection rate. Location of the tumor is highly associated with the detection of inguinal sentinel nodes. Despite fairly high pooled sensitivity, no definite conclusion can be made regarding false negative rate of this technique due to low sample size and sub-optimal quality of the included studies. Large multicenter studies with long and consistent follow up are needed to definitely validate this technique in the future.
Topics: Anus Neoplasms; Coloring Agents; Dye Dilution Technique; Humans; Lymph Nodes; Lymphatic Metastasis; Neoplasm Staging; Predictive Value of Tests; Sentinel Lymph Node Biopsy
PubMed: 24078990
DOI: No ID Found -
Phytotherapy Research : PTR Mar 2023Metabolic syndrome is characterized by multiple metabolic disorders. Several studies indicated that curcumin plus piperine could affect lipids profiles in various... (Meta-Analysis)
Meta-Analysis Review
A systematic review and meta-analysis of randomized controlled trials investigating the effect of the curcumin and piperine combination on lipid profile in patients with metabolic syndrome and related disorders.
Metabolic syndrome is characterized by multiple metabolic disorders. Several studies indicated that curcumin plus piperine could affect lipids profiles in various diseases. The present meta-analysis aims to assess the effect of curcumin plus piperine on lipid profiles in patients with MetS and associated disorders using a systematic review and meta-analysis of randomized controlled trials. Trials were searched by several electronic databases up to May 2022. The Comprehensive Meta-Analysis (CMA) version3 software carried out this systematic review and meta-analysis. Random-effects model and the inverse variance method were used to conduct the meta-analysis. We evaluated the publication bias and heterogeneity of all eligible studies. In addition, subgroup analyses and sensitivity assessments were performed to assess potential sources of heterogeneity. The combined results by the random-effects model demonstrated that curcumin plus piperine significantly decreased total cholesterol and LDL-C in patients suffering from metabolic syndrome. In comparison, the results of the overall effect size did not show any significant change in triglyceride concentrations. Our results were robust in sensitivity analysis and were not dependent on the dose of curcumin, the dose of piperine, and the duration of treatment. Our results showed that co-administration of piperine and curcumin supplementation improves the lipid profile in metabolic syndrome. However, further long-term RCTs are required to ascertain their clinical benefit.
Topics: Humans; Metabolic Syndrome; Curcumin; Randomized Controlled Trials as Topic; Triglycerides; Dietary Supplements
PubMed: 36649934
DOI: 10.1002/ptr.7730 -
Chinese Medicine Dec 2020Indigo naturalis is a blue dye in ancient, as well as an extensive used traditional Chinese medicine. It has a wide spectrum of pharmacological properties and can be... (Review)
Review
BACKGROUND
Indigo naturalis is a blue dye in ancient, as well as an extensive used traditional Chinese medicine. It has a wide spectrum of pharmacological properties and can be used to treat numerous ailments such as leukemia, psoriasis, and ulcerative colitis. This article aims to expand our understanding of indigo naturalis in terms of its chemical constituents, pharmacological action and clinical applications.
METHODS
We searched PubMed, web of science, CNKI, Google academic, Elsevier and other databases with the key words of "Indigo naturalis", and reviewed and sorted out the modern research of indigo naturalis based on our research results.
RESULTS
We outlined the traditional manufacturing process, chemical composition and quality control of indigo naturalis, systematically reviewed traditional applictions, pharmacological activities and mechanism of indigo naturalis, and summarized its clinical trials about treatment of psoriasis, leukemia and ulcerative colitis.
CONCLUSIONS
Indigo naturalis has a variety of pharmacological activities, such as anti-inflammatory, antioxidant, antibacterial, antiviral, immunomodulatory and so on. It has very good clinical effect on psoriasis, leukemia and ulcerative colitis. However, it should be noted that long-term use of indigo naturalis may produce some reversible adverse reactions. In summarize, indigo naturalis is an extremely important drug with great value and potential.
PubMed: 33317592
DOI: 10.1186/s13020-020-00406-x -
Complementary Therapies in Medicine Aug 2023Numerous approaches have been assigned to treat dyslipidemia (DLP). Turmeric/curcumin have been widely investigated with this regard. In the current study, we explored... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
Numerous approaches have been assigned to treat dyslipidemia (DLP). Turmeric/curcumin have been widely investigated with this regard. In the current study, we explored the effect of curcumin/turmeric supplementation on lipid profile.
METHODS
Online databases were searched up to October 2022. The outcomes included triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-c), high-density lipoprotein cholesterol (HDL-c), apolipoprotein B (Apo-B), and apolipoprotein A (Apo-A). We used the Cochrane quality assessment tool to evaluate the risk of bias. The effect sizes were estimated as weighted mean difference (WMD) and 95% confidence intervals (CIs).
