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Rhinology Jun 2024The extent to which gender affects outcomes in chronic rhinosinusitis (CRS) is unclear. The objective of this study was to examine differential outcomes between genders...
BACKGROUND
The extent to which gender affects outcomes in chronic rhinosinusitis (CRS) is unclear. The objective of this study was to examine differential outcomes between genders following endoscopic sinus surgery (ESS) among CRS patients.
METHODS
PubMed/Ovid, Embase and Cochrane databases were queried. Outcomes included disease burden on imaging and endoscopy, patient-reported outcome measures (PROMs) including the Sinonasal Outcome Test (SNOT-22), revision rates, and olfactory outcomes. Meta-analysis was performed using the Mantel-Haenszel method with random effects model.
RESULTS
Of 4,656 articles screened, 32 (n=103,499) were included for qualitative analysis and four (n=2,602) for meta-analysis. On qualitative analysis, 19 of the 32 studies noted a significant gender difference in post-operative outcomes, with five studies favoring women and 14 favoring men. Nine of 18 studies with PROMs noted a difference between genders, all favoring men. Olfactory outcomes were mixed with studies divided on favoring men vs women. No studies noted significant gender differences of disease burden on imaging or endoscopy. Across four studies included in the meta-analysis, women had higher preoperative and post-operative SNOT-22 scores.
CONCLUSION
Meta-analysis shows that women patients have worse pre and postoperative SNOT-22 scores. Postoperative gender differences are most apparent in studies that examined PROMs. Further research is needed to investigate the underlying causes and to mitigate disparities between genders.
PubMed: 38913328
DOI: 10.4193/Rhin24.009 -
Heliyon Jun 2024With high fatality and no cure, chronic wasting disease (CWD) has infected cervids in multiple regions, including the United States, Canada, Europe, and South Korea....
With high fatality and no cure, chronic wasting disease (CWD) has infected cervids in multiple regions, including the United States, Canada, Europe, and South Korea. Despite the rapid growth of literature on CWD, the full scope of its ecological, social, and economic impacts and the most effective and socially acceptable management strategies to mitigate the disease is unclear. Of 3008 initially identified published peer-reviewed papers, 134 were included in a final systematic literature review to synthesize the current knowledge on CWD transmission patterns, impacts, and the effectiveness of management interventions. The number of publications on CWD has increased steadily since 2000 with an average of six papers per year. Most papers were related to CWD prevalence (39 %), human behavior (33 %), CWD impacts (31 %), and management interventions (16 %). Environmental factors such as soil, water, and plants were identified as the most common transmission medium, with a higher prevalence rate among adult male cervids than females. Hunters showed a higher risk perception and were more likely to change hunting behavior due to CWD detection than non-hunters. Ecological impacts included the decreased survival rate accompanied by lower population growth, eventually leading to the decline of cervid populations. Culling was found to be an effective and widely implemented management strategy across countries, although it often was associated with public resistance. Despite potentially high negative economic impacts anticipated due to CWD, studies on this subject were limited. Sustained surveillance, ongoing research, and engagement of affected stakeholders will be essential for future disease control and management.
PubMed: 38912477
DOI: 10.1016/j.heliyon.2024.e31951 -
Cureus May 2024Ischemic strokes (IS) in young adults often evade early detection, resulting in delayed diagnosis until complications arise. Cervical/vertebral artery dissection, a... (Review)
Review
Exploring the Nexus: A Systematic Review on the Interplay of the Methylenetetrahydrofolate Reductase (MTHFR) Gene C677T Genotype, Hyperhomocysteinemia, and Spontaneous Cervical/Vertebral Artery Dissection in Young Adults.
