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Apoptosis : An International Journal on... Aug 2022Programmed cell death is considered a key player in a variety of cellular processes that helps to regulate tissue growth, embryogenesis, cell turnover, immune response,... (Review)
Review
Programmed cell death is considered a key player in a variety of cellular processes that helps to regulate tissue growth, embryogenesis, cell turnover, immune response, and other biological processes. Among different types of cell death, apoptosis has been studied widely, especially in the field of cancer research to understand and analyse cellular mechanisms, and signaling pathways that control cell cycle arrest. Hallmarks of different types of cell death have been identified by following the patterns and events through microscopy. Identified biomarkers have also supported drug development to induce cell death in cancerous cells. There are various serological and microscopic techniques with advantages and limitations, that are available and are being utilized to detect and study the mechanism of cell death. The complexity of the mechanism and difficulties in distinguishing among different types of programmed cell death make it challenging to carry out the interventions and delay its progression. In this review, mechanisms of different forms of programmed cell death along with their conventional and unconventional methods of detection of have been critically reviewed systematically and categorized on the basis of morphological hallmarks and biomarkers to understand the principle, mechanism, application, advantages and disadvantages of each method. Furthermore, a very comprehensive comparative analysis has been drawn to highlight the most efficient and effective methods of detection of programmed cell death, helping researchers to make a reliable and prudent selection among the available methods of cell death assay. Conclusively, how programmed cell death detection methods can be improved and can provide information about distinctive stages of cell death detection have been discussed.
Topics: Apoptosis; Biomarkers; Cell Death; Signal Transduction
PubMed: 35713779
DOI: 10.1007/s10495-022-01735-y -
The Journal of Dermatology Jan 2022Trichoscopy represents a non-invasive diagnostic modality widely used in daily practice. Despite the common perception that this technique has been fairly established,... (Review)
Review
Trichoscopy represents a non-invasive diagnostic modality widely used in daily practice. Despite the common perception that this technique has been fairly established, some key issues remain to be addressed. Complexity and inconsistency in terminology in past literature are likely to confuse investigators when they are recording, reporting, and retrieving the findings. In addition, a diagnostic algorithm adopting sufficiently integrated and updated findings is not readily available. By adopting a systematic review approach, this review attempted to redefine major trichoscopic findings and integrate their synonyms individually into the most frequently used terms besides identifying and discussing terms which potentially cause confusion. The findings are categorized into five subgroups: hair shaft, follicular, perifollicular, scalp findings, and hair distribution pattern abnormalities. The calculation of sensitivities and positive predictive values of such redefined findings was conducted by reviewing the descriptions in the past literature on major hair diseases, including alopecia areata, androgenetic alopecia/female pattern hair loss, telogen effluvium, trichotillomania, lichen planopilaris, frontal fibrosing alopecia, central centrifugal cicatricial alopecia, discoid lupus erythematosus, folliculitis decalvans, tinea capitis, and dissecting cellulitis, to confirm the diagnostically meaningful findings for representative diseases. This attempt redefined, for instance, yellow dots, short vellus hairs, exclamation mark hairs, black dots, and broken hairs as the findings of diagnostic significance for alopecia areata and hair diameter diversity, peripilar sign, and focal atrichia for androgenetic alopecia/female pattern hair loss. An updated diagnostic flowchart is proposed with the instructions to maximize its usefulness. Current limitations and future perspectives of trichoscopy as well as other emerging non-invasive diagnostic modalities for hair diseases are also discussed.
Topics: Alopecia; Alopecia Areata; Dermoscopy; Female; Hair; Hair Diseases; Humans; Software Design
PubMed: 34806223
DOI: 10.1111/1346-8138.16233 -
Journal of the American Academy of... Sep 2021Multiple studies have reported on dermoscopic structures in basal cell carcinoma (BCC) and its subtypes, with varying results.
BACKGROUND
Multiple studies have reported on dermoscopic structures in basal cell carcinoma (BCC) and its subtypes, with varying results.
OBJECTIVE
To systematically review the prevalence of dermoscopic structures in BCC and its subtypes.
METHODS
Databases and reference lists were searched for relevant trials according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies were assessed for the relative proportion of BCC dermoscopic features. Random-effects models were used to estimate summary effect sizes.
RESULTS
Included were 31 studies consisting of 5950 BCCs. The most common dermoscopic features seen in BCC were arborizing vessels (59%), shiny white structures (49%), and large blue-grey ovoid nests (34%). Arborizing vessels, ulceration, and blue-grey ovoid nests and globules were most common in nodular BCC; short-fine telangiectasia, multiple small erosions, and leaf-like, spoke wheel and concentric structures in superficial BCC; porcelain white areas and arborizing vessels in morpheaform BCC; and arborizing vessels and ulceration in infiltrative BCC.
