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World Neurosurgery Jul 2017To investigate the diagnostic accuracy of various evoked potential monitoring techniques in predicting postoperative neurologic deficit in intracranial aneurysm surgery. (Meta-Analysis)
Meta-Analysis Review
The Diagnostic Accuracy of Evoked Potential Monitoring Techniques During Intracranial Aneurysm Surgery for Predicting Postoperative Ischemic Damage: A Systematic Review and Meta-Analysis.
OBJECTIVE
To investigate the diagnostic accuracy of various evoked potential monitoring techniques in predicting postoperative neurologic deficit in intracranial aneurysm surgery.
METHODS
A literature search of the MEDLINE, Embase, and Cochrane databases was conducted for English language articles published between March 31, 1983 and March 31, 2016. Original studies that reported the use of evoked potential monitoring during intracranial aneurysm surgery in predicting postoperative neurologic damage were selected, and their relevant reference lists were hand searched. Test performance characteristics were summarized using hierarchic summary receiver operating characteristic (ROC) curves and bivariable random-effects models.
RESULTS
Thirteen qualifying studies (1597 patients; 1689 aneurysms) from 6 countries were identified. Eight studies investigated the use of the somatosensory evoked potential (SSEP) monitoring technique, 5 investigated transcranial motor evoked potential (TcMEP) and another 5 investigated direct cortical motor evoked potential (DMEP). Bivariable pooled sensitivity and specificity were 48% (95% confidence interval [CI], 30.7-65.0) and 92% (CI, 88%-94.4%), respectively, for SSEP; 73% (CI, 21.0%-96.7%) and 94% (CI, 87.1%-97.5%) for TcMEP; and 97% (CI, 74.43%-99.99%) and 89% (CI, 84.0%-94.5%) for DMEP. ROC curve analysis showed that TcMEP had the highest accuracy (area under ROC curve 0.95; 95% CI, 0.93-0.97), followed by DMEP (0.91, 0.89-0.94) and SSEP (0.88, 0.85-0.91).
CONCLUSIONS
TcMEP and DMEP have higher diagnostic accuracy than SSEP in predicting postoperative neurologic deficit. The type of anesthetic agent, the use of neuromuscular blocking drugs, and the choice of diagnostic criteria for significant change in cerebral blood flow during aneurysm surgery affect the diagnostic accuracy of evoked potential techniques in predicting postoperative neurologic deficit.
Topics: Brain Ischemia; Evoked Potentials; Evoked Potentials, Motor; Evoked Potentials, Somatosensory; Humans; Intracranial Aneurysm; Intraoperative Neurophysiological Monitoring; Neurosurgical Procedures; Postoperative Complications; Sensitivity and Specificity
PubMed: 28433839
DOI: 10.1016/j.wneu.2017.04.071 -
Journal of Aging and Physical Activity Apr 2016This paper provides a systematic review of current research findings using exergaming as a treatment for improving cognition and dual-task function in older adults. A... (Review)
Review
This paper provides a systematic review of current research findings using exergaming as a treatment for improving cognition and dual-task function in older adults. A literature search was conducted to collect exergaming intervention studies that were either randomized controlled or uncontrolled studies. Of the seven identified studies (five randomized controlled studies and two uncontrolled studies), three studies focused on cognitive function alone, two studies focused on dual-task function alone, and two studies measured both cognitive function and dual-task function. Current evidence supports that exergaming improves cognitive function and dual-task function, which potentially leads to fall prevention. However, it is unclear whether exergaming, which involves both cognitive input and physical exercise, has additional benefits compared with traditional physical exercise alone. Further studies should include traditional exercise as a control group to identify these potential, additional benefits.
Topics: Accidental Falls; Aging; Cognition; Exercise; Exercise Therapy; Humans; Psychomotor Performance; Randomized Controlled Trials as Topic; Task Performance and Analysis; Treatment Outcome; Video Games
PubMed: 26291754
DOI: 10.1123/japa.2014-0267 -
JMIR MHealth and UHealth Mar 2018General consumers can now easily access drug information and quickly check for potential drug-drug interactions (PDDIs) through mobile health (mHealth) apps. With aging... (Review)
Review
BACKGROUND
General consumers can now easily access drug information and quickly check for potential drug-drug interactions (PDDIs) through mobile health (mHealth) apps. With aging population in Canada, more people have chronic diseases and comorbidities leading to increasing numbers of medications. The use of mHealth apps for checking PDDIs can be helpful in ensuring patient safety and empowerment.