Ischemic strokes (IS) in young adults often evade early detection, resulting in delayed diagnosis until complications arise. Cervical/vertebral artery dissection, a significant contributor to these strokes, presents with symptoms such as migraine with aura, severe headache, and neck pain, commonly overlooked due to their nonspecific nature. This review investigates early indicators of artery dissections, emphasizing their importance in diagnosis and exploring the correlation between methylenetetrahydrofolate reductase (MTHFR) gene C677T genotype polymorphism, hyperhomocysteinemia (HHCY), and IS in young adults. This systematic review encompasses a thorough analysis of 11 papers, including four observational studies, three case reports, three narrative reviews, and one experimental study, involving 4,840 patients aged 18-45 years. Findings reveal HHCY as a significant contributor to vascular damage and tissue ischemia leading to IS. The MTHFR gene C677T genotype polymorphism is closely associated with HHCY, often contributing to underdiagnosed strokes in young adults. Cervical/vertebral artery dissection may manifest as initial symptoms of neck pain or headache, remaining undiagnosed until imaging is conducted. Importantly, the review suggests that MTHFR gene polymorphism can be mitigated through simple supplementation with vitamin B12 and folates, serving as a valuable tool for primary prevention. Additionally, betaine, a methyl donor, was explored in severe MTHFR gene polymorphism cases resistant to conventional supplementation. In conclusion, recognizing the significance of early signs and symptoms, along with a high clinical suspicion, is crucial for preventing catastrophic outcomes, mortality, and morbidity associated with IS in young adults lacking traditional risk factors. The MTHFR gene C677T genotype polymorphism, a potential genetic cause, can be easily managed with simple measures but is often overlooked or underdiagnosed.
PubMed: 38910639
DOI: 10.7759/cureus.60878 -
Journal of Plastic, Reconstructive &... Jun 2024Protocols surrounding opioid reduction have become commonplace in plastic surgery to improve peri-operative outcomes. Within such protocols, opioid requirement is a... (Review)
Review
INTRODUCTION
Protocols surrounding opioid reduction have become commonplace in plastic surgery to improve peri-operative outcomes. Within such protocols, opioid requirement is a frequently analyzed outcome. Though often examined, there is no literature standard conversion for morphine milligram equivalents (MME) at present, leading to questionable external validity. We hypothesized significant heterogeneity in MME reporting would exist within plastic surgery literature.
METHODS
Following the PRISMA guidelines, the authors conducted a systematic review of 16 journals. Clinical studies focused on opioid reduction within plastic surgery were identified. Primary outcomes included reporting of morphine equivalents (ME) delivery (IV/oral), operative ME, inpatient ME, outpatient ME, timeline, and method of calculation.
RESULTS
Among the 101 studies analyzed, 73% reported opioid requirements in the form of ME. Among those that used ME, 3% reported IV ME, 41% reported oral, 32% reported both, and 25% gave no indication of either. Operative ME were reported in 19% of studies. Furthermore, 54% of studies reported inpatient ME whereas 32% of studies reported outpatient ME. Only 19% reported the number of days opioids were consumed postoperatively. Moreover, 27% of the studies reported the actual method of ME conversion, with 17 unique methods described. Only 8 studies (8%) reported using the Center for Disease Control and Prevention guidelines for ME conversion.
CONCLUSION
There is significant variability among the reported ME conversion methodology within plastic surgery literature. Highlighting these discrepancies is an essential step in creating and implementing a single, standard method to mitigate opioid morbidity in plastic surgery and to optimize enhanced recovery protocols.
PubMed: 38909598
DOI: 10.1016/j.bjps.2024.06.001 -
Journal of Stomatology, Oral and... Jun 2024The present systematic review was performed to identify risk factors associated with life-threatening complications of head and neck space infections (LCHNSI) within the...
OBJECTIVE
The present systematic review was performed to identify risk factors associated with life-threatening complications of head and neck space infections (LCHNSI) within the included studies and assess the magnitude of their impact on patients.
METHODS
We systematically searched PubMed, Web of Science, EmBase, Scopus and CNKI for articles that reported risk factors associated with life-threatening complications of head and neck space infections from inception to 14 December 2023. Only factors reported in at least three papers were considered in the meta-analysis. Pooled odds ratio (OR) and 95 % confidence interval (CI) were calculated using fixed effects model and random effects model. The between-study heterogeneity of effect size was quantified using the Q statistic and I. In addition, subgroup analysis stratified by study characteristics and sensitivity analysis were performed to explore the potential sources of heterogeneity and the stability of the results.