LIMITATIONS
Studies had significant heterogeneity. Studies reporting BCC histopathologic subtypes did not provide clinical data on pigmentation of lesions.
CONCLUSION
In addition to arborizing vessels, shiny white structures are a common feature of BCC. A constellation of dermoscopic features may aid in differentiating between BCC histopathologic subtypes.
Topics: Carcinoma, Basal Cell; Dermoscopy; Humans; Pigmentation; Pigmentation Disorders; Skin Neoplasms
PubMed: 31706938
DOI: 10.1016/j.jaad.2019.11.008 -
Efficacy of sonic and ultrasonic activation during endodontic treatment: a Meta-analysis of studies.Acta Odontologica Scandinavica Nov 2022To ensure a successful endodontic treatment, it is important to have a proper disinfection of the root canal. The current study compares the root canal cleanliness and... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To ensure a successful endodontic treatment, it is important to have a proper disinfection of the root canal. The current study compares the root canal cleanliness and smear layer score between sonic and ultrasonic activation.
METHOD
Systematic literature review was implemented, using 12 databases. All studies comparing the efficacy of sonic and ultrasonic activation and reporting at least one outcome of interest were included.
RESULTS
At the apical level, pooling the data in the random-effects model (I=64%, ) revealed a statistically significant lower smear layer score within the sonic activation group (MD-0.48; 95% CI-0.92, -0.04; ). Furthermore, there was a statistically significant lower push-out bond strength value among the sonic group, in contrast to the ultrasonic group at the middle (MD-0.69; 95% CI-1.13, -0.25; ) and at the apical levels (MD-0.78; 95% CI-1.09, -0.46; ) of the root canal.
CONCLUSIONS
Sonic activation accomplished advancement relative to ultrasonic agitation in removing the smear layer, while ultrasonic activation resulted in significant cohesion between the sealers and the dentine tubules, decreasing the vulnerability of apical leakage and tooth fracture.
Topics: Humans; Smear Layer; Root Canal Irrigants; Root Canal Preparation; Dental Pulp Cavity; Ultrasonics; Sodium Hypochlorite; Therapeutic Irrigation; Edetic Acid; Microscopy, Electron, Scanning
PubMed: 35430959
DOI: 10.1080/00016357.2022.2061591 -
The Cochrane Database of Systematic... Dec 2015After the introduction of microsurgical principles in endodontics involving new techniques for root canal treatment, there has been a drive to enhance the visualisation... (Comparative Study)
Comparative Study Review
BACKGROUND
After the introduction of microsurgical principles in endodontics involving new techniques for root canal treatment, there has been a drive to enhance the visualisation of the surgical field. It is important to know if the technical advantages for the operator brought in by magnification devices such as surgical microscopes, endoscopes and magnifying loupes, are also associated with advantages for the patient in terms of improvement of clinical and radiographic outcomes. This version updates the review published in 2009.
OBJECTIVES
To evaluate and compare the effects of endodontic treatment performed with the aid of magnification devices versus endodontic treatment without magnification devices. We also aimed to compare the different magnification devices used in endodontics with one another.
SEARCH METHODS
The following electronic databases were searched: the Cochrane Oral Health Group Trials Register (to 13 October 2015), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, 2015, Issue 9), MEDLINE via OVID (1946 to 13 October 2015) and EMBASE via OVID (1980 to 13 October 2015). We searched the US National Institutes of Health Trials Register (http://clinicaltrials.gov) and the WHO Clinical Trials Registry Platform for ongoing trials. No restrictions were placed on the language or date of publication when searching the electronic databases.
SELECTION CRITERIA
We considered all randomised controlled trials (RCTs) and quasi-randomised controlled trials comparing endodontic therapy performed with versus without one or more magnification devices, as well as randomised and quasi-randomised trials comparing two or more magnification devices used as an adjunct to endodontic therapy.
DATA COLLECTION AND ANALYSIS
We conducted screening of search results independently and in duplicate. We obtained full papers for potentially relevant trials. The Cochrane Collaboration statistical guidelines were to be followed for data synthesis.
MAIN RESULTS
No trials met the inclusion criteria for this review.
AUTHORS' CONCLUSIONS
No article was identified in the current literature that satisfied the criteria for inclusion. It is unknown if and how the type of magnification device affects the treatment outcome, considering the high number of factors that may have a significant impact on the success of endodontic surgical procedure. This should be investigated by further long-term, well-designed RCTs that conform to the CONSORT statement (www.consort-statement.org/).
