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Ethiopian Journal of Health Sciences Jan 2024Healthcare systems should ensure the provision of quality services to patients without harming them. However, the provision of services is occasionally accompanied by... (Review)
Review
BACKGROUND
Healthcare systems should ensure the provision of quality services to patients without harming them. However, the provision of services is occasionally accompanied by harm or complications, most of which are preventable. Most studies have focused on secondary healthcare rather than primary healthcare (PHC). Thus, this study aimed to identify various dimensions and components of patient safety in PHC worldwide.
METHODS
This systematic review study was conducted in November 2022 based on PRISMA reporting guidelines. Studies were retrieved from PubMed, Scopus, Cochrane Library, Web of Science, and EMBASE and searched for English documents using the keywords "patient safety" and "PHC" from 2000 to 2022. Finally, two reviewers extracted the data independently and analyzed using thematic content analysis.
RESULTS
Overall, 23 out of the initially 4937 identified articles were selected for the final analysis based on the inclusion and exclusion criteria. Most of these studies used a qualitative-quantitative approach (61.9%, seven studies for both), and 64% had been conducted in European countries. Eventually, five dimensions and 22 components were identified for patient safety in PHC, including management measures, quality management, resources and technology, documents, and patient-related factors.
CONCLUSION
The patient safety dimensions and components identified in this research can help develop a clear definition of patient safety and its assessment standards and criteria in PHC. Considering that most previous studies on patient safety in PHC were conducted in European and developed countries, it is suggested that researchers conduct more studies in developing countries to fill this research gap.
Topics: Humans; Primary Health Care; Patient Safety; Quality of Health Care
PubMed: 38957341
DOI: 10.4314/ejhs.v34i1.9 -
Frontiers in Oncology 2024The performance of artificial intelligence (AI) in the prediction of lymph node (LN) metastasis in patients with oral squamous cell carcinoma (OSCC) has not been...
Application of CT and MRI images based on artificial intelligence to predict lymph node metastases in patients with oral squamous cell carcinoma: a subgroup meta-analysis.
BACKGROUND
The performance of artificial intelligence (AI) in the prediction of lymph node (LN) metastasis in patients with oral squamous cell carcinoma (OSCC) has not been quantitatively evaluated. The purpose of this study was to conduct a systematic review and meta-analysis of published data on the diagnostic performance of CT and MRI based on AI algorithms for predicting LN metastases in patients with OSCC.
METHODS
We searched the Embase, PubMed (Medline), Web of Science, and Cochrane databases for studies on the use of AI in predicting LN metastasis in OSCC. Binary diagnostic accuracy data were extracted to obtain the outcomes of interest, namely, the area under the curve (AUC), sensitivity, and specificity, and compared the diagnostic performance of AI with that of radiologists. Subgroup analyses were performed with regard to different types of AI algorithms and imaging modalities.
RESULTS
Fourteen eligible studies were included in the meta-analysis. The AUC, sensitivity, and specificity of the AI models for the diagnosis of LN metastases were 0.92 (95% CI 0.89-0.94), 0.79 (95% CI 0.72-0.85), and 0.90 (95% CI 0.86-0.93), respectively. Promising diagnostic performance was observed in the subgroup analyses based on algorithm types [machine learning (ML) or deep learning (DL)] and imaging modalities (CT vs. MRI). The pooled diagnostic performance of AI was significantly better than that of experienced radiologists.
DISCUSSION
In conclusion, AI based on CT and MRI imaging has good diagnostic accuracy in predicting LN metastasis in patients with OSCC and thus has the potential for clinical application.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/PROSPERO/#recordDetails, PROSPERO (No. CRD42024506159).
PubMed: 38957322
DOI: 10.3389/fonc.2024.1395159 -
Cureus Jun 2024Sleep duration has been proposed as a potential and important modifiable risk factor, yet its precise relationship with hypertension among Asian adults remains unclear.... (Review)
Review
Sleep duration has been proposed as a potential and important modifiable risk factor, yet its precise relationship with hypertension among Asian adults remains unclear. This meta-analysis aims to elucidate the impact of short sleep duration on hypertension risk within the adult Asian population. A systematic search of databases, including PubMed, Scopus, and ScienceDirect, was conducted to identify relevant studies published up to January 4, 2024. Eligible studies comprised observational cohort studies and cross-sectional studies that compared short sleep duration to normal sleep duration in relation to hypertension risk among Asian adults. The definitions for short and normal sleep durations were derived from the respective studies. The random effects model was utilized to pool effect estimates, and all statistical analyses were conducted using Review Manager 5.4 software (RevMan) (Cochrane Collaboration, Oxford, UK). Results from a systematic search obtained seven studies assessing sleep duration and hypertension risk in Asian populations. Based on a meta-analysis of six studies, short sleep duration is associated with a higher hypertension risk when compared to normal sleep duration (OR: 1.36; 95% CI: 1.13-1.64; p: 0.0010; I: 75%). Subgroup analysis based on sex showed that the association is evident across males (OR: 1.12; 95% CI: 1.01-1.25; p: 0.03; I: 64%) and females (OR: 1.22; 95% CI: 1.10-1.35; p: 0.0003; I: 82%). In conclusion, based on the analyzed studies, short sleep duration is associated with a higher mild risk of hypertension, irrespective of sex. Thus, short sleep duration can be a modifiable risk factor that can be prevented to reduce the risk of hypertension. By incorporating sleep hygiene practices and promoting healthy sleep habits, significant improvement in cardiovascular health can be made, especially in hypertension risk at a population level. Further studies on the effect of sleep duration in different age populations should be conducted to confirm the impact of short sleep duration.
