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International Journal of Reproductive... Dec 2023Management for pelvic floor disorders needs to be improved. Platelet-rich plasma (PRP) offers an innovative treatment in general medical care to promote cell... (Review)
Review
BACKGROUND
Management for pelvic floor disorders needs to be improved. Platelet-rich plasma (PRP) offers an innovative treatment in general medical care to promote cell regeneration.
OBJECTIVE
This review aims to investigate the role of PRP in pelvic floor disorders.
MATERIALS AND METHODS
6 international databases were accessed using several keywords namely PubMed, Science Direct, Cochrane Library, ProQuest, Google Scholar, and Scopus. The inclusion criteria were articles written in English, published in 10-yr period from 2012 until 2022, and investigated the relevant topic. This systematic review followed PRISMA guideline.
RESULTS
644 articles were found in several databases and 15 articles met the criteria. Management for pelvic floor disorders needs to be improved, but there are still many challenges, such as less effective treatments, risk of recurrence, and postoperative wound healing. PRP offers an innovative treatment in general medical care to promote cell regeneration. A total of 644 articles from the database were found, but 15 studies met the criteria. A total of 600 women with various pelvic floor disorders treated with PRP were analyzed. PRP positively impacts female sexual dysfunction, perineal trauma, vulvovaginal atrophy, stress urinary incontinence, vesicovaginal fistula, perineal rupture, and pelvic organ prolapse. Dosages, preparation techniques, injection techniques, and additive materials are varied. Most studies do not report side effects from the therapy, but the urinary disorder complaints must be paid attention to.
CONCLUSION
PRP can be used to manage pelvic floor disorders. Future studies should clarify and standardize the dose in each case and how to make PRP produce the best results.
PubMed: 38370486
DOI: 10.18502/ijrm.v21i12.15034 -
Orthopedic Reviews 2024Partial patellar tendon tears (PPTTs) are overuse injuries in sports with frequent jumping, such as basketball and volleyball. There are several treatment options,...
INTRODUCTION
Partial patellar tendon tears (PPTTs) are overuse injuries in sports with frequent jumping, such as basketball and volleyball. There are several treatment options, including both operative and non-operative modalities. Current literature is largely focused broadly on patellar tendinopathy; however, there are few studies which specifically evaluate treatment outcomes for PPTTs.
OBJECTIVE
To systematically review the literature on treatment options, clinical outcomes, and return to sport (RTS) in athletes with a PPTT.
METHODS
PubMed, Embase, and Cochrane were searched through May 1, 2023 for studies reporting treatment outcomes in athletes with partial patellar tendon tears. Data was extracted on the following topics: treatment modalities, surgical failures/reoperations, surgical complications, RTS, and postoperative time to RTS.
RESULTS
The review covers 11 studies with 454 athletes: 343 males (86.2%) and 55 females (13.8%). The average age was 25.8 years, ranging from 15 to 55 years. 169 patients (37.2%) received only non-operative treatments, while 295 (65.0%) underwent surgery. 267 patients (92.1%) returned to sports after 3.9 months of treatment. The average follow-up was 55.8 months.
CONCLUSION
Our review of current literature on PPTTs in athletes illustrates over 90% return to sport following either conservative or surgical treatment. There is currently little data that directly compares the treatment options to establish an evidence-based "gold-standard" treatment plan. The data we present suggests that current treatment options are satisfactory but would benefit from future study.
PubMed: 38343530
DOI: 10.52965/001c.92644 -
Journal of Orthopaedic Surgery and... Feb 2024Chronic Achilles tendon ruptures (CATR) often require surgical intervention to restore function. Despite numerous treatment modalities available, the optimal management...
BACKGROUND
Chronic Achilles tendon ruptures (CATR) often require surgical intervention to restore function. Despite numerous treatment modalities available, the optimal management strategy remains controversial given the limited high-quality evidence available. This article aims to provide evidence-based guidelines for the surgical management of CATR through a comprehensive systematic review of the available data. The consensus reached by synthesizing the findings will assist clinicians in making informed decisions and improving patient outcomes.
METHODS
A group of 9 foot surgeons in three continents was consulted to gather their expertise on guidelines regarding the surgical management of CATR. Following the proposal of 9 clinical topics, a thorough and comprehensive search of relevant literature published since 1980 was conducted for each topic using electronic databases, including PubMed, MEDLINE, and Cochrane Library, to identify relevant studies published until 1 October 2023. All authors collaborated in drafting, discussing, and finalizing the recommendations and statements. The recommendations were then categorized into two grades: grade a (strong) and grade b (weak), following the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) concept. Additionally, feedback from 21 external specialists, who were independent from the authors, was taken into account to further refine and finalize the clinical guidelines.
RESULTS
Nine statements and guidelines were completed regarding surgical indications, surgical strategies, and postoperative rehabilitation protocol.
CONCLUSION
Based on the findings of the systematic review, this guideline provides recommendations for the surgical management of CATR. We are confident that this guideline will serve as a valuable resource for physicians when making decisions regarding the surgical treatment of patients with CATR.
