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Journal of Neuro-oncology Jul 2023Brain malignancy and, at the same time central nervous system malignancy are two of the most difficult problems in the oncology field of practice. Brain tumors located... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
Brain malignancy and, at the same time central nervous system malignancy are two of the most difficult problems in the oncology field of practice. Brain tumors located near or within eloquent areas may represent another challenge toward neurosurgeon treatment. As such, electrical stimulation, either directly or through other methods, may prove necessary as proper mapping of the eloquent area thus may create a proper resection guide. Minimal resection will hopefully preserve patient neurological function and ensure patient quality of life.
METHODS
This research is a systematic review and meta-analysis that aim to compare outcomes, primarily adverse event analysis, between direct cortical stimulation and transcortical magnetic stimulation.
RESULTS
Fourteen studies were identified between 2010 and the 2023 interval. While this number is sufficient, most studies were not randomized and were not accompanied by blinding. Meta-analysis was then applied as a hypothesis test, which showed that TMS were not inferior compared to DCS in terms of motoric and lingual outcome which were marked subjectively by diamond location and objectively through a p-value above 0.05.
CONCLUSION
TMS is a noninvasive imaging method for the evaluation of eloquent brain areas that is not inferior compared to the invasive gold-standard imaging method (DCS). However its role as adjuvant to DCS and alternative only when awake surgery is not available must be emphasized.
Topics: Humans; Transcranial Magnetic Stimulation; Brain Neoplasms; Quality of Life; Brain Mapping; Wakefulness; Magnetic Resonance Imaging
PubMed: 37438656
DOI: 10.1007/s11060-023-04378-4 -
Behaviour Research and Therapy Aug 2023Distressing intrusive memories of a traumatic event are one of the hallmark symptoms of posttraumatic stress disorder. Thus, it is crucial to identify early... (Meta-Analysis)
Meta-Analysis
Distressing intrusive memories of a traumatic event are one of the hallmark symptoms of posttraumatic stress disorder. Thus, it is crucial to identify early interventions that prevent the occurrence of intrusive memories. Both, sleep and sleep deprivation have been discussed as such interventions, yet previous studies yielded contradicting effects. Our systematic review aims at evaluating existing evidence by means of traditional and individual participant data (IPD) meta-analyses to overcome power issues of sleep research. Until May 16, 2022, six databases were searched for experimental analog studies examining the effect of post-trauma sleep versus wakefulness on intrusive memories. Nine studies were included in our traditional meta-analysis (8 in the IPD meta-analysis). Our analysis provided evidence for a small effect favoring sleep over wakefulness, log-ROM = 0.25, p < .001, suggesting that sleep is associated with a lower number of intrusions but unrelated to the occurrence of any versus no intrusions. We found no evidence for an effect of sleep on intrusion distress. Heterogeneity was low and certainty of evidence for our primary analysis was moderate. Our findings suggest that post-trauma sleep has the potential to be protective by reducing intrusion frequency. More research is needed to determine the impact following real-world trauma and the potential clinical significance.
Topics: Humans; Memory; Stress Disorders, Post-Traumatic; Sleep; Sleep Deprivation; Cognition
PubMed: 37422952
DOI: 10.1016/j.brat.2023.104359 -
Psychological Research Feb 2024Although the arousal elicited by emotional stimuli, similarly to valence, is an integrative part of emotion theories, previous studies and reviews mostly focused on the... (Review)
Review
Although the arousal elicited by emotional stimuli, similarly to valence, is an integrative part of emotion theories, previous studies and reviews mostly focused on the valence of a stimulus and rarely investigated the role of arousal. Here, I systematically searched for articles that used visual attentional paradigms, manipulated emotional arousal by auditory or visual, task-relevant or task-irrelevant stimuli, measured behavioral responses, ocular behavior, or neural correlates. I found that task-relevant arousing stimuli draw and hold attention regardless of the modality. In contrast, task-irrelevant arousing stimuli impaired task performance. However, when the emotional content precedes the task or it is presented for a longer duration, arousal increased performance. Future directions on how research could address the remaining questions are discussed.
Topics: Humans; Emotions; Attention; Arousal; Task Performance and Analysis; Wakefulness
PubMed: 37417982
DOI: 10.1007/s00426-023-01852-6 -
BMC Women's Health Jul 2023To estimate the pooled prevalence of sexual dysfunction (SD) in women with multiple sclerosis (MS). (Meta-Analysis)
Meta-Analysis
OBJECTIVE
To estimate the pooled prevalence of sexual dysfunction (SD) in women with multiple sclerosis (MS).
