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Systematic Reviews Jun 2024The use of prophylactic antibiotics in surgery is contentious. With the rise in antimicrobial resistance, evidence-based antibiotic use should be followed. This... (Meta-Analysis)
Meta-Analysis
BACKGROUND
The use of prophylactic antibiotics in surgery is contentious. With the rise in antimicrobial resistance, evidence-based antibiotic use should be followed. This systematic review and network meta-analysis will assess the effectiveness of different antibiotics on the prevention of surgical site infection (SSI) following hand trauma surgery.
METHODS AND ANALYSIS
The databases Embase, MEDLINE, CINAHL and CENTRAL, ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform will be searched. Abstracts will be screened by two persons independently to identify eligible studies. This systematic review will include both randomised and non-randomised prospective comparative studies in participants with hand and/or wrist injuries requiring surgery; bite injuries will be excluded. The network meta-analysis will compare the use of different prophylactic antibiotics against each other, placebo and/or no antibiotics on the development of SSI within 30 days of surgery (or 90 days if there is an implanted device). The Cochrane risk-of-bias tool 2 will be used to assess the risk of methodological bias in randomised controlled trials, and the Newcastle-Ottowa scale (NOS) will be used to assess the risk of bias in non-randomised studies. A random-effects network meta-analysis will be conducted along with subgroup analyses looking at antibiotic timing, injury type, and operation location. Sensitivity analyses including only low risk-of-bias studies will be conducted, and the confidence in the results will be assessed using Confidence in Network Meta-Analysis (CINEMA).
DISCUSSION
This systematic review and network meta-analysis aims to provide an up-to-date synthesis of the studies assessing the use of antibiotics following hand and wrist trauma to enable evidence-based peri-operative prescribing.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO CRD42023429618.
Topics: Humans; Systematic Reviews as Topic; Surgical Wound Infection; Antibiotic Prophylaxis; Hand Injuries; Anti-Bacterial Agents; Network Meta-Analysis; Research Design; Acute Care Surgery
PubMed: 38877569
DOI: 10.1186/s13643-024-02573-6 -
Journal of Bodywork and Movement... Jul 2024Studies with focus on effects of manual therapy techniques on postural control and muscle activity in patients with chronic ankle instability (are lacking. The purpose... (Randomized Controlled Trial)
Randomized Controlled Trial
INTRODUCTION
Studies with focus on effects of manual therapy techniques on postural control and muscle activity in patients with chronic ankle instability (are lacking. The purpose of this study was to evaluate the feasibility of a planned cross-over study to assess efficacy of manual therapy techniques applications in patients with chronic ankle instability.
METHODS
This feasibility study used a randomized controlled, blinded assessor cross-over design. Criteria of success under evaluation were adherence and attrition rates and adverse events. while preliminary treatment effects of manual therapy techniques on muscular activity (measured by surface electromyography) and on dynamic balance (measured by time to stabilization test) were secondary aims.
RESULTS
Thirteen participants (mean age: 24.4 ± 3.8 years) with chronic ankle instability volunteered in this feasibility study. Success criteria showed a high adherence (98.7%) and low attrition (0%). No missing data were reported but four out of 26 data sets could not be used for statistical analysis because of non-readability of the recorded data. Preliminary treatment effect showed divergent results for surface electromyography and time to stabilization. One significant result (p = 0.03, ES = 1.48) in peroneus longus muscle activity after jump landing between 30 and 60 ms could be determined.
CONCLUSIONS
This study showed that the study protocol is feasible but should be modified by offering participants the opportunity to familiarize to the jumps and to the test repetitions. This study generates better understanding of manual therapy techniques for patients with chronic ankle instability.
Topics: Humans; Joint Instability; Cross-Over Studies; Postural Balance; Adult; Male; Female; Electromyography; Ankle Joint; Young Adult; Muscle, Skeletal; Musculoskeletal Manipulations; Feasibility Studies; Ankle Injuries
PubMed: 38876670
DOI: 10.1016/j.jbmt.2024.03.020 -
Journal of Bodywork and Movement... Jul 2024The upper quarter y-balance test (YBT-UQ) is a functional screening tool used to detect musculoskeletal injury risk, aid rehabilitation, and monitor dynamic function,... (Review)
Review
INTRODUCTION
The upper quarter y-balance test (YBT-UQ) is a functional screening tool used to detect musculoskeletal injury risk, aid rehabilitation, and monitor dynamic function, strength and control, yet little is currently known about intrinsic and extrinsic factors that influence reach scores.