Topics: Humans; Achilles Tendon; Orthopedic Procedures; Ankle Injuries; Tendon Injuries; Consensus; Rupture
PubMed: 38341569
DOI: 10.1186/s13018-024-04559-5 -
Annals of Medicine and Surgery (2012) Feb 2024Although neonatal sepsis is acknowledged as the primary cause of newborn death in Ethiopia, data on its impact at the national level are limited. Strong supporting data... (Review)
Review
BACKGROUND
Although neonatal sepsis is acknowledged as the primary cause of newborn death in Ethiopia, data on its impact at the national level are limited. Strong supporting data are required to demonstrate how this affects neonatal health. This umbrella study was conducted to determine the overall prevalence of newborn sepsis and its relationship with maternal and neonatal factors.
METHODS
This umbrella review included five articles from various databases. The AMSTAR-2 method was used to assess the quality of included systematic review and meta-analysis studies. STATA Version 18 software was used for statistical analysis. A random-effects model was used to estimate the overall effects.
RESULTS
In this umbrella review, 9032 neonates with an outcome of interest were included. The overall pooled prevalence of neonatal sepsis was 45% (95% CI: 39-51%; I=99.34). The overall pooled effect size showed that prematurity was significantly associated with neonatal sepsis [odds ratio=3.11 (95% CI: 2.22-3.99)]. Furthermore, maternal factors are strongly associated with neonatal sepsis.
CONCLUSIONS
Nearly half of Ethiopian neonates are affected by neonatal sepsis. It is critical to reduce premature birth, low birth weight, and preterm membrane rupture to reduce the incidence of neonatal sepsis. Furthermore, it is preferable to design and strengthen policies and programs aimed at improving maternal nutritional status and treating maternal infections, which all contribute to lowering the burden of neonatal sepsis.
PubMed: 38333239
DOI: 10.1097/MS9.0000000000001619 -
International Journal of Hyperthermia :... 2024Caesarean scar pregnancy (CSP) presents a significant clinical challenge owing to the associated risks of uterine scar rupture, severe haemorrhage and adverse maternal... (Meta-Analysis)
Meta-Analysis Review
Efficacy and safety of high-intensity focused ultrasound combined with suction curettage for the treatment of caesarean scar pregnancy: a systematic review and single-arm meta-analysis.
PURPOSE
Caesarean scar pregnancy (CSP) presents a significant clinical challenge owing to the associated risks of uterine scar rupture, severe haemorrhage and adverse maternal outcomes. This study aimed to assess the safety and efficacy of combining high-intensity focused ultrasound (HIFU) with suction curettage for treating CSP.
METHODS
We conducted a comprehensive search in four databases, namely PubMed, Web of Science, Embase and Cochrane Library, to identify published studies evaluating the use of HIFU combined with suction curettage to treat CSP. Intraoperative blood loss, treatment success rate, and reproductive results were the primary outcomes assessed.
RESULTS
A total of 18 studies involving 1251 patients with CSP, all of whom received preoperative HIFU therapy were included. The average hospital stay was 6.22 days, the intraoperative blood loss was 26.29 ml and the incidence of adverse events was 15.60%, including abdominal or lower limb pain, fever, vaginal bleeding, haematuria and vomiting. Furthermore, post-treatment follow-up showed that serum β-human chorionic gonadotropin levels were rapidly normalized (average of 25.48 days) and menstruation returned (average of 33.03 days). The treatment had a remarkable success rate of 97.60% and a subsequent pregnancy rate of 68.70%.
CONCLUSION
While the combination of HIFU and suction-curettage may induce common adverse effects such as lower abdominal or limb pain, these reactions typically do not necessitate therapeutic intervention. Additionally, the size of the gestational sac is a determinant of the procedure's success. In conclusion, HIFU combined with suction curettage demonstrates promising clinical efficacy, safety and favourable reproductive outcomes in managing CSP.
Topics: Humans; Female; Pregnancy; Blood Loss, Surgical; Vacuum Curettage; Cicatrix; Pain; Cesarean Section
PubMed: 38329796
DOI: 10.1080/02656736.2024.2310019 -
Frontiers in Public Health 2024This study aimed to determine the prevalence and factors associated with maternal and neonatal sepsis in sub-Saharan Africa. (Meta-Analysis)
Meta-Analysis
OBJECTIVES
This study aimed to determine the prevalence and factors associated with maternal and neonatal sepsis in sub-Saharan Africa.
METHODS
This systematic review and meta-analysis used the PRISMA guideline on sepsis data in sub-Saharan Africa. The bibliographic search was carried out on the following databases: Medline/PubMed, Cochrane Library, African Index Medicus, and Google Scholar. Additionally, the reference lists of the included studies were screened for potentially relevant studies. The last search was conducted on 15 October 2022. The Joanna Briggs Institute quality assessment checklist was applied for critical appraisal. Estimates of the prevalence of maternal and neonatal sepsis were pooled using a random-effects meta-analysis model. Heterogeneity between studies was estimated using the Q statistic and the I2 statistic. The funnel plot and Egger's regression test were used to assess the publication bias.
RESULTS
A total of 39 studies were included in our review: 32 studies on neonatal sepsis and 7 studies on maternal sepsis. The overall pooled prevalence of maternal and neonatal sepsis in Sub-Saharan Africa was 19