METHODS
We systematically searched PubMed, Scopus, EMBASE, Web of Science, and google scholar and also gray literature up to October 2021. The search strategy includes: ("Multiple Sclerosis" OR "MS" OR "Disseminated Sclerosis" OR (Disseminated AND Sclerosis) OR (Sclerosis AND Multiple)) AND ("Sexual Dysfunction" OR (Sexual AND Dysfunction) OR (Sexual AND Dysfunctions) OR (Sexual AND Disorders) OR (Sexual AND Disorder) OR "Sexual Dysfunctions" OR "Sexual Disorders" OR "Sexual Disorder" OR "Psychosexual Dysfunctions" OR (Dysfunction AND Psychosexual) OR (Dysfunctions AND Psychosexual) OR "Psychosexual Dysfunction" OR "Psychosexual Disorders" OR (Disorder AND Psychosexual) OR (Disorders AND Psychosexual) OR "Psychosexual Disorder" OR "Hypoactive Sexual Desire Disorder" OR "Sexual Aversion Disorder" OR (Aversion Disorders AND Sexual) OR (Disorders AND Sexual Aversion) OR "Sexual Aversion Disorders" OR "Orgasmic Disorder" OR (Disorders AND Orgasmic) OR "Orgasmic Disorders" OR "Sexual Arousal Disorder" OR (Arousal Disorders AND Sexual) OR (Disorders AND Sexual Arousal) OR "Sexual Arousal Disorders" OR "Frigidity").
RESULTS
We found 2150 articles by literature search, after deleting duplicates 1760 remained. Fifty-six articles remained for meta-analysis. The pooled prevalence of SD in MS patients estimated as 61% (95%CI:56-67%) (I:95.7%, P < 0.001). The pooled prevalence of Anorgasmia in MS patients estimated as 29% (95%CI:20-39%) (I:85.3%, P < 0.001). The pooled odds of developing SD in MS women estimated as 3.05(95%CI: 1.74-5.35) (I:78.3%, P < 0.001). The pooled prevalence of decreased vaginal lubrication in MS patients estimated as 32%(95%CI:27-37%) (I = 94.2%, P < 0.001). The pooled prevalence of reduced libido was 48%(95%CI:36-61%) (I:92.6%, P < 0.001). The pooled prevalence of arousal problems was 40%(95%CI: 26-54%) (I:97.4%, P < 0.001). The pooled prevalence of intercourse satisfaction was 27% (95%CI: 8-46%) (I:99%, P < 0.001).
CONCLUSION
The result of this systematic review and meta-analysis show that the pooled prevalence of SD in women with MS is 61% and the odds of developing SD in comparison with controls is 3.05.
Topics: Female; Humans; Prevalence; Sclerosis; Sexual Dysfunction, Physiological; Multiple Sclerosis; Sexual Dysfunctions, Psychological
PubMed: 37403051
DOI: 10.1186/s12905-023-02501-1 -
In Vivo (Athens, Greece) 2023Awake surgery has become a valid alternative to general anesthesia in many surgery fields. This technique played a very important role during the COVID-19 period. The... (Review)
Review
BACKGROUND/AIM
Awake surgery has become a valid alternative to general anesthesia in many surgery fields. This technique played a very important role during the COVID-19 period. The growing use of this technique has many advantages. We performed a systematic review to study the potentialities of awake breast surgery.
MATERIALS AND METHODS
We searched Pubmed, Embase, and Cochrane library database and retrieved a total of 109 records. Forty-nine of them were excluded as unsuitable. Finally, we selected a total of 12 records concerning different types of studies for topic appropriateness. Three reviewers reviewed independently each record.
RESULTS
Five articles analyzing the sustainability of awake surgery during the COVID-19 period were selected. In addition, one article analyzing the impact on the immune system and six articles and eight case reports analyzing anesthetic techniques were also selected. The studies analyzing awake breast surgery during the COVID-19 period showed advantages in terms of sustainability and length of hospitalization. The study analyzing the immune response after awake breast surgery showed lesser lymphocyte response than the general anesthesia group. The studies analyzing anesthetic techniques in awake breast surgery showed that the nerve blocks allow good level of safety and postoperative pain control.
CONCLUSION
The awake breast surgery and fast track implementation shortened hospital stays and reduced costs, without influencing the surgical results. Furthermore, awake breast surgery reduced surgical stress compared to general anesthesia. Among the various anesthetic techniques, nerve blocks are the most advantageous in terms of safety and efficacy compared to epidural anesthesia.