OBJECTIVE
The aim of this study was to review the characteristics and quality of publicly available mHealth apps that check for PDDIs.
METHODS
Apple App Store and Google Play were searched to identify apps with PDDI functionality. The apps' general and feature characteristics were extracted. The Mobile App Rating Scale (MARS) was used to assess the quality.
RESULTS
A total of 23 apps were included for the review-12 from Apple App Store and 11 from Google Play. Only 5 of these were paid apps, with an average price of $7.19 CAD. The mean MARS score was 3.23 out of 5 (interquartile range 1.34). The mean MARS scores for the apps from Google Play and Apple App Store were not statistically different (P=.84). The information dimension was associated with the highest score (3.63), whereas the engagement dimension resulted in the lowest score (2.75). The total number of features per app, average rating, and price were significantly associated with the total MARS score.
CONCLUSIONS
Some apps provided accurate and comprehensive information about potential adverse drug effects from PDDIs. Given the potentially severe consequences of incorrect drug information, there is a need for oversight to eliminate low quality and potentially harmful apps. Because managing PDDIs is complex in the absence of complete information, secondary features such as medication reminder, refill reminder, medication history tracking, and pill identification could help enhance the effectiveness of PDDI apps.
PubMed: 29592848
DOI: 10.2196/mhealth.8613 -
Ear and Hearing 2017This systematic review aimed to investigate the prevalence and characteristics of vestibular adverse effects of aminoglycoside (AG) therapy in humans and to analyze... (Review)
Review
OBJECTIVES
This systematic review aimed to investigate the prevalence and characteristics of vestibular adverse effects of aminoglycoside (AG) therapy in humans and to analyze objective vestibular tests for the detection of AG-induced vestibulotoxicity.
DESIGN
PubMed, Cochrane Database, Web of Science, and reference lists of all included studies were screened by two independent researchers. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines were followed. Studies were included according to preset inclusion criteria and reported outcomes of studies evaluating vestibular function using one or more objective vestibular function tests in adults and children after systemic AG administration. The methodological quality of each study was assessed using the quality assessment tool for quantitative studies. Interrater reliability was established using Cohen's Kappa.
RESULTS
Twenty-seven studies were included, with the vast majority showing AG-induced vestibulotoxic side effects, ranging from 0 to 60%. Most studies reported AG-induced abnormalities by caloric and rotatory testing, whereas only a few studies reported using video Head Impulse test and vestibular evoked myogenic potential testing.
CONCLUSIONS
Because type I hair cells (particularly of the semicircular canals) are more susceptible to ototoxicity, video Head Impulse test and vestibular evoked myogenic potential testing seem more promising for the early detection of vestibulotoxicity than caloric and rotatory testing. Prospective studies using an extensive vestibular test battery are needed to further characterize the impact of AGs on the different vestibular end organs and to identify the most sensitive vestibular technique for the early detection of vestibulotoxicity.
Topics: Aminoglycosides; Caloric Tests; Head Impulse Test; Humans; Vestibular Diseases; Vestibular Evoked Myogenic Potentials; Vestibular Function Tests
PubMed: 28650850
DOI: 10.1097/AUD.0000000000000458 -
Cancers Oct 2022The chronic blood shortage has forced clinicians to seek alternatives to allogeneic blood transfusions during surgery. Due to anatomic uniqueness resulting in a vast... (Review)
Review
BACKGROUND
The chronic blood shortage has forced clinicians to seek alternatives to allogeneic blood transfusions during surgery. Due to anatomic uniqueness resulting in a vast vasculature, liver surgery can lead to significant blood loss, and an estimated 30% of patients require blood transfusions in major hepatectomy. Allogeneic transfusion harbors the risk of an immunologic reaction. However, the hesitation to reinfuse a patient's own blood during cancer surgery is reinforced by the potentiality of reintroducing and disseminating tumor cells into an individual undergoing curative treatment. Two methods of autotransfusions are common: autotransfusion after preoperative blood donation and intraoperative blood salvage (IBS). We aim to investigate the effect of autotransfusion on recurrence and survival rates of patients undergoing surgery for HCC.
METHODS
The protocol for this meta-analysis was registered at PROSPERO prior to data extraction. MEDLINE, Web of Science and Cochrane Library were searched for publications on liver surgery and blood salvage (autologous transfusion or intraoperative blood salvage). Comparative studies were included. Outcomes focused on long-term oncologic status and mortality. Hazard ratios (HR) estimated outcomes with a fixed-effects model. Risk of bias was assessed using ROBINS-I, and certainty of evidence was evaluated with GRADE. Separate analyses were performed for liver transplantation and hepatectomies.
