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Facts, Views & Vision in ObGyn Jun 2024Oxidised regenerated cellulose was introduced 60 years ago to control diffuse bleeding from large surfaces. Although considered safe and effective, foreign body...
Oxidised regenerated cellulose was introduced 60 years ago to control diffuse bleeding from large surfaces. Although considered safe and effective, foreign body reactions can mimic suspicious masses in several organs. We describe the third case, reported in PubMed, of an oxidised regenerated cellulose-based granuloma mimicking a suspicious ovarian tumour on MRI. During surgery, the diagnosis was suspected by granulomatous tissue and confirmed by pathology. The follow-up after the excision was uneventful. Although a rare complication, physicians should be aware of this presentation and of the recommendation to remove excess Surgicel after the bleeding has stopped.
PubMed: 38950539
DOI: 10.52054/FVVO.16.2.015 -
Journal of Cardiovascular Medicine... Aug 2024To systematically evaluate the effectiveness of mobile health (mHealth) interventions on medication adherence in patients with heart failure. (Meta-Analysis)
Meta-Analysis
AIMS
To systematically evaluate the effectiveness of mobile health (mHealth) interventions on medication adherence in patients with heart failure.
METHODS
The literature search was conducted in PubMed, Web of Science, the Cochrane Library databases, Embase, China National Knowledge Infrastructure (CNKI), Wanfang Database and China Scientific Journal Database (VIP). The retrieval period was from the establishment of the database to May 2023. The included studies were trials to explore the effectiveness of mHealth interventions on medication adherence in patients with heart failure. Cochrane collaboration's tool was used for assessing risk of bias in randomized controlled trials. Stata 17.0 software was used to conduct data analysis. Continuous data were expressed as standard mean differences, and dichotomous data were expressed as relative risks with 95% confidence intervals (CIs).
RESULTS
A total of 13 studies and 2534 participants were included. One study was rated as Grade A, and the other 12 studies were Grade B. The results of meta-analysis indicate that mHealth interventions are effective in improving medication adherence [relative risk (RR) = 1.26, 95% CI 1.10-1.44, P < 0.05 and standard mean difference = 0.80, 95% CI 0.44-1.15, P < 0.05], and reducing readmission rates (RR = 0.63, 95% CI 0.53-0.76, P < 0.05) and mortality (RR = 0.63, 95% CI 0.43-0.94, P < 0.05) of patients with heart failure.
CONCLUSION
mHealth interventions are beneficial to improve medication adherence in patients with heart failure, and could effectively reduce the readmission rates and mortality of patients in the studies. There is a need to continuously improve the professional abilities of intervention personnel, carry out teamwork, and extend intervention and follow-up time. Convenient, fast and low-cost mobile medical devices should be adopted to reduce the cost of medical treatment. Scientific and reasonable intervention content will be formulated according to evidence-based guidelines and theoretical basis to enhance patients' ability at self-management and understanding of heart failure knowledge.
Topics: Humans; Heart Failure; Telemedicine; Medication Adherence; Female; Male; Middle Aged; Aged; Treatment Outcome; Randomized Controlled Trials as Topic
PubMed: 38949146
DOI: 10.2459/JCM.0000000000001631 -
Frontiers in Neuroscience 2024Previous neuroimaging studies have revealed structural and functional brain abnormalities in patients with cervical spondylosis (CS). However, the results are divergent...
BACKGROUND
Previous neuroimaging studies have revealed structural and functional brain abnormalities in patients with cervical spondylosis (CS). However, the results are divergent and inconsistent. Therefore, the present study conducted a multi-modal meta-analysis to investigate the consistent structural and functional brain alterations in CS patients.
METHODS
A comprehensive literature search was conducted in five databases to retrieve relevant resting-state functional magnetic resonance imaging (rs-fMRI), structural MRI and diffusion tensor imaging (DTI) studies that measured brain functional and structural differences between CS patients and healthy controls (HCs). Separate and multimodal meta-analyses were implemented, respectively, by employing Anisotropic Effect-size Signed Differential Mapping software.