PubMed: 38957247
DOI: 10.7759/cureus.61508 -
Aesthetic Surgery Journal Jul 2024Various surgical techniques have been devised for the surgical cosmetic enhancement of female outer genitalia. The selection of an optimal method should be based on...
BACKGROUND
Various surgical techniques have been devised for the surgical cosmetic enhancement of female outer genitalia. The selection of an optimal method should be based on satisfaction rates and safety; however, a comprehensive, contemporary systematic assessment of these factors in has been limited in the literature.
OBJECTIVES
Our aim was to conduct a comprehensive systematic review and meta-analysis to evaluate the overall satisfaction rates and risk factors associated with various labiaplasty techniques and tools.
METHODS
The authors performed a systematic literature search in three medical databases: PubMed, Elsevier and Cochrane Library (CENTRAL) with the closing date of October 2023. Original articles with quantitative satisfaction rates and frequencies of most common complications (hematoma, dehiscence, swelling, bleeding and infection) were included.
RESULTS
Systematic search provided a total of 3954 records. After selection and review of the articles, 86 eligible, peer-reviewed studies were identified, of which 53 provided quantitative data. High overall satisfaction rate was found for all methods (Prop: 94%; CI: 93-95%), with highest satisfaction for deepithelization (Prop: 97%; CI: 85%-99%). Complications were generally rare, with elevated incidences for some techniques (wedge resection - dehiscence: Prop: 8%; CI: 5%-13% and composite reduction - swelling: Prop: 13%; CI: 2%-54%). Scalpel has significantly higher incidence of complications than laser, namely for bleeding, swelling and hematoma.
CONCLUSIONS
Labiaplasty can be considered a generally effective approach to outer female genitalia beautification, with low associated risks. Surgeons must tailor their approach to the patients' needs and anatomy to achieve maximal satisfaction, given the differences in the frequency of complications for each method.
PubMed: 38957153
DOI: 10.1093/asj/sjae143 -
Recent Patents on Anti-cancer Drug... Jul 2024Evodiamine (EVO) is an alkaloid extracted from the dried and nearly ripe fruits of Euodia rutaecarpa and used as an anti-cancer, anti-inflammatory and anti-obesity... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Evodiamine (EVO) is an alkaloid extracted from the dried and nearly ripe fruits of Euodia rutaecarpa and used as an anti-cancer, anti-inflammatory and anti-obesity agent. However, robust evidence of preclinical experiments has been lacking so far. Therefore, the purpose of this article was to investigate the effect of EVO in combination with other treatments on tumors in animal experiments.
METHODS
A systematic review and meta-analysis were conducted to assess the anti-tumor effect of evodiamine-combined therapy. The search engine and electronic databases included PubMed, Scopus, China Knowledge Resource Integrated Database (CNKI), and SinoMed. The research method was based on the PRISMA checklist.
RESULTS
A total of 7 studies and 108 animals were included. As a result, EVO combined therapy was found to be more effective than EVO monotherapy. The SMD was -25.64(95% CI: -5.77 -3.13) in tumor growth. In tumor weight, the SMD was -8.91(95% CI: -16.37, -1.44).
CONCLUSION
EVO has the potential to alleviate the toxicity of chemotherapeutic agents, which increases the translatability to the clinical situation.
PubMed: 38956908
DOI: 10.2174/0115748928303602240610063501 -
Oral Diseases Jul 2024High-risk human papillomaviruses (HPV) are an established cause of oropharyngeal cancer. Their relationship with oral cancer remains unclear with detection ranging from... (Review)
Review
OBJECTIVE
High-risk human papillomaviruses (HPV) are an established cause of oropharyngeal cancer. Their relationship with oral cancer remains unclear with detection ranging from 0% to 100%. HPV DNA detection or evidence of exposure alone is insufficient to conclude causality. This systematic review assesses the extent of bias in studies of HPV detection in cancers of the oral cavity.