Topics: Endodontics; Endoscopes; Humans; Lenses; Microscopy; Root Canal Therapy
PubMed: 26650099
DOI: 10.1002/14651858.CD005969.pub3 -
Journal of Clinical Medicine Mar 2022Noninvasive imaging techniques have recently outlined precise microscopic features of acne elementary lesions and accurate quantifications for disease severity staging... (Review)
Review
Noninvasive imaging techniques have recently outlined precise microscopic features of acne elementary lesions and accurate quantifications for disease severity staging and therapeutical efficacy follow-up. The aim of this review is to systematically describe current applications of dermoscopy, reflectance confocal microscopy (RCM), and optical coherence tomography (OCT) in acne vulgaris assessment and management. The study followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. We included studies conducted on human subjects with elementary lesions of acne vulgaris, reporting assessment of the lesions with dermoscopy, RCM, and/or OCT. At present there are few large studies regarding acne and noninvasive imaging techniques, representing the main limitation of this review. Clinical examination represents the first line in acne diagnosis and treatment. However, dermoscopy, RCM, and OCT are further tools that can improve acne classification, monitoring of treatment, and pathophysiologic characterization. In the near future, dermoscopy, RCM, and OCT could become routinely used for the evaluation of acne vulgaris to provide a deeper knowledge of the disease and to guide the clinician in the prescription of tailored treatment protocols based on each patient's characteristics.
PubMed: 35407391
DOI: 10.3390/jcm11071783 -
European Journal of Neurology Aug 2023In these guidelines, we aimed to develop evidence-based recommendations for the use of screening questionnaires and diagnostic tests in patients with neuropathic pain...
Joint European Academy of Neurology-European Pain Federation-Neuropathic Pain Special Interest Group of the International Association for the Study of Pain guidelines on neuropathic pain assessment.
BACKGROUND AND PURPOSE
In these guidelines, we aimed to develop evidence-based recommendations for the use of screening questionnaires and diagnostic tests in patients with neuropathic pain (NeP).
METHODS
We systematically reviewed studies providing information on the sensitivity and specificity of screening questionnaires, and quantitative sensory testing, neurophysiology, skin biopsy, and corneal confocal microscopy. We also analysed how functional neuroimaging, peripheral nerve blocks, and genetic testing might provide useful information in diagnosing NeP.
RESULTS
Of the screening questionnaires, Douleur Neuropathique en 4 Questions (DN4), I-DN4 (self-administered DN4), and Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) received a strong recommendation, and S-LANSS (self-administered LANSS) and PainDETECT weak recommendations for their use in the diagnostic pathway for patients with possible NeP. We devised a strong recommendation for the use of skin biopsy and a weak recommendation for quantitative sensory testing and nociceptive evoked potentials in the NeP diagnosis. Trigeminal reflex testing received a strong recommendation in diagnosing secondary trigeminal neuralgia. Although many studies support the usefulness of corneal confocal microscopy in diagnosing peripheral neuropathy, no study specifically investigated the diagnostic accuracy of this technique in patients with NeP. Functional neuroimaging and peripheral nerve blocks are helpful in disclosing pathophysiology and/or predicting outcomes, but current literature does not support their use for diagnosing NeP. Genetic testing may be considered at specialist centres, in selected cases.
CONCLUSIONS
These recommendations provide evidence-based clinical practice guidelines for NeP diagnosis. Due to the poor-to-moderate quality of evidence identified by this review, future large-scale, well-designed, multicentre studies assessing the accuracy of diagnostic tests for NeP are needed.
Topics: Humans; Public Opinion; Surveys and Questionnaires; Neuralgia; Sensitivity and Specificity; Trigeminal Neuralgia
PubMed: 37253688
DOI: 10.1111/ene.15831 -
Clinical Endocrinology Aug 2021Acute suppurative thyroiditis (AST) is a rare but potentially fatal condition which can initially be difficult to distinguish from the more common subacute thyroiditis... (Review)
Review
OBJECTIVE
Acute suppurative thyroiditis (AST) is a rare but potentially fatal condition which can initially be difficult to distinguish from the more common subacute thyroiditis (SAT). We aim to update understanding of this medical emergency.
DESIGN
A systematic review over the past 20 years was performed on the epidemiology, clinical features, investigations, management and outcomes of AST. All full-text cases of microscopy or culture- proven AST in the English literature were included.