RESULTS
13 rs-fMRI studies that used regional homogeneity, amplitude of low-frequency fluctuations (ALFF) and fractional ALFF, seven voxel-based morphometry (VBM) studies and one DTI study were finally included in the present research. However, no studies on surface-based morphometry (SBM) analysis were included in this research. Due to the insufficient number of SBM and DTI studies, only rs-fMRI and VBM meta-analyses were conducted. The results of rs-fMRI meta-analysis showed that compared to HCs, CS patients demonstrated decreased regional spontaneous brain activities in the right lingual gyrus, right middle temporal gyrus (MTG), left inferior parietal gyrus and right postcentral gyrus (PoCG), while increased activities in the right medial superior frontal gyrus, bilateral middle frontal gyrus and right precuneus. VBM meta-analysis detected increased GMV in the right superior temporal gyrus (STG) and right paracentral lobule (PCL), while decreased GMV in the left supplementary motor area and left MTG in CS patients. The multi-modal meta-analysis revealed increased GMV together with decreased regional spontaneous brain activity in the left PoCG, right STG and PCL among CS patients.
CONCLUSION
This meta-analysis revealed that compared to HCs, CS patients had significant alterations in GMV and regional spontaneous brain activity. The altered brain regions mainly included the primary visual cortex, the default mode network and the sensorimotor area, which may be associated with CS patients' symptoms of sensory deficits, blurred vision, cognitive impairment and motor dysfunction. The findings may contribute to understanding the underlying pathophysiology of brain dysfunction and provide references for early diagnosis and treatment of CS.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/PROSPERO/, CRD42022370967.
PubMed: 38948928
DOI: 10.3389/fnins.2024.1415411 -
Frontiers in Neuroscience 2024Brain medical image segmentation is a critical task in medical image processing, playing a significant role in the prediction and diagnosis of diseases such as stroke,...
INTRODUCTION
Brain medical image segmentation is a critical task in medical image processing, playing a significant role in the prediction and diagnosis of diseases such as stroke, Alzheimer's disease, and brain tumors. However, substantial distribution discrepancies among datasets from different sources arise due to the large inter-site discrepancy among different scanners, imaging protocols, and populations. This leads to cross-domain problems in practical applications. In recent years, numerous studies have been conducted to address the cross-domain problem in brain image segmentation.
METHODS
This review adheres to the standards of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) for data processing and analysis. We retrieved relevant papers from PubMed, Web of Science, and IEEE databases from January 2018 to December 2023, extracting information about the medical domain, imaging modalities, methods for addressing cross-domain issues, experimental designs, and datasets from the selected papers. Moreover, we compared the performance of methods in stroke lesion segmentation, white matter segmentation and brain tumor segmentation.
RESULTS
A total of 71 studies were included and analyzed in this review. The methods for tackling the cross-domain problem include Transfer Learning, Normalization, Unsupervised Learning, Transformer models, and Convolutional Neural Networks (CNNs). On the ATLAS dataset, domain-adaptive methods showed an overall improvement of ~3 percent in stroke lesion segmentation tasks compared to non-adaptive methods. However, given the diversity of datasets and experimental methodologies in current studies based on the methods for white matter segmentation tasks in MICCAI 2017 and those for brain tumor segmentation tasks in BraTS, it is challenging to intuitively compare the strengths and weaknesses of these methods.
CONCLUSION
Although various techniques have been applied to address the cross-domain problem in brain image segmentation, there is currently a lack of unified dataset collections and experimental standards. For instance, many studies are still based on n-fold cross-validation, while methods directly based on cross-validation across sites or datasets are relatively scarce. Furthermore, due to the diverse types of medical images in the field of brain segmentation, it is not straightforward to make simple and intuitive comparisons of performance. These challenges need to be addressed in future research.
PubMed: 38948927
DOI: 10.3389/fnins.2024.1401329 -
PeerJ 2024Electroencephalography (EEG) is a technique for measuring brain activity that is widely used in neuroscience research. Event-related potentials (ERPs) in the EEG make it...
INTRO
Electroencephalography (EEG) is a technique for measuring brain activity that is widely used in neuroscience research. Event-related potentials (ERPs) in the EEG make it possible to study sensory and cognitive processes in the brain. Previous reports have shown that aerobic exercise can have an impact on components of ERPs such as amplitude and latency. However, they focused on the measurement of ERPs after exercise.