METHODS
PubMed, Ovid MEDLINE, EMBASE, and PsycInfo databases were searched for observational studies reporting the effect of HPV in oral cavity specific cancers.
RESULTS
All 15 included studies presented HPV DNA detection or serum HPV-antibodies, none included mRNA E6/E7 analysis. Cases with oral cancer had 5.36 times (95% CI 3.29-8.72) higher odds of having HPV detected compared to controls. The odds of HPV detection were higher in cell-based (OR 6.93; 95% CI 0.82-58.55) and tissue samples (OR 5.28; 95% CI 3.41-8.18) than blood-based samples (OR 3.36; 95% CI 1.53-7.40).
CONCLUSION
When cancer site is clearly differentiated between oropharynx and oral cavity, 12 studies showed strong association between HPV and oral cancer, but the available estimates lack internal validity due to inconsistent measurements, high confounding, and lack of gold standard testing. There is not high-quality evidence to conclude a causal relationship of HPV with oral cancer.
PubMed: 38956902
DOI: 10.1111/odi.15062 -
The Journal of Contemporary Dental... Apr 2024The main aim of this present systematic review is to evaluate if the preservation of pericervical dentin (PCD) increases the fracture resistance of endodontically... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
The main aim of this present systematic review is to evaluate if the preservation of pericervical dentin (PCD) increases the fracture resistance of endodontically treated permanent posterior teeth.
MATERIALS AND METHODS
Two independent reviewers conducted a comprehensive review of all published studies from 2007 (1/1/2007) to 2023 (31/5/23) since the concept of PCD first appeared in the literature in 2007. Searches were conducted in multiple electronic database engines: PubMed, Scopus, EBSCO (Dentistry and oral health sciences), Web of Sciences (WOS), Cochrane, Google Scholar and Open Grey, Ovid and Shodhganga, in addition to cross-references and hand search. Articles were chosen according to a certain inclusion and exclusion criteria, which, in brief, are laboratory-based studies published in English that assess the impact of PCD on fracture resistance of endodontically treated permanent posterior teeth. Using domains, such as sample size, sample dimensions, and control group as quality assessment criteria, evaluated the selected articles and classified them according to their risk of bias into low, moderate, and high. A meta-analysis was conducted using random effects modeling at a significance level of < 0.05.
RESULTS
A total of studies 6,043 were retrieved from 10 different electronic search databases and hand searches, but only 12 laboratory-based studies were selected after removing duplicates and applying the eligibility criteria. Of the included 12 studies, nine studies showed low risk of bias and three studies showed moderate risk of bias. Two studies showed related data for meta-analysis, the difference observed between the two studies is statistically non-significant.
CONCLUSION
Based on the results of the study, there is evidence to support that PCD preservation offers fracture resistance to the endodontically treated posterior teeth.
CLINICAL SIGNIFICANCE
The practice of conservative cavity preparation and avoiding the usage of instruments with high taper increases the fracture resistance of the tooth by retaining the PCD. How to cite this article: Haridoss S, Rajendran M, Swaminathan K, . Impact of Pericervical Dentin on Fracture Resistance of Endodontically Treated Posterior Permanent Teeth: A Systematic Review and Meta-analysis. J Contemp Dent Pract 2024;25(4):372-385.
Topics: Humans; Tooth Fractures; Tooth, Nonvital; Dentin; Dental Stress Analysis; Dentition, Permanent
PubMed: 38956854
DOI: 10.5005/jp-journals-10024-3671 -
Otology & Neurotology : Official... Jul 2024To systematically review how audiometric data change over time in patients with Menière's disease (MD) undergoing non-ablative medical therapy.
OBJECTIVE
To systematically review how audiometric data change over time in patients with Menière's disease (MD) undergoing non-ablative medical therapy.
DATABASES REVIEWED
Medline (via PubMed), Scopus, Web of Science, Cumulated Index to Nursing and Allied Health Literature (CINAHL), Google Scholar.
METHODS
A systematic review and meta-analysis of the literature was performed. Adult patients undergoing non-ablative medical therapy and reported duration of disease or follow-up were included and pooled estimates of pure-tone average (PTA) were tabulated. Studies were excluded if they did not use established MD, did not have pure-tone average (PTA) audiometric data, underwent ear surgery or ablative therapies, and were systematic reviews or case reports.