RESULTS
Fifteen studies were included in the analysis (nine on transplantation and six on hepatectomies), and they comprised 2052 patients. Overall survival was comparable between patients who received intraoperative blood salvage (IBS) or not for liver transplantation (HR 1.13, 95% CI [0.89, 1.42] = 0.31). Disease-free survival also was comparable (HR 0.97, 95% CI [0.76, 1.24], = 0.83). Autotransfusion after prior donation was predominantly used in hepatectomy. Patients who received autotransfusion had a significantly better overall survival than the control (HR 0.71, 95% CI [0.58, 0.88], = 0.002). Disease-free survival was also significantly higher in patients with autotransfusion (HR 0.88, 95% CI [0.80, 0.96], = 0.005). Although overall, the certainty of evidence is low and included studies exhibited methodological heterogeneity, the heterogeneity of outcomes was low to moderate.
CONCLUSION
Autotransfusion, including intraoperative blood salvage, does not adversely affect the overall or disease-free survival of patients with HCC undergoing resection or transplantation. The results of this meta-analysis justify a randomized-controlled trial regarding the feasibility and potential benefits of autotransfusion in HCC surgery.
PubMed: 36230760
DOI: 10.3390/cancers14194837 -
Frontiers in Psychology 2022The purpose of this systematic review and meta-analysis is to assess the association between meaning in life (MiL), meaning-making and posttraumatic growth (PTG) in the...
INTRODUCTION
The purpose of this systematic review and meta-analysis is to assess the association between meaning in life (MiL), meaning-making and posttraumatic growth (PTG) in the context of cancer.
METHODS
A systematic search was conducted in eighteen electronic databases. The screening and selection process followed the PRISMA guidelines. For the purpose of the meta-analysis, the correlation coefficients between meaning in life and posttraumatic growth were extracted from the included studies. The effect size () was calculated using the restricted maximum-likelihood estimator, a random-effects model. Heterogeneity was assessed through the statistic, index and forest plot, while publication bias was analyzed with the use of the funnel plot and Egger's test.
RESULTS
889 records were considered according to the inclusion criteria. A total of nine articles, published between 2006 and 2021, were included in the systematic review. More than half were published in the last five years. The sample was mostly diagnosed with breast cancer. The meta-analysis included five articles ( = 844) and the results indicate a significant moderate correlation between meaning in life and posttraumatic growth ( = 0.43, 95% IC [0.36, 0.50]).
DISCUSSION
In conclusion, there is a clear association between meaning in life and posttraumatic growth in cancer patients. Future research should explore this relationship further, in order to better assist and guide meaning centered interventions that can potentiate a positive adjustment and possibly growth from the cancer experience.
PubMed: 36570997
DOI: 10.3389/fpsyg.2022.995981 -
Brazilian Journal of Otorhinolaryngology 2017The natural aging process may result in morphological changes in the vestibular system and in the afferent neural pathway, including loss of hair cells, decreased... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
The natural aging process may result in morphological changes in the vestibular system and in the afferent neural pathway, including loss of hair cells, decreased numbers of vestibular nerve cells, and loss of neurons in the vestibular nucleus. Thus, with advancing age, there should be a decrease in amplitudes and an increase in latencies of the vestibular evoked myogenic potentials, especially the prolongation of p13 latency. Moreover, many investigations have found no significant differences in latencies with advancing age.
OBJECTIVE
To determine if there are significant differences in the latencies of cervical and ocular evoked myogenic potentials between elderly and adult patients.
METHODS
This is a systematic review with meta-analysis of observational studies, comparing the differences of these parameters between elderly and young adults, without language or date restrictions, in the following databases: Pubmed, ScienceDirect, SCOPUS, Web of Science, SciELO and LILACS, in addition to the gray literature databases: OpenGrey.eu and DissOnline, as well as Research Gate.
RESULTS
The n1 oVEMP latencies had a mean delay in the elderly of 2.32ms with 95% CI of 0.55-4.10ms. The overall effect test showed p=0.01, disclosing that such difference was significant. The heterogeneity found was I=96% (p<0.001). Evaluation of p1 latency was not possible due to the low number of articles selected for this condition. cVEMP analysis was performed in 13 articles. For the p13 component, the mean latency delay in the elderly was 1.34ms with 95% CI of 0.56-2.11ms. The overall effect test showed a p<0.001, with heterogeneity value I=92% (p<0.001). For the n23 component, the mean latency delay for the elderly was 2.82ms with 95% CI of 0.33-5.30ms. The overall effect test showed p=0.03. The heterogeneity found was I=99% (p<0.001).