OBJECTIVES
The aim of this systematic review was to investigate the feasibility of measuring ERPs during cycling, and to assess the impact of cycling on ERPs during cycling.
METHODS
We followed the PRISMA guidelines for new systematic reviews. To be eligible, studies had to include healthy adults and measure ERPs during cycling. All articles were found using Google Scholar and by searching references. Data extracted from the studies included: objectives of ERP studies, ERP paradigm, EEG system, study population data, exercise characteristics (duration, intensity, pedaling cadence), and ERP and behavioral outcomes. The Cochrane Risk of Bias 2 tool was used to assess study bias.
RESULTS
Twenty studies were selected. The effect of cycling on ERPs was mainly based on a comparison of P3 wave amplitude between cycling and resting states, using an attentional task. The ERP paradigm most often used was the auditory oddball task. Exercise characteristics and study methods varied considerably.
DISCUSSION
It is possible to measure ERPs during cycling under conditions that are likely to introduce more artifacts, including a 3-h athletic exercise session and cycling outdoors. Secondly, no assessment of the effect of cycling on ERPs was possible, because the methods differed too widely between studies. In addition, the theories proposed to explain the results sometimes seemed to contradict each other. Although most studies reported significant results, the direction of the effects was inconsistent. Finally, we suggest some areas for improvement for future studies on the subject.
Topics: Humans; Electroencephalography; Bicycling; Evoked Potentials; Exercise; Brain
PubMed: 38948229
DOI: 10.7717/peerj.17448 -
PeerJ 2024The methods previously proposed in the literature to assess patients with rotator cuff related shoulder pain, based on special orthopedic tests to precisely identify the... (Meta-Analysis)
Meta-Analysis
BACKGROUND
The methods previously proposed in the literature to assess patients with rotator cuff related shoulder pain, based on special orthopedic tests to precisely identify the structure causing the shoulder symptoms have been recently challenged. This opens the possibility of a different way of physical examination.
OBJECTIVE
To analyze the differences in shoulder range of motion, strength and thoracic kyphosis between rotator cuff related shoulder pain patients and an asymptomatic group.
METHOD
The protocol of the present research was registered in the International Prospective Register of Systematic Review (PROSPERO) (registration number CRD42021258924). Database search of observational studies was conducted in MEDLINE, EMBASE, WOS and CINHAL until July 2023, which assessed shoulder or neck neuro-musculoskeletal non-invasive physical examination compared to an asymptomatic group. Two investigators assessed eligibility and study quality. The Newcastle Ottawa Scale was used to evaluate the methodology quality.
RESULTS
Eight studies ( = 604) were selected for the quantitative analysis. Meta-analysis showed statistical differences with large effect for shoulder flexion (I2 = 91.7%, < 0.01, HG = -1.30), external rotation (I2 = 83.2%, < 0.01, HG = -1.16) and internal rotation range of motion (I2 = 0%, < 0.01, HG = -1.32). Regarding to shoulder strength; only internal rotation strength showed statistical differences with small effect (I2 = 42.8%, < 0.05, HG = -0.3).
CONCLUSIONS
There is moderate to strong evidence that patients with rotator cuff related shoulder pain present less shoulder flexion, internal and external rotation range of motion and less internal rotation strength than asymptomatic individuals.
Topics: Humans; Range of Motion, Articular; Shoulder Pain; Rotator Cuff; Muscle Strength; Rotator Cuff Injuries; Shoulder Joint; Kyphosis
PubMed: 38948223
DOI: 10.7717/peerj.17604 -
PeerJ 2024Eagle syndrome is caused by an elongated styloid process affecting carotid arteries and cranial nerves. Pain, dysphagia, tinnitus, paresthesia (classic subtype), and... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Eagle syndrome is caused by an elongated styloid process affecting carotid arteries and cranial nerves. Pain, dysphagia, tinnitus, paresthesia (classic subtype), and neurovascular events (vascular subtype) may be triggered by head movements or arise spontaneously. However, Eagle syndrome remains underappreciated in the neurological community. We aimed to determine the most common neurological and non-neurological clinical presentations in patients with Eagle syndrome and to assess the clinical outcome post-surgical resection in comparison to non-surgical therapies.