Topics: Humans; Female; Wakefulness; Brain Neoplasms; COVID-19; Nerve Block; Breast Neoplasms
PubMed: 37369489
DOI: 10.21873/invivo.13225 -
BMC Infectious Diseases Jun 2023Awake prone positioning has been widely used in non-intubated patients with acute hypoxic respiratory failure (AHRF) due to COVID-19, but the evidence is mostly from... (Meta-Analysis)
Meta-Analysis
Awake prone positioning for non-intubated patients with COVID-19-related acute hypoxic respiratory failure: a systematic review based on eight high-quality randomized controlled trials.
BACKGROUND
Awake prone positioning has been widely used in non-intubated patients with acute hypoxic respiratory failure (AHRF) due to COVID-19, but the evidence is mostly from observational studies and low-quality randomized controlled trials (RCTs), with conflicting results from published studies. A systematic review of published high-quality RCTs to resolve the controversy over the efficacy and safety of awake prone positioning in non-intubated patients with AHRF due to COVID-19.
METHODS
Candidate studies were identified through searches of PubMed, Web of Science, Cochrane, Embase, Scopus databases from December 1, 2019 to November 1, 2022. Literature screening, data extraction and risk of bias assessment were independently conducted by two researchers.
RESULTS
Eight RCTs involving 2657 patients were included. Meta-analysis of fixed effects models showed that awake prone positioning did not increase mortality(OR = 0.88, 95%CI [0.72, 1.08]), length of stay in ICU (WMD = 1.14, 95%CI [-0.45, 2.72]), total length of stay (WMD = 0.11, 95%CI [-1.02, 1.23]), or incidence of adverse events (OR = 1.02, 95%CI [0.79, 1.31]) compared with usual care, but significantly reduced the intubation rate (OR = 0.72, 95%CI [0.60, 0.86]). Similar results were found in a subgroup analysis of patients who received only high flow nasal cannula (Mortality: OR = 0.86, 95%CI [0.70, 1.05]; Intubation rate: OR = 0.69, 95%CI [0.58, 0.83]). All eight RCTs had high quality of evidence, which ensured the reliability of the meta-analysis results.
CONCLUSIONS
Awake prone positioning is safe and feasible in non-intubated patients with AHRF caused by COVID-19, and can significantly reduce the intubation rate. More studies are needed to explore standardized implementation strategies for the awake prone positioning.
TRIAL REGISTRATION
CRD42023394113.
Topics: Humans; COVID-19; Wakefulness; Prone Position; Randomized Controlled Trials as Topic; Hypoxia; Respiratory Distress Syndrome; Respiratory Insufficiency
PubMed: 37337193
DOI: 10.1186/s12879-023-08393-8 -
Clinical Psychology Review Jul 2023The vast majority of research on, and clinical assessment of, cognitions related to suicide and non-suicidal self-injury (NSSI) has focused on verbal thoughts. And yet,... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The vast majority of research on, and clinical assessment of, cognitions related to suicide and non-suicidal self-injury (NSSI) has focused on verbal thoughts. And yet, mental imagery is more realistic and emotionally arousing than verbal thoughts.
METHODS
We conducted a systematic review and meta-analysis documenting the prevalence of suicidal and NSSI mental imagery and describing the content and characteristics of suicidal and NSSI mental imagery, links between suicidal and NSSI mental imagery and suicidal and NSSI behavior, and how to intervene on suicidal and NSSI mental imagery. Studies published through December 17, 2022 were identified through a systematic search of MEDLINE and PsycINFO.
RESULTS
Twenty-three articles were included. Prevalence rates of suicidal (73.56%) and NSSI (84.33%) mental imagery were high among clinical samples. Self-harm mental imagery commonly depicts engagement in self-harm behavior and is experienced as vivid, realistic, and preoccupying. When experimentally induced, self-harm mental imagery reduces physiological and affective arousal. Preliminary evidence suggests that suicidal mental imagery is associated with suicidal behavior.
CONCLUSIONS
Suicidal and NSSI mental imagery are highly prevalent and may be associated with heightened risk for self-harm behavior. Assessments and interventions for self-harm should consider incorporating and addressing suicidal and NSSI mental imagery to mitigate risk.
Topics: Humans; Suicide, Attempted; Self-Injurious Behavior; Suicide; Suicidal Ideation; Cognition; Risk Factors
PubMed: 37329877
DOI: 10.1016/j.cpr.2023.102302 -
Frontiers in Public Health 2023The recent increase of group A (GAS) infections in Europe has aroused global concern. We aim to provide molecular biological data for GAS prevention and control in... (Review)
Review
BACKGROUND
The recent increase of group A (GAS) infections in Europe has aroused global concern. We aim to provide molecular biological data for GAS prevention and control in China by analyzing the temporal shift of type.