RESULTS
The review included a total of 29 studies. The results revealed that the risk factors which associated with LCHNSI were included diabetes mellitus (OR = 3.31, 95 % CI: 2.49-4.40), total leukocyte count(≥15 × 10/L) (OR = 1.21, 95 %CI: 1.04-1.42), multiple space involvement (OR = 4.32, 95 %CI: 3.47-5.38), combined systemic diseases (OR = 9.94, 95 %CI: 6.30-15.67), advanced age(≥60) (OR = 3.90, 95 %CI: 2.80-5.44), dyspnoea (OR = 23.39, 95 %CI: 12.41-44.10), high temperature(≥39°C) (OR = 3.23, 95 %CI: 2.02-5.17), retropharyngeal space involvement (OR = 3.62, 95 %CI: 2.06-6.35), parapharyngeal space involvement (OR = 4.62, 95 %CI: 2.27-9.42).
CONCLUSIONS
According to the current analysis, diabetes mellitus, total leukocyte count(≥15 × 10/L), combined systemic diseases, multiple space involvement, advanced age(≥60), dyspnoea, high temperature (≥39 °C), retropharyngeal space involvement, parapharyngeal space involvement were the risk factors for LCHNSI. To mitigate the incidence of LCHNSI, clinical staff should carefully manage these risk factors, ensure prompt diagnosis, and implement timely preventive measures.
PubMed: 38908479
DOI: 10.1016/j.jormas.2024.101954 -
Physica Medica : PM : An International... Jun 2024This study reviewed and meta-analyzed evidence on radiomics-based hybrid models for predicting radiation pneumonitis (RP). These models are crucial for improving...
PURPOSE
This study reviewed and meta-analyzed evidence on radiomics-based hybrid models for predicting radiation pneumonitis (RP). These models are crucial for improving thoracic radiotherapy plans and mitigating RP, a common complication of thoracic radiotherapy. We examined and compared the RP prediction models developed in these studies with the radiomics features employed in RP models.
METHODS
We systematically searched Google Scholar, Embase, PubMed, and MEDLINE for studies published up to April 19, 2024. Sixteen studies met the inclusion criteria. We compared the RP prediction models developed in these studies and the radiomics features employed.
RESULTS
Radiomics, as a single-factor evaluation, achieved an area under the receiver operating characteristic curve (AUROC) of 0.73, accuracy of 0.69, sensitivity of 0.64, and specificity of 0.74. Dosiomics achieved an AUROC of 0.70. Clinical and dosimetric factors showed lower performance, with AUROCs of 0.59 and 0.58. Combining clinical and radiomic factors yielded an AUROC of 0.78, while combining dosiomic and radiomics factors produced an AUROC of 0.81. Triple combinations, including clinical, dosimetric, and radiomics factors, achieved an AUROC of 0.81. The study identifies key radiomics features, such as the Gray Level Co-occurrence Matrix (GLCM) and Gray Level Size Zone Matrix (GLSZM), which enhance the predictive accuracy of RP models.
CONCLUSIONS
Radiomics-based hybrid models are highly effective in predicting RP. These models, combining traditional predictive factors with radiomic features, particularly GLCM and GLSZM, offer a clinically feasible approach for identifying patients at higher RP risk. This approach enhances clinical outcomes and improves patient quality of life.
PROTOCOL REGISTRATION
The protocol of this study was registered on PROSPERO (CRD42023426565).
PubMed: 38906047
DOI: 10.1016/j.ejmp.2024.103414 -
PLOS Global Public Health 2024Compassion fatigue is a significant concern globally, particularly in Sub-Saharan Africa, where the COVID-19 pandemic exacerbated existing challenges, placing...
