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Archives of Gerontology and Geriatrics Nov 2023The purpose of this study was to systematically assess existing studies to demonstrate the association between potentially inappropriate medication (PIM) and frailty. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
The purpose of this study was to systematically assess existing studies to demonstrate the association between potentially inappropriate medication (PIM) and frailty.
DESIGN
Systematic review and meta-analysis.
METHODS
We searched major electronic databases (PubMed, Web of Science, the Cochrane Library, Embase, CINHAL, PsycInfo, China National Knowledge Infrastructure, China Biology Medicine disk, Weipu, and Wanfang) from their inception until February 25, 2023 (data updated on May 4, 2023), for observational studies investigating PIM and frailty. I was used to measure the heterogeneity between studies quantitatively. A random effect model calculated pooled effect size owing to high heterogeneity. Subgroup analysis was conducted to explore sources of heterogeneity. Additionally, the studies' quality was evaluated using the Newcastle Ottawa Scale (a modified Newcastle Ottawa Scale was used to evaluate cross-sectional studies).
RESULTS
Twenty-four studies were included for systematic review, 14 of which were included in the meta-analysis. After pooling the effect size, the odds ratio with PIM as the dependent variable was 1.12 (95%CI: 1.01-1.25), and that with frailty as the dependent variable was 1.75 (95%CI: 1.25-2.43), indicating a bidirectional association between PIM and frailty.
CONCLUSIONS
PIM and frailty interact with each other and have a bidirectional association, thus providing additional information for early clinical identification and prevention of frailty, and medication safety management.
Topics: Humans; Aged; Frailty; Potentially Inappropriate Medication List; Cross-Sectional Studies; China
PubMed: 37311369
DOI: 10.1016/j.archger.2023.105087 -
Acta Ophthalmologica Feb 2024Optic disc drusen (ODD) are calcium-containing deposits in the optic nerve head, capable of causing visual field defects and sudden visual loss. The underlying... (Meta-Analysis)
Meta-Analysis Review
Optic disc drusen (ODD) are calcium-containing deposits in the optic nerve head, capable of causing visual field defects and sudden visual loss. The underlying pathophysiology remains inadequately understood and treatment options are missing. In this paper, we systematically reviewed prevalence studies of ODD in non-selected populations to provide an overview of its prevalence, conducted meta-analyses to determine modality-specific prevalence estimates and performed a forecasting study to estimate current and future global population number of individuals with ODD. We searched 11 literature databases on 25 October 2022 for prevalence studies of ODD in non-selected populations. Eight eligible studies provided data from a total of 27 463 individuals. Prevalence estimates were stratified according to diagnostic modalities: ophthalmoscopy 0.37% (95% CI: 0.10-0.95%), fundus photography 0.12% (95% CI: 0.03-0.24%), spectral domain optical coherence tomography with enhanced depth imaging 2.21% (95% CI: 1.25-3.42%) and histopathology 1.82% (95% CI: 1.32-2.38%). Using histopathology-based summary prevalence estimate, we forecast 145 million individuals with ODD currently, a number expected to increase further due to world population growth. These numbers underscore the importance of including ODD in health education and highlight the necessity of continuing research in ODD.
Topics: Humans; Optic Disk; Optic Disk Drusen; Prevalence; Tomography, Optical Coherence
PubMed: 37144704
DOI: 10.1111/aos.15690 -
Clinical Spine Surgery Mar 2024Systematic review and meta-analysis. (Meta-Analysis)
Meta-Analysis
STUDY DESIGN
Systematic review and meta-analysis.
OBJECTIVE
To compare the results of endoscopic transforaminal lumbar interbody fusion (Endo-TLIF) and minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) for patients with lumbar degenerative diseases.
SUMMARY OF BACKGROUND DATA
The MIS-TLIF has been widely used in lumbar degenerative diseases and achieved favorable clinical effects. The main disadvantage is the limited working space and visualization, especially in the deeper operational field, for preparing fusion bed. In recent years, with the development of surgical techniques, optical technology, and special instruments, Endo-TLIF has gradually been applied.
MATERIALS AND METHODS
A systematic review and meta-analysis of cohort studies between Endo-TLIF and MIS-TLIF in the lumbar degenerative diseases. The following outcome measures were extracted: visual analog scale (VAS), Oswestry Disability Index, fusion rate, disk height, segmental lordosis, operative time, length of hospital stay and complications. Data analysis was performed by RevMan 5.3.
RESULTS
Eight studies comprising 687 patients were included in this meta-analysis. The pooled result revealed there was no significant differences in the VAS of leg, Oswestry Disability Index, fusion rate, disk height, segmental lordosis, and complication rate between the 2 groups ( P >0.05). However, the VAS of back in the Endo-TLIF group was significantly less than those in the MIS-TLIF group within 2 weeks after surgery [weighted mean difference (WMD)=-1.33 (-1.98, -0.68), P <0.0001] and at 3 months postoperatively [WMD=-0.72(-0.85, -0.59), P <0.00001]. The Endo-TLIF group also seemed to fewer VAS of back at the last follow-up (≥12 mo) [WMD=-0.12 (-0.25, -0.00), P =0.05]. Compared with the MIS-TLIF group, the Endo-TLIF group was associated with longer operation time [WMD=26.74 (2.14, 51.34), P =0.03], but shorter length of hospital stay [WMD=-1.98(-2.91, -1.05), P <0.0001].
CONCLUSIONS
Compared with minimally invasive TLIF, endoscopic TLIF achieved comparable improvement of symptoms and intervertebral fusion, longer operation time, and smaller surgical trauma. Endoscopic TLIF, which requires a demanding learning curve, maybe a feasible and effective technique for the patients with symptomatic lumbar degenerative diseases.
Topics: Humans; Lumbar Vertebrae; Minimally Invasive Surgical Procedures; Lordosis; Treatment Outcome; Spinal Fusion; Retrospective Studies
PubMed: 36727763
DOI: 10.1097/BSD.0000000000001428 -
British Journal of Neurosurgery Oct 2023Report of three patients undergoing lumbar epidural schwannoma tumourectomy. Percutaneous endoscopy has been routinely used in the treatment of disk herniation but has...
STUDY DESIGN
Report of three patients undergoing lumbar epidural schwannoma tumourectomy. Percutaneous endoscopy has been routinely used in the treatment of disk herniation but has not been reported in the management of intraspinal tumours.
METHODS
Three patients diagnosed with schwannoma by imaging and pathological examination underwent percutaneous full endoscopic tumourectomy. A 5-mm incision was made, the puncture needle passed through the skin, subcutaneous tissue and the deep fascia and vertebral muscles to the intervertebral foramen area. Next, a working cannula was inserted into the lesion area. Foraminotomy was completed by trephine and microscopic power drill if the foramen was stenosed. Tumour tissue was totally removed piecemeal. After probing the nerve foramen and the nerve root satisfactorily, the working cannula was removed and the incision sutured.
RESULTS
Three patients were operated successfully. Symptoms recovered in all cases and no complication or recurrence was found on follow-up.
CONCLUSIONS
This case report presents a new technique for non-infiltrating extradural lumbar tumour treatment, demonstrating feasibility and safety of percutaneous full endoscopic lumbar tumourectomy.
Topics: Humans; Treatment Outcome; Diskectomy, Percutaneous; Lumbar Vertebrae; Spinal Puncture; Endoscopy; Intervertebral Disc Displacement; Neurilemmoma; Retrospective Studies
PubMed: 33739902
DOI: 10.1080/02688697.2020.1821173