METHODS
We collected studies reporting GAS types in China from 1990 to 2020 by PRISMA statement and established a summary database including types and literature quality assessment. Based on the database we analyzed the geographic distribution of types from 1990 to 2020 and assessed the coverage of the known GAS 30-valent vaccine. Outbreak-associated types that had been reported over the past 30 years were also included.
RESULTS
47 high quality studies were included for a systematic analysis of type distribution. This generated a database including totally 12,347 GAS isolates and 85 types. Shift of dominant type was witnessed during the past 30 years in China. In mainland China, dominant types changed from 3, 1, 4, 12 in 1990s to 12 and 1 in 2000s and 2010s. Hong Kong and Taiwan were dominated by 12, 4 and 1, of which 4 reduced but 12 increased in 2010s significantly. From 1990 to 2020, newly found types were increasingly reported in various regions of China. The reported 30-valent M protein vaccine covered 26 M types prevalent in China, including all dominant types.
Topics: Humans; Antigens, Bacterial; Bacterial Outer Membrane Proteins; Carrier Proteins; Streptococcus pyogenes; Streptococcal Infections; China
PubMed: 37325303
DOI: 10.3389/fpubh.2023.1157289 -
International Journal of Geriatric... Jun 2023Assessing for recovery in delirium is essential in guiding ongoing investigation and treatment. Yet, there is little scrutiny and no research or clinical consensus on... (Review)
Review
OBJECTIVES
Assessing for recovery in delirium is essential in guiding ongoing investigation and treatment. Yet, there is little scrutiny and no research or clinical consensus on how recovery should be measured. We reviewed studies which used tests of neuropsychological domains and functional ability to track recovery of delirium longitudinally in acute hospital settings.
METHODS/DESIGN
We systematically searched databases (MEDLINE, PsycInfo, CINAHL, Embase, ClinicalTrials.gov, Cochrane Central Register of Controlled Trials), from inception to October 14 , 2022. Inclusion criteria were: adult acute hospital patients (≥18 years) diagnosed with delirium by a validated tool; 1+ repeat assessment using an assessment tool measuring domains of delirium/functional recovery ≤7 days from baseline. Two reviewers independently screened articles, performed data extraction, and assessed risk of bias. A narrative data synthesis was completed.
RESULTS
From 6533 screened citations, we included 39 papers (reporting 32 studies), with 2370 participants with delirium. Studies reported 21 tools with an average of four repeat assessments including baseline (range 2-10 assessments within ≤7 days), measuring 15 specific domains. General cognition, functional ability, arousal, attention and psychotic features were most commonly assessed for longitudinal change. Risk of bias was moderate to high for most studies.
CONCLUSIONS
There was no standard approach for tracking change in specific domains of delirium. The methodological heterogeneity of studies was too high to draw firm conclusions on the effectiveness of assessment tools to measure delirium recovery. This highlights the need for standardised methods for assessing recovery from delirium.
Topics: Humans; Activities of Daily Living; Delirium; Hospitals
PubMed: 37294207
DOI: 10.1002/gps.5943 -
Neuroscience and Biobehavioral Reviews Sep 2023Binge-Eating Disorder (BED) involves anticipatory craving and urges, subjective loss-of-control during binge-eating episodes, and post-feeding psychological distress and... (Meta-Analysis)
Meta-Analysis Review
Binge-Eating Disorder (BED) involves anticipatory craving and urges, subjective loss-of-control during binge-eating episodes, and post-feeding psychological distress and guilt. Evidence indicates neurocognitive dysfunctions contribute to BED onset, maintenance, and treatment response. However, an integrated understanding of how cognitive processes underpin BED symptomology is lacking. We utilised a multi-stage decision-making model defining ten cognitive processes underpinning Preference Formation, Choice Implementation, Feedback Processing, and Flexibility/Shifting, to comprehensively review research published since 2013. We used preregistered PICOS criteria to assess 1966 articles identified from PubMed, PsycInfo, and Scopus database searches. This yielded 50 studies reporting behavioural cognitive tasks outcomes, comparing individuals with BED to controls with normal and higher weight. Meta-analyses revealed a unique profile of cognitive dysfunctions that spanned all decision-making stages. Significant deficits were evident in Uncertainty Evaluation, Attentional Inhibition, Choice Consistency, and Cognitive Flexibility/Set-shifting. We propose a novel model of dysfunctional decision-making processes in BED and describe their role in binge-eating behaviour. We further highlight the potential for cognitive interventions to target these processes and address the significant treatment gap in BED.
Topics: Humans; Binge-Eating Disorder; Overweight; Attention; Cognitive Dysfunction; Craving
PubMed: 37263530
DOI: 10.1016/j.neubiorev.2023.105250