OBJECTIVES
This systematic review aimed to determine if age, sex, or interventions influenced reach scores and whether between-limb differences were common in non-injured sporting populations, with a secondary aim to identify if sport impacted YBT-UQ reach.
METHODS
Web of Science, PubMed, and SportDiscus were systematically searched from January 2012 to November 16, 2023, revealing twenty-three studies satisfying inclusion criteria of published in English between 2012 and 2023, healthy participants of any age including both males and females, athletic populations, YBT-UQ use to assess upper limb mobility/stability, report normalised reach scores, and peer-reviewed full-texts. Methodological quality was evaluated via National Institutes of Health (NIH) quality assessment tools for controlled interventions, observational cohort and cross-sectional designs, and pre-post with no control group.
RESULTS
Age, sex, sport, and fatigue were influencing factors; greater reach scores were achieved in older athletes (i.e. >18 years), males, and in a well-rested state. Between-limb differences were not common in sporting populations; therefore, asymmetries may be useful for practitioners to aid injury risk identification.
CONCLUSION
This is the first systematic review investigating YBT-UQ influencing factors and thereby provides context for clinicians regarding characteristics that impact reach scores in sporting populations, from which normative values could be determined and further aid clinical decisions or areas to improve regarding injury risk.
Topics: Humans; Upper Extremity; Postural Balance; Male; Age Factors; Sex Factors; Female; Athletic Injuries; Adult; Athletes; Muscle Strength; Fatigue; Sports
PubMed: 38876624
DOI: 10.1016/j.jbmt.2024.02.043 -
Applied Ergonomics Jun 2024Many physically straining occupations involve lifting movements over the full-vertical range of motion, which over time may lead to the development of musculoskeletal...
Many physically straining occupations involve lifting movements over the full-vertical range of motion, which over time may lead to the development of musculoskeletal injuries. To address this, occupational exoskeletons can be designed to provide meaningful support to the back and shoulders during lifting movements. This paper introduces the main functional design features of the OmniSuit, a novel passive occupational exoskeleton. We present the technical and biomechanical considerations for the expected support level, as well as an evaluation of the physiological benefit and usability of the exoskeleton in a sample of 31 healthy volunteers performing physically demanding tasks in a laboratory setting. The OmniSuit exoskeleton significantly reduced Deltoid, Trapezius and Erector Spinae muscle activity between 4.1%MVC and 15.7%MVC when lifting a 2.5kg weight above shoulder level (p<0.001), corresponding to a reduction of up to 49.1% compared to without exoskeleton. A position-dependent reduction of Erector Spinae muscle activity was observed (p<0.001), with reductions ranging between 4.6%MVC and 14.0%MVC during leaning and squatting, corresponding to a reduction up to 41.5% compared to without exoskeleton. The measured muscular support and the predicted support torque based on the biomechanical model were found to show a similar profile for those phases of the movement which are most straining to the shoulder and back muscles. Participants reported experiencing good device usability and minimal discomfort (<1/10) in the shoulder and back during task execution with exoskeleton support. These first results validate that the considered biomechanical model helped design an ergonomic and efficient exoskeleton, and confirm the potential of such wearable assistive devices to provide support over multiple joints during physically demanding tasks.
PubMed: 38876001
DOI: 10.1016/j.apergo.2024.104332 -
JBJS Reviews Jun 2024» Tumors of the brachial plexus are uncommon and can present as a mass, with or without neurological symptoms. At times, asymptomatic tumors are also picked up... (Review)
Review
» Tumors of the brachial plexus are uncommon and can present as a mass, with or without neurological symptoms. At times, asymptomatic tumors are also picked up incidentally when imaging is performed for other reasons.» Magnetic resonance imaging is the main imaging modality used to evaluate tumors of the brachial plexus. Other imaging modalities can be used as required.» Benign tumors that are asymptomatic should be observed. Excision can be considered for those that are found to be growing over time.» Biopsies of tumors of the brachial plexus are associated with the risk of nerve injury. Despite this, they should be performed for tumors that are suspected to be malignant before starting definitive treatment.» For malignant tumors, treatment decisions should be discussed at multidisciplinary tumor boards, and include both the oncology and peripheral nerve surgical team, musculoskeletal radiology, neuroradiology, and general radiology.