CONCLUSION
The latency of oVEMP n1 wave component and latencies of cVEMP p13 and n23 wave components are longer in the elderly aged >60 years than in young adults.
Topics: Aged; Aging; Humans; Reaction Time; Vestibular Evoked Myogenic Potentials
PubMed: 28237301
DOI: 10.1016/j.bjorl.2016.12.006 -
CNS & Neurological Disorders Drug... 2015Researchers have been using the electroencephalogram to better understand the cognitive and neurobiological bases of panic disorder (PD) through the P300 component; this... (Review)
Review
Researchers have been using the electroencephalogram to better understand the cognitive and neurobiological bases of panic disorder (PD) through the P300 component; this is an electric potential of the cerebral cortex that is generated in response to external sensorial stimuli and which involves more complex neurophysiological processes related to stimulus interpretation; it is then used to investigate possible alterations in the information processing and attention of patients suffering from this disorder. Aiming to verify the results found by experimental articles already published about P300 in PD patients and the information processing differences between PD patients and healthy controls, a systematic review of the PubMed and Institute for Scientific Information databases was conducted. The selection criterion involved those articles, written in English, which referred to an experimental research that focused on the P300 component, with a sample composed of PD (or panic attacks) patients. Seven articles were found that fit the selected criteria. Most of the articles show that these patients suffer from: impaired information processing and attention, an inability to automatically respond to new stimuli, and impaired interpretation of internal and external stimuli related to the disorder. Such impairment may be related to an unspecified dysfunction in the limbic-reticular structures, which would affect: active, focused and short-term attention, working and short-term memory, recognition and decision making. Some limitations were highlighted, such as the use of small samples and possible comorbidity with other disorders, which did not allow clearer results. This research can contribute to understand the neurobiological differences of PD patients and develop treatments based on such evidence.
Topics: Attention; Brain; Electroencephalography; Event-Related Potentials, P300; Humans; Memory; Panic Disorder
PubMed: 25106626
DOI: 10.2174/1871527314666150303164539 -
Nutrition Reviews Sep 2009In recent years, nuts have received special attention because of their potential role in preventing cardiovascular disease. Because nuts are very rich in total fat that... (Review)
Review
In recent years, nuts have received special attention because of their potential role in preventing cardiovascular disease. Because nuts are very rich in total fat that can potentially be oxidized and their skins contain several antioxidants, studies have been conducted to evaluate the potential effect of nut consumption on oxidative stress. This review evaluates the in vitro and in vivo studies conducted in animals or humans to analyze the effect of nuts on oxidation.
Topics: Animals; Antioxidants; Biomarkers; Cardiovascular Diseases; Diet; Eating; Fatty Acids; Humans; Lipid Peroxidation; Nuts; Oxidation-Reduction; Oxidative Stress; Plant Extracts
PubMed: 19703258
DOI: 10.1111/j.1753-4887.2009.00223.x -
Reproductive Toxicology (Elmsford, N.Y.) Aug 2021Exposure of environmental toxicants such as potentially toxic metals and pesticides have largely been attributed to produce adverse effects on general women's health and...
Exposure of environmental toxicants such as potentially toxic metals and pesticides have largely been attributed to produce adverse effects on general women's health and to be more precise on the reproductive system. In order to explore exposure of toxicants and metabolizing gene variants as risk factor for polycystic ovarian syndrome (PCOS), literature search was carried out using the databases PubMed, Central Cochrane Library, Google Scholar, Science Direct with appropriate keywords upto 6 December 2020. While most of the studies indicate higher serum Cu concentration and lower concentration of Mn as risk factor, studies also report presence of higher pesticide concentration in PCOS women. Genes such as MTHFR, CYPs participate in the metabolism of toxicants and may show different response due to underlying genetic variants. Thus, toxicant exposure are to some extent responsible for the pathogenesis of syndrome through oxidative stress and endocrine disruption, but the susceptibility may vary due to the underlying genetic polymorphism of the exposed population.
Topics: Endocrine Disruptors; Environmental Exposure; Female; Hazardous Substances; Humans; Polycystic Ovary Syndrome; Polymorphism, Genetic
PubMed: 34126208
DOI: 10.1016/j.reprotox.2021.06.005