RESULTS
Out of 4182 articles retrieved from the initial search, 64 randomized clinical trials (RCTs) were included in the study. Between-study heterogeneity was significant. Meta-analysis showed that turmeric/curcumin supplementation exerts statistically significant improvements on blood levels of TC (WMD = -3.99 mg/dL; 95% CI = -5.33, -2.65), TG (WMD = -6.69 mg/dL; 95% CI = -7.93, -5.45), LDL-c (WMD = -4.89 mg/dL; 95% CI = -5.92, -3.87), and HDL-c (WMD = 1.80 mg/dL; 95% CI = 1.43, 2.17). However, turmeric/curcumin supplementation was not associated with improvements in blood levels of Apo-A or Apo-B. The studies did not thoroughly address the issues of potency, purity, or consumption with other foods.
CONCLUSION
Turmeric/curcumin supplementation seems to be effective in improving blood levels of TC, TG, LDL-c, and HDL-c; but may not be capable of improving their pertinent apolipoproteins. Since the evidence was assessed to be low and very low concerning the outcomes, these findings should be dealt with caution.
Topics: Humans; Apolipoproteins A; Cholesterol, HDL; Cholesterol, LDL; Curcuma; Curcumin; Dietary Supplements; Lipids; Randomized Controlled Trials as Topic; Triglycerides
PubMed: 37230418
DOI: 10.1016/j.ctim.2023.102955 -
British Journal of Cancer Jun 2014The purpose of this study was to determine the accuracy of sentinel lymph node (SLN) biopsy with technetium 99 (99mTc) and/or blue dye-enhanced lymphoscintigraphy in... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The purpose of this study was to determine the accuracy of sentinel lymph node (SLN) biopsy with technetium 99 (99mTc) and/or blue dye-enhanced lymphoscintigraphy in vulval cancer.
METHODS
Sensitive searches of databases were performed upto October 2013. Studies with at least 75% of women with FIGO stage IB or II vulval cancer evaluating SLN biopsy with 99mTc, blue dye or both with reference standard of inguinofemoral lymphadenectomy (IFL) or clinical follow-up were included. Meta-analyses were performed using Meta-Disc version 1.4.
RESULTS
Of the 2950 references, 29 studies (1779 women) were included; most of them evaluated 99mTc combined with blue dye. Of these, 24 studies reported results for SLN followed by IFL, and 5 reported clinical follow-up only for SLN negatives. Pooling of all studies was inappropriate because of heterogeneity. Mean SLN detection rates were 94.0% for 99mTc, 68.7% for blue dye and 97.7% for both. SLN biopsy had pooled sensitivity of 95% (95% CI 92-98%) with negative predictive value (NPV) of 97.9% in studies using 99mTc/blue dye, ultrastaging and immunohistochemistry with IFL as reference. Pooled sensitivity for SLN with clinical follow-up for SLN-negatives was 91% (85-95%) with NPV 95.6%. Patients undergoing SLN biopsy experienced less morbidity than those undergoing IFL.
CONCLUSIONS
Sentinel lymph node biopsy using 99mTC, blue dye and ultrastaging with immunohistochemistry is highly accurate when restricted to carefully selected patients, within a rigorous protocol, with close follow-up and where sufficient numbers for learning curve optimisation exist. Patients must make an informed choice between the slightly higher groin recurrence rates of SLN biopsy vs the greater morbidity of IFL.