RESULTS
Out of 198 articles meeting full eligibility, 13 studies, involving 950 patients with MD, were included in the review and further analyzed. No effect on progression of PTA from initial diagnosis was seen between the different medical therapies within 2 years of non-ablative medical treatment. There was a significant worsening of PTA after 2 year, regardless of treatment used. High levels of heterogeneity among studies were noted up to 6 months from diagnosis (I2 = 79%), likely reflecting differences in patient characteristics, treatment regimens, and study design. Overall, the risk of bias was low for the majority of included studies.
CONCLUSIONS
Patients diagnosed with MD who are undergoing non-ablative medical therapy should be counseled on the likelihood of worsening of hearing loss over the course of the disease despite elected treatment.
PubMed: 38956802
DOI: 10.1097/MAO.0000000000004251 -
Otology & Neurotology : Official... Jul 2024To characterize the pattern of hearing loss in Charcot-Marie-Tooth (CMT) disease to help guide clinical management.
OBJECTIVE
To characterize the pattern of hearing loss in Charcot-Marie-Tooth (CMT) disease to help guide clinical management.
DATABASES REVIEWED
CINAHL, PubMed, and Scopus.
METHODS
Two independent investigators selected studies on CMT patients with pure-tone average (PTA) and auditory brainstem response (ABR) data. Case reports, case series <5 patients, and data that overlapped with another study were excluded. Investigators performed data extraction, quality rating, and risk-of-bias assessment using the Newcastle-Ottawa Scale. Meta-analysis of mean difference using fixed/random effects models was used. Also, data were analyzed using a weighted one-way analysis of variance, with post-hoc Tukey's test for comparison.
RESULTS
Ultimately, 6 prospective studies (N = 197) were included. The most common demyelinating subtype (CMT1A) had significantly prolonged ABR latency values across wave III (0.20 ms, 95% confidence interval [CI]: 0.05-0.35), wave V (0.20 ms, 95% CI: 0.01-0.39), waves I-III (0.20 ms, 95% CI: 0.01-0.39), and waves I-V (0.20 ms, 95% CI: 0.01-0.39) when compared to matched controls. The autosomal recessive demyelinating subtype (CMT4C) had significantly worse PTA when compared to the most common subtype (CMT1A) (Δ 28.93 dB, 95% CI 18.34-39.52) and nondemyelinating subtype (CMT2A) (Δ 28.3 dB, 95% CI: 15.98-40.62).
CONCLUSIONS
Patients with CMT can present with a variety of phenotypes depending on the causative mutation. The ABR interpeak latency values for the most common demyelinating form of CMT are delayed when compared to matched controls. Most subtypes have normal hearing thresholds, apart from CMT4C, which presents with mild hearing loss on average.
PubMed: 38956759
DOI: 10.1097/MAO.0000000000004243 -
Journal of Cardiothoracic Surgery Jul 2024Tricuspid regurgitation (TR) is a common valvular heart disease worldwide, and current guidelines for TR treatment are relatively conservative, as well as with... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Tricuspid regurgitation (TR) is a common valvular heart disease worldwide, and current guidelines for TR treatment are relatively conservative, as well as with detrimental outcomes. Restoration of sinus rhythm was reported to improve the TR severity in those TR patients with atrial fibrillation (AF). However, relevant research was limited. The aim of this meta-analysis was to evaluate the clinical outcomes of restoration of sinus rhythm in TR patients with AF.
METHODS
In this study, PubMed, Web of Science, and Scopus databases were searched for study enrollment until July 2023. This study was designed under the guidance of Preferred Reporting Items for Systematic Reviews and Meta-Analyses. These studies containing the patient's baseline characteristics, surgical procedure, and at least one of the clinical outcomes were included. The primary endpoint was TR grade during follow-up after restoration of sinus rhythm.
RESULTS
Out of 1074 records, 6 were enrolled. Restoration of sinus rhythm is associated with a reduction of TR severity (TR grade, odds ratio 0.11, 95% confidence interval (CI): 0.01 to 1.28, P = 0.08, I = 83%; TR area, mean difference (MD) -2.19 cm, 95% CI: -4.17 to -0.21 cm, P = 0.03, I = 96%). Additionally, remolding of right heart with a significant reduction of tricuspid valve annulus diameter (MD -0.36 cm, 95%CI: -0.47 to -0.26 cm, P < 0.00001, I = 29%) and right atrium volume index (MD -11.10 mL/m, 95%CI: -16.81 to -5.39 mL/m, P = 0.0001, I = 79%) was observed during follow-up.
CONCLUSIONS
In conclusion, rhythm-control therapy could reduce TR severity in AF patients with TR and is associated with right heart remodeling.
Topics: Atrial Fibrillation; Humans; Tricuspid Valve Insufficiency; Heart Rate
PubMed: 38956670
DOI: 10.1186/s13019-024-02891-9