RESULTS
200 cases of AST have been described in 148 articles from January 2000 - January 2020. Bacterial AST is most common, often presenting with neck pain (89%) and fever (82%). Immunosuppression and pyriform sinus fistula are the most common causes, most often due to gram-positive aerobes. Transient hyperthyroidism is common (42%). Aspiration and antibiotics are becoming a more common treatment. Overall mortality was 7.8%. Tuberculous and fungal AST are less likely to present with fever and neck pain. Fungal AST is more common in immunosuppressed individuals (31%) and has a high overall mortality (33%). Tuberculous AST is more common in TB endemic areas.
CONCLUSION
The symptoms and signs of AST commonly overlap with SAT and initially can be hard to diagnose. AST can be rapidly morbid or even fatal. Clinicians need to consider AST when they assess patients with thyroiditis who are systemically unwell, have high fever, high white cell count and c-reactive protein, tender neck and abnormal neck imaging. An investigative and treatment strategy is described based on a systematic review of the literature.
Topics: Anti-Bacterial Agents; Diagnosis, Differential; Humans; Neck; Thyroiditis; Thyroiditis, Suppurative
PubMed: 33559162
DOI: 10.1111/cen.14440 -
Experimental Dermatology Jul 2023Common skin disorders such as acne vulgaris, rosacea and folliculitis are bothersome prevalent inflammatory diseases of hair follicles that can easily be investigated... (Review)
Review
Common skin disorders such as acne vulgaris, rosacea and folliculitis are bothersome prevalent inflammatory diseases of hair follicles that can easily be investigated bedside using optical coherence tomography (OCT) and reflectance confocal microscopy (RCM) with micrometre resolution, opening a novel era for high-resolution hair follicle diagnostics and quantitative treatment evaluation. EMBASE, PubMed and Web of Science were searched until 5 January 2023 to identify all studies imaging hair follicle characteristics by RCM and OCT for diagnosis and monitoring of treatment in hair follicle-based skin disorders. This study followed PRISMA guidelines. After inclusion of articles, methodological quality was assessed using the QUADAS-2 critical appraisal checklist. Thirty-nine in vivo studies (33 RCM and 12 OCT studies) were included. The studies focused on acne vulgaris, rosacea, alopecia areata, hidradenitis suppurativa, folliculitis, folliculitis decalvans, lichen planopilaris, discoid lupus erythemasus, frontal fibrosing alopecia and keratosis pilaris. Inter- and perifollicular morphology including number of demodex mites, hyperkeratinization, inflammation and vascular morphology could be assessed by RCM and OCT in all included skin disorders. Methodological study quality was low, and interstudy outcome variability was high. Quality assessment showed high or unclear risk of bias in 36 studies. Both RCM and OCT visualize quantitative features as size, shape, content and abnormalities of hair follicles, and have potential to support clinical diagnosis and evaluate treatment effects. However, larger studies with better methodological quality are needed to implement RCM and OCT directly into clinical practice.
Topics: Humans; Tomography, Optical Coherence; Hair; Folliculitis; Acne Vulgaris; Dermatitis; Rosacea; Hair Diseases; Alopecia Areata; Microscopy, Confocal
PubMed: 37140216
DOI: 10.1111/exd.14830 -
Journal of Clinical Medicine Sep 2019Basal cell carcinoma (BCC) is the most common cancer worldwide and its incidence is constantly rising. Early diagnosis and treatment can significantly reduce patient... (Review)
Review
Basal cell carcinoma (BCC) is the most common cancer worldwide and its incidence is constantly rising. Early diagnosis and treatment can significantly reduce patient morbidity and healthcare costs. The value of reflectance confocal microscopy (RCM) in non-melanoma skin cancer diagnosis is still under debate. This systematic review and meta-analysis were conducted to assess the diagnostic accuracy of RCM in primary BCC. PubMed, Google Scholar, Scopus, and Web of Science databases were searched up to July 05, 2019, to collect articles concerning primary BCC diagnosis through RCM. The studies' methodological quality was assessed by the QUADAS-2 tool. The meta-analysis was conducted using Stata 13.0, RevMan 5.0, and MetaDisc 1.4 software. We included 15 studies totaling a number of 4163 lesions. The pooled sensitivity and specificity were 0.92 (95% CI, 0.87-0.95; I= 85.27%) and 0.93 (95% CI, 0.85-0.97; I= 94.61%), the pooled positive and negative likelihood ratios were 13.51 (95% CI, 5.8-31.37; I= 91.01%) and 0.08 (95% CI, 0.05-0.14; I= 84.83%), and the pooled diagnostic odds ratio was 160.31 (95% CI, 64.73-397.02; I=71%). Despite the heterogeneity and risk of bias, this study demonstrates that RCM, through its high sensitivity and specificity, may have a significant clinical impact on the diagnosis of primary BCC.
PubMed: 31540342
DOI: 10.3390/jcm8091462