Topics: Humans; Brachial Plexus; Peripheral Nervous System Neoplasms; Magnetic Resonance Imaging
PubMed: 38875357
DOI: 10.2106/JBJS.RVW.24.00019 -
Food Science & Nutrition Jun 2024The morbidity and mortality associated with type 2 diabetes mellitus (T2DM) have grown exponentially over the last 30 years. Together with its associated... (Review)
Review
The morbidity and mortality associated with type 2 diabetes mellitus (T2DM) have grown exponentially over the last 30 years. Together with its associated complications, the mortality rates have increased. One important complication in those living with T2DM is the acceleration of age-related cognitive decline. T2DM-induced cognitive impairment seriously affects memory, executive function, and quality of life. However, there is a lack of effective treatment for both diabetes and cognitive decline. Thus, finding novel treatments which are cheap, effective in both diabetes and cognitive impairment, are easily accessible, are needed to reduce impact on patients with diabetes and health-care systems. Carnosine, a histidine containing dipeptide, plays a protective role in cognitive diseases due to its antioxidant, anti-inflammation, and anti-glycation properties, all of which may slow the development of neurodegenerative diseases and ischemic injury. Furthermore, carnosine is also involved in regulating glucose and insulin in diabetes. Herein, we discuss the neuroprotective role of carnosine and its mechanisms in T2DM-induced cognitive impairment, which may provide a theoretical basis and evidence base to evaluate whether carnosine has therapeutic effects in alleviating cognitive dysfunction in T2DM patients.
PubMed: 38873448
DOI: 10.1002/fsn3.4077 -
Frontiers in Public Health 2024Armed conflict injury is a growing public health concern, particularly in regions like the Middle East and North Africa (MENA). The protracted conflicts and political...
BACKGROUND
Armed conflict injury is a growing public health concern, particularly in regions like the Middle East and North Africa (MENA). The protracted conflicts and political unrest in this region have led to a substantial number of injuries. Despite this, there is still limited understanding of the specific injury patterns stemming from conflicts, such as the 2006 Lebanon conflict. This study aimed to assess the characteristics and burdens of injuries resulting from this conflict, which occurred 16 years prior to this research.
METHODS
This retrospective study analyzed data of individuals affected by the 2006 Lebanon conflict, across three tertiary care centers. Demographics, injuries, complications, injury management, and hospitalization expenses were extracted from medical records and analyzed using SPSS version 29.0. Categorical variables were presented as counts and proportions, and continuous variables as mean ± standard deviation (SD). Hospital comparisons utilized chi-square or Fisher's exact tests for categorical variables, and one-way ANOVAs for continuous variables. Analysis was conducted from September to November 2023.
RESULTS
Across three hospitals, 341 patients were studied, comprising 73.6% males and 26.4% females. Among them, a notable proportion (57.3% males and 34.1% females) fell within the 18-39 age range. Children and adolescents under 18 years accounted for 15.9% of males and 25.9% of females. Blast-related injuries predominated, with 24.5% resulting from direct damage caused by explosive parts and 33.3% from blast wave forces. Extremity trauma occurred in 49.0% of patients, and head/neck trauma in 24.9%. Common injuries, including penetrating, musculoskeletal, and traumatic brain injuries affected 34.9%, 31.1, and 10.0% of patients, respectively. Wound repair, fracture treatment, and debridement were the most performed procedures on 15.5, 13.5 and 9.7% of the patients, respectively. The total cost of care was USD 692,711, largely covered by the Ministry of Public Health (95.9%).
CONCLUSION
Conflict-related injuries significantly contribute to the global burden of disease. Therefore, there is a pressing need to improve national guidelines to prioritize life-threatening cases and potential long-term disabilities. Furthermore, enhancing electronic registry systems to collect clinical data on injured patients is essential for conducting research and better understanding the needs of conflict casualties.
Topics: Humans; Lebanon; Male; Female; Retrospective Studies; Adult; Adolescent; Middle Aged; Survivors; Child; Wounds and Injuries; Young Adult; Child, Preschool; Aged; Infant; Tertiary Care Centers; Armed Conflicts
PubMed: 38864014
DOI: 10.3389/fpubh.2024.1382514 -
The Surgeon : Journal of the Royal... Jun 2024Surgeons are expected to work long hours in operating theatres. A high prevalence of work-related musculoskeletal (WRMSK) injuries and pain in healthcare professions... (Review)
Review
INTRODUCTION
Surgeons are expected to work long hours in operating theatres. A high prevalence of work-related musculoskeletal (WRMSK) injuries and pain in healthcare professions exists. We aimed to study WRMSK pain and injuries in general surgeons and study their risk in different surgical techniques comprising open, laparoscopic and robotic-assisted surgery.
METHODS
A systematic search was performed in compliance with The PRISMA checklist. Search was performed in PubMed and Cochrane library databases for 6 years to 2024. The search terms used were "disability and surgeon", "occupational injuries and surgeon", and "musculoskeletal pain and surgeons", in addition to MESH terms in PubMed database. Risk of bias was calculated among studies.