Compassion fatigue is a significant concern globally, particularly in Sub-Saharan Africa, where the COVID-19 pandemic exacerbated existing challenges, placing unprecedented strain on healthcare professionals. This study systematically estimated the prevalence of compassion fatigue among healthcare professionals before and during COVID-19 in Sub-Saharan Africa. A systematic review was conducted using keywords in PubMed, ScienceDirect, Google Scholar, and grey literature, covering all literature published between 2012 and December 30, 2023. The search team independently conducted study selection, quality assessments, data extractions, and analysis of all included studies. The systematic review, reported following PRISMA guidelines, included 11 studies. The results show that the pooled overall prevalence of compassion fatigue in Sub-Saharan Africa was 70% (95% CI: 57-82, I2 = 88.37%). The highest prevalence was found in Eastern Africa at 74% (95% CI: 55-93, I2 = 94.40%), compared to 64% in Southern Africa (95% CI: 49-79, I2 = 59.01%). Nurses reported the highest rates of compassion fatigue at 80% (95% CI: 57-100, I2 = 34.77%), followed by general healthcare professionals at 59% (95% CI: 22-97, I2 = 94.11%) and nursing students at 50% (95% CI: 35-64, I2 = 0.00%). Before COVID-19, the overall prevalence of compassion fatigue was 66% (95% CI: 41-91, I2 = 27%). During COVID-19, this increased to 74% (95% CI: 63-85, I2 = 88.73%). Our results indicate that nearly 3 in 4 healthcare professionals in Sub-Saharan Africa experience compassion fatigue, and this prevalence increased due to the pandemic. The high prevalence underscores the importance of addressing and mitigating compassion fatigue to support the mental health and emotional well-being of healthcare professionals dedicated to helping others in challenging circumstances. Systematic registration: PROSPERO. REG No: CRD42023449462.
PubMed: 38905176
DOI: 10.1371/journal.pgph.0003388 -
Frontiers in Nutrition 2024Physical exertion during exercise often leads to increased oxidative stress and inflammatory responses, significantly affecting physical performance. Current strategies...
BACKGROUND
Physical exertion during exercise often leads to increased oxidative stress and inflammatory responses, significantly affecting physical performance. Current strategies to mitigate these effects are limited by their effectiveness and potential side effects. Molecular hydrogen (H₂) has gained attention for its antioxidant and anti-inflammatory properties. Studies have suggested that H supplementation contributes to antioxidant potential and anti-fatigue during exercise, but the variance in the observations and study protocols is presented across those studies.
OBJECTIVE
This systematic review and meta-analysis aimed to comprehensively characterize the effects of H₂ supplementation on physical performance (i.e., endurance, muscular strength, and explosive power), providing knowledge that can inform strategies using H for enhancing physical performance.
METHODS
We conducted a literature search of six databases (PubMed, Web of Science, Medline, Sport-Discus, Embase, and PsycINFO) according to the PRISMA guidelines. The data were extracted from the included studies and converted into the standardized mean difference (SMD). After that, we performed random-effects meta-analyses and used the statistic to evaluate heterogeneity. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) was used to assess the quality of the evidence obtained from this meta-analysis.
RESULTS
In total, 27 publications consisting of 597 participants were included. The search finally included aerobic endurance, anaerobic endurance, muscular strength, lower limb explosive power, rating of perceived exertion (RPE), blood lactate (BLA), and average heart rate (HR) in the effect size (ES) synthesis. The ES of H on aerobic endurance, including V̇O (SMD = 0.09, = 0.394; = 0%) and aerobic endurance exercise (SMD = 0.04, = 0.687; = 0%), were not significant and trivial; the ES of H on 30 s maximal anaerobic endurance (SMD = 0.19, = 0.239; = 0%) was not significant and trivial; the ES of H on muscular strength (SMD = 0.19, = 0.265; = 0%) was not significant and trivial; but the ES of H on lower limb explosive power (SMD = 0.30, = 0.018; = 0%) was significant and small. In addition, H reduces RPE (SMD = -0.37, = 0.009; = 58.0%) and BLA (SMD = -0.37, = 0.001; = 22.0%) during exercise, but not HR (SMD = -0.27, = 0.094; = 0%).