METHODOLOGY
We conducted a systematic review of patient-level data on adults with Eagle syndrome, following PRISMA guidelines. We extracted data on demographics, presenting symptoms, neurological deficits, radiological findings, and treatments, including outcomes and complications, from studies in multiple indexing databases published between 2000 and 2023. The study protocol is registered with PROSPERO.
RESULTS
In total, 285 studies met inclusion criteria, including 497 patients with Eagle syndrome (mean age 47.3 years; 49.8% female). Classical Eagle (370 patients, 74.5%) was more frequent than vascular Eagle syndrome (117 patients, 23.5%, < 0.0001). Six patients (1.2%) presented with both variants and the subvariant for four patients (0.8%) was unknown. There was a male preponderance (70.1% male) in the vascular subtype. A history of tonsillectomy was more frequent in classic (48/153 cases) than in vascular (2/33 cases) Eagle syndrome (Odds Ratio 5.2, 95% CI [1.2-22.4]; = 0.028). By contrast, cervical movements as trigger factors were more prevalent in vascular (12/33 cases) than in classic (7/153 cases) Eagle syndrome (Odds Ratio 7.95, 95% CI [2.9-21.7]; = 0.0001). Headache and Horner syndrome were more frequent in vascular Eagle syndrome and dysphagia and neck pain more prominent in classic Eagle syndrome (all < 0.01). Surgically treated patients achieved overall better outcomes than medically treated ones: Eighty-one (65.9%) of 123 medically treated patients experienced improvement or complete resolution, while the same applied to 313 (97.8%) of 320 surgical patients (Odds Ratio 1.49, 95% CI [1.1-2.0]; = 0.016).
CONCLUSIONS
Eagle syndrome is underdiagnosed with potentially serious neurovascular complications, including ischemic stroke. Surgical treatment achieves better outcomes than conservative management. Although traditionally the domain of otorhinolaryngologist, neurologist should include this syndrome in differential diagnostic considerations because of the varied neurological presentations that are amenable to effective treatment.
Topics: Female; Humans; Male; Middle Aged; Ossification, Heterotopic; Phenotype; Temporal Bone; Treatment Outcome
PubMed: 38948209
DOI: 10.7717/peerj.17423 -
Brain & Spine 2024Cystic schwannomas have only been reported in a few case reports/series. As a result, they may be misdiagnosed and a standardized management approach remains challenging... (Review)
Review
INTRODUCTION
Cystic schwannomas have only been reported in a few case reports/series. As a result, they may be misdiagnosed and a standardized management approach remains challenging to establish.
RESEARCH QUESTION
The aim of this study was to compile all reported cases of cystic schwannomas and analyze the perioperative course based on a systematic review of the literature with an additional two cases from the authors' experience.
MATERIAL AND METHODS
We conducted a search of MEDLINE and CENTRAL databases for spinal intradural extramedullary cystic schwannomas, in accordance to the PRISMA statement. All title/abstracts were screened, and a full-text review of the remaining articles was conducted. The results were compiled in tables and summarized using means and standard deviation (SD), median and interquartile range, and percentage and 95% confidence intervals.
RESULTS
We identified 263 articles, of which 35, which reported 54 cases, were included. Including our case-reports (n = 56), patients had a mean age of 47.7 years (SD ± 13.0 years) at presentation, 57% were males, and most lesions were lumbar (43%). The most common symptoms were pain (82%) and muscle weakness (68%) with 84% of patients showing neurological findings. 70% of patients showed a complete relief of symptoms after surgery and 96% reported improvement. Only four complications were reported.
DISCUSSION AND CONCLUSION
Schwannomas should be considered in the differential diagnosis of intradural extramedullary cystic lesions. Patients typically present with subacute to chronic pain and/or neurologic changes. Surgical resection is the primary therapeutic modality and usually has a good to excellent outcome.