RESULTS
The search revealed 3648 citations from which a final list of 24 citations were included after application of inclusion and exclusion criteria. The citations comprised over 1900 surgeons including consultants and surgical trainees from different subspecialities. Incorporated citations consisted of 21 cross-sectional 3 observational studies. Most common pain sites, risks and preventative measure for MSK injuries were revealed.
CONCLUSION
There is high prevalence of WRMSK pain among general surgeons. Surgeons were primarily affected at physical body parts ranging from the neck, shoulders, upper back and lower back to upper extremity. Robotic-assisted surgery led to lower post-operative discomfort and decreased demanding muscle activity in upper extremities but enhanced static neck position resulting in subjective back stiffness compared with laparoscopic surgery.
PubMed: 38862375
DOI: 10.1016/j.surge.2024.05.001 -
BMJ Open Sport & Exercise Medicine 2024Prevention of sports injury and illness and protection of athlete health are key mandates of the IOC. Methodological limitations in Olympic Games surveillance and...
Prevention of sports injury and illness and protection of athlete health are key mandates of the IOC. Methodological limitations in Olympic Games surveillance and retired Olympian studies mean there are gaps in the available evidence on Olympian health and the varied challenges occurring at different stages throughout an athlete's career. This (protocol) paper describes the methods for implementation of the IOC Olympian Health Cohort. The study aims to establish a longitudinal cohort of current Olympians and follow them prospectively (around 15 years) throughout their Olympic careers and retirement. The study will use participants who have completed self-report questionnaires. Olympians will be recruited after each Summer and Winter Olympic Games, and all National Olympic Committee (NOC) athletes aged 16 years or older are eligible. The first phase included the Tokyo 2020/2021 and Beijing 2022 Olympians, with the study promoted via IOC platforms, Athlete365 and NOCs. Questionnaires include baseline demographics, sports exposure and history of injuries and illnesses impacting the athlete's ability to continue to train and/or compete for at least 2 weeks. Questions also address retirement from sports, musculoskeletal, mental and general health, and quality of life measures. This protocol describes the methods for the 15-year global IOC Olympian Health Cohort Study, from participant recruitment to the development and distribution of the study questionnaire. This protocol will be updated to report future changes in the study's conduct or questionnaire content. These data will help identify risk factors and inform risk-reduction strategies. The ultimate goal is to protect the health of all athletes during their careers and retirement.
PubMed: 38859820
DOI: 10.1136/bmjsem-2024-002061 -
Endocrinology and Metabolism (Seoul,... Jun 2024Aging leads to sarcopenia, which is characterized by reduced muscle mass and strength. Many factors, including altered muscle protein turnover, diminished neuromuscular...
BACKGRUOUND
Aging leads to sarcopenia, which is characterized by reduced muscle mass and strength. Many factors, including altered muscle protein turnover, diminished neuromuscular function, hormonal changes, systemic inflammation, and the structure and composition of muscle fibers, play a crucial role in age-related muscle decline. This study explored differences in muscle fiber types contributing to overall muscle function decline in aging, focusing on individuals with hip fractures from falls.
METHODS
A pilot study at Chungnam National University Hospital collected muscle biopsies from hip fracture patients aged 20 to 80 undergoing surgical treatment. Muscle biopsies from the vastus lateralis and gluteus maximus were obtained during hip arthroplasty or internal fixation. Handgrip strength, calf and thigh circumference, and bone mineral density were evaluated in individuals with hip fractures from falls. We analyzed the relationships between each clinical characteristic and muscle fiber type.
RESULTS
In total, 26 participants (mean age 67.9 years, 69.2% male) were included in this study. The prevalence of sarcopenia was 53.8%, and that of femoral and lumbar osteoporosis was 19.2% and 11.5%, respectively. Vastus lateralis analysis revealed an age-related decrease in type IIx fibers, a higher proportion of type IIa fibers in women, and an association between handgrip strength and type IIx fibers in men. The gluteus maximus showed no significant correlations with clinical parameters.
CONCLUSION
This study identified complex associations between age, sex, handgrip strength, and muscle fiber composition in hip fracture patients, offering insights crucial for targeted interventions combating age-related muscle decline and improving musculoskeletal health.
Topics: Humans; Male; Female; Aged; Hip Fractures; Sarcopenia; Quadriceps Muscle; Middle Aged; Pilot Projects; Aged, 80 and over; Hand Strength; Adult; Bone Density; Muscle Fibers, Skeletal; Young Adult; Aging; Muscle Fibers, Fast-Twitch
PubMed: 38858821
DOI: 10.3803/EnM.2024.1935