CONCLUSION
These findings suggest that H supplementation is favorable in healthy adults to improve lower limb explosive power, alleviate fatigue, and boost BLA clearance, but may not be effectively improving aerobic and anaerobic endurance and muscular strength. Future studies with more rigorous designs are thus needed to examine and confirm the effects of H on these important functionalities in humans.
SYSTEMATIC REVIEW REGISTRATION
http://www.crd.york.ac.uk/PROSPERO.
PubMed: 38903627
DOI: 10.3389/fnut.2024.1387657 -
Systematic Reviews Jun 2024Depression is a globally prevalent mental condition, particularly among older adults. Previous research has identified that social networks have a buffering effect on...
BACKGROUND AND OBJECTIVE
Depression is a globally prevalent mental condition, particularly among older adults. Previous research has identified that social networks have a buffering effect on depression. Existing systematic reviews have either limited their research to specific geographic areas or provided evidence from over a decade ago. The vast body of recent literature particularly from the last decade emphasizes the need for a comprehensive review. This systematic review aims to analyze the association of structural aspects of social networks and depression in older adults.
METHODS
The electronic databases APA PsycINFO, ProQuest, PSYINDEX, PubMed, Scopus, SocINDEX, and Web of Science were searched from date of data base inception until 11 July 2023. Studies were eligible for inclusion if they reported on community-dwelling older adults (defined as a mean age of at least 60 years old), had an acceptable definition for depression, referred to the term social network in the abstract, and were published in English. Quality was appraised using the Newcastle Ottawa Scale for cross-sectional and longitudinal studies. Outcome data were extracted independently from each study and analyzed by direction of the relationship, social network domain and cross-sectional or longitudinal study design.
RESULTS
In total, 127 studies were included. The study categorizes structural network aspects into seven domains and finds that larger and more diverse networks, along with closer social ties, help mitigate depression. The literature on the relationships between depression and network density, homogeneity, and geographical proximity is scarce and inconclusive. DISCUSSION AND IMPLICATIONS: Despite inconsistent findings, this review highlights the importance of quantifying complex social relations of older adults. Limitations of this review include publication and language bias as well as the exclusion of qualitative research. Further research should use longitudinal approaches to further investigate the reciprocal relationship between social networks and depression. Following this review, interventions should promote the integration of older adults in larger and more diverse social settings. Other: This work was supported by the Deutsche Forschungsgemeinschaft (DFG, German Research Foundation) under Grant [454899704]. This systematic review was pre-registered. The review-protocol can be accessed at https://doi.org/10.17605/OSF.IO/6QDPK .
Topics: Humans; Independent Living; Aged; Depression; Social Networking; Social Support
PubMed: 38902787
DOI: 10.1186/s13643-024-02581-6 -
Nurse Educator Jun 2024Evidence demonstrates professional nurses' vital need for self-care, underscoring the necessity to support the integration of self-care behaviors in nursing education.
BACKGROUND
Evidence demonstrates professional nurses' vital need for self-care, underscoring the necessity to support the integration of self-care behaviors in nursing education.
PURPOSE
The aim was to synthesize the impact of self-care strategies in nursing curricula to evaluate students' experiential, evidence-based outcomes.
METHODS
A systematic review was conducted to examine interventional self-care studies in undergraduate and graduate nursing curricula published in the English language from 2018 to 2023. Searches were conducted between June 1, 2023, and July 12, 2023, in MEDLINE, PsycINFO, CINAHL, ProQuest, and PubMed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, yielding 20 peer-reviewed articles. Studies were evaluated for quality utilizing Medical Education Research Study Quality Instrument scoring; each author examined results independently to ensure rigor and mitigate bias.
RESULTS
Notable increases were observed regarding students' recognition of self-care needs across a variety of curricular methodologies and self-care strategies.
CONCLUSIONS
Evidence is mounting to substantiate curricular integration of self-care strategies in nursing education; further research of a robust nature is needed to refine curricular approaches.
PubMed: 38900993
DOI: 10.1097/NNE.0000000000001690