PubMed: 38947985
DOI: 10.1016/j.bas.2024.102843 -
Frontiers in Immunology 2024The identification of novel, yet easily measurable biomarkers of inflammation and oxidative stress might assist in the diagnosis and management of patients with... (Meta-Analysis)
Meta-Analysis
UNLABELLED
The identification of novel, yet easily measurable biomarkers of inflammation and oxidative stress might assist in the diagnosis and management of patients with rheumatic diseases (RDs). We conducted a systematic review and meta-analysis of studies investigating the circulating concentrations of bilirubin, the end product of heme metabolism and a potent endogenous antioxidant with anti-inflammatory properties, in patients with RDs and healthy controls. The electronic databases PubMed, Scopus, and Web of Science were searched from inception to 31 December 2023 for relevant articles. We evaluated the risk of bias and the certainty of evidence using the Joanna Briggs Checklist and the Grades of Recommendation, Assessment, Development, and Evaluation Working Group system, respectively. In 17 eligible studies, all with low risk of bias, compared to controls, patients with RDs had significantly lower concentrations of total bilirubin (standard mean difference, SMD=-0.68, 95% CI -0.91 to -0.44, p<0.001; I = 92.5%, p<0.001; low certainty of evidence), direct (conjugated) bilirubin (SMD=-0.67, 95% CI -0.92 to -0.41, p<0.001; I = 81.7%, p<0.001; very low certainty of evidence), and the active antioxidant and anti-inflammatory indirect (unconjugated) form of bilirubin (SMD=-0.71, 95% CI -1.18 to -0.24, p=0.003; I = 95.1%, p<0.001; very low certainty of evidence). The results of the meta-analysis were stable in sensitivity analysis. In meta-regression, there were no significant associations between the SMD of total bilirubin and several clinical and demographic characteristics, including age, male to female ratio, number of participants, liver enzymes and erythrocyte sedimentation rate. In subgroup analysis, the SMD of total bilirubin was significant across a range of RDs, including rheumatoid arthritis, systemic lupus erythematosus, primary Sjögren syndrome, and myositis. Therefore, the results of our systematic review and meta-analysis suggests that the reductions in bilirubin concentrations observed in patients with RDs reflect a state of impaired antioxidant and anti-inflammatory defence due to bilirubin consumption and highlight the promising role of this endogenous product as a biomarker of RDs.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/prospero/, identifier CRD42023500649.
Topics: Female; Humans; Bilirubin; Biomarkers; Oxidative Stress; Rheumatic Diseases; Male
PubMed: 38947324
DOI: 10.3389/fimmu.2024.1369284 -
Pulmonary Medicine 2024Bilothorax is defined as the presence of bile in the pleural space. It is a rare condition, and diagnosis is confirmed with a pleural fluid-to-serum bilirubin ratio of...
BACKGROUND
Bilothorax is defined as the presence of bile in the pleural space. It is a rare condition, and diagnosis is confirmed with a pleural fluid-to-serum bilirubin ratio of >1.
METHODS
The PubMed, Embase, Google Scholar, and CINAHL databases were searched using predetermined Boolean parameters. The systematic literature review was done per PRISMA guidelines. Retrospective studies, case series, case reports, and conference abstracts were included. The patients with reported pleural fluid analyses were pooled for fluid parameter data analysis.
RESULTS
Of 838 articles identified through the inclusion criteria and removing 105 duplicates, 732 articles were screened with abstracts, and 285 were screened for full article review. After this, 123 studies qualified for further detailed review, and of these, 115 were pooled for data analysis. The mean pleural fluid and serum bilirubin levels were 72 mg/dL and 61 mg/dL, respectively, with a mean pleural fluid-to-serum bilirubin ratio of 3.47. In most cases, the bilothorax was reported as a subacute or remote complication of hepatobiliary surgery or procedure, and traumatic injury to the chest or abdomen was the second most common cause. Tube thoracostomy was the main treatment modality (73.83%), followed by serial thoracentesis. Fifty-two patients (51.30%) had associated bronchopleural fistulas. The mortality was considerable, with 18/115 (15.65%) reported death. Most of the patients with mortality had advanced hepatobiliary cancer and were noted to die of complications not related to bilothorax.
CONCLUSION
Bilothorax should be suspected in patients presenting with pleural effusion following surgical manipulation of hepatobiliary structures or a traumatic injury to the chest. This review is registered with CRD42023438426.
Topics: Female; Humans; Bile; Bilirubin; Pleural Effusion; Thoracentesis; Thoracostomy; Aged
PubMed: 38947176
DOI: 10.1155/2024/3973056