Topics: Coloring Agents; Early Detection of Cancer; Female; Humans; Immunohistochemistry; Lymph Nodes; Lymphatic Metastasis; Lymphoscintigraphy; Neoplasm Recurrence, Local; Radiopharmaceuticals; Sentinel Lymph Node Biopsy; Staining and Labeling; Technetium; Vulvar Neoplasms
PubMed: 24867697
DOI: 10.1038/bjc.2014.205 -
Lasers in Medical Science Mar 2022Various clinical trials have explored whether the pulsed dye laser (PDL) method is safe to treat scars, especially surgical scars. However, comprehensive evidence... (Meta-Analysis)
Meta-Analysis
Various clinical trials have explored whether the pulsed dye laser (PDL) method is safe to treat scars, especially surgical scars. However, comprehensive evidence confirming the exact outcomes of PDL for treating surgical scars is lacking. The efficacy and safety of PDL in the treatment of surgical scars were determined through a review of several studies. The PubMed, Embase, Cochrane Library, and Web of Science databases were searched, and the main clinical outcomes were Vancouver Scar Scale (VSS) scores in terms of pigmentation, vascularity, pliability, and height. Review Manager 5.4 software was used for statistical analyses of the data; we chose a standardized mean difference (SMZ) to present the results with 95% confidence interval (CI). Overall, seven randomized controlled trials were used for this meta-analysis, all of these papers used 585 nm or 595 nm PDL with 7 mm or 10 mm spot size and a fluence of 3.5 to 10 J/cm for treating surgical scars; besides, the pulse duration ranged from 450 μs to 10 ms. We found that PDL significantly resulted in decreased VSS scores (P = 0.02) in four aspects: pigmentation (P = 0.0002), vascularity (P < 0.00001), pliability (P = 0.0002), and height (P = 0.0002). Moreover, scar improvement was similar when using 585 nm and 595 nm PDL in terms of pigmentation (P = 0.76), vascularity (P = 0.34), pliability (P = 0.64), and height (P = 0.57). Furthermore, our review indicated that PDL has no obvious adverse effects for most people, except transitory erythema and purpura. The meta-analysis showed that both 585 nm and 595 nm PDL therapy can effectively reduce the VSS score, suggesting that PDL can be a safe and effective method for the treatment of surgical scars.
Topics: Cicatrix; Erythema; Humans; Lasers, Dye; Low-Level Light Therapy; Treatment Outcome
PubMed: 34351564
DOI: 10.1007/s10103-021-03385-z -
Gastrointestinal Endoscopy Apr 2016Endoscopic real-time imaging of Barrett's esophagus (BE) with advanced imaging technologies enables targeted biopsies and may eliminate the need for random biopsies to... (Meta-Analysis)
Meta-Analysis Review
ASGE Technology Committee systematic review and meta-analysis assessing the ASGE Preservation and Incorporation of Valuable Endoscopic Innovations thresholds for adopting real-time imaging-assisted endoscopic targeted biopsy during endoscopic surveillance of Barrett's esophagus.
BACKGROUND AND AIMS
Endoscopic real-time imaging of Barrett's esophagus (BE) with advanced imaging technologies enables targeted biopsies and may eliminate the need for random biopsies to detect dysplasia during endoscopic surveillance of BE. This systematic review and meta-analysis was performed by the American Society for Gastrointestinal Endoscopy (ASGE) Technology Committee to specifically assess whether acceptable performance thresholds outlined by the ASGE Preservation and Incorporation of Valuable Endoscopic Innovations (PIVI) document for clinical adoption of these technologies have been met.
METHODS
We conducted meta-analyses calculating the pooled sensitivity, negative predictive value (NPV), and specificity for chromoendoscopy by using acetic acid and methylene blue, electronic chromoendoscopy by using narrow-band imaging, and confocal laser endomicroscopy (CLE) for the detection of dysplasia. Random effects meta-analysis models were used. Statistical heterogeneity was evaluated by means of I(2) statistics.
RESULTS
The pooled sensitivity, NPV, and specificity for acetic acid chromoendoscopy were 96.6% (95% confidence interval [CI], 95-98), 98.3% (95% CI, 94.8-99.4), and 84.6% (95% CI, 68.5-93.2), respectively. The pooled sensitivity, NPV, and specificity for electronic chromoendoscopy by using narrow-band imaging were 94.2% (95% CI, 82.6-98.2), 97.5% (95% CI, 95.1-98.7), and 94.4% (95% CI, 80.5-98.6), respectively. The pooled sensitivity, NPV, and specificity for endoscope-based CLE were 90.4% (95% CI, 71.9-97.2), 98.3% (95% CI, 94.2-99.5), and 92.7% (95% CI, 87-96), respectively.
CONCLUSIONS
Our meta-analysis indicates that targeted biopsies with acetic acid chromoendoscopy, electronic chromoendoscopy by using narrow-band imaging, and endoscope-based CLE meet the thresholds set by the ASGE PIVI, at least when performed by endoscopists with expertise in advanced imaging techniques. The ASGE Technology Committee therefore endorses using these advanced imaging modalities to guide targeted biopsies for the detection of dysplasia during surveillance of patients with previously nondysplastic BE, thereby replacing the currently used random biopsy protocols.
Topics: Acetic Acid; Barrett Esophagus; Biopsy; Coloring Agents; Esophagoscopy; Esophagus; Humans; Intravital Microscopy; Methylene Blue; Microscopy, Confocal; Narrow Band Imaging; Predictive Value of Tests; Watchful Waiting
PubMed: 26874597
DOI: 10.1016/j.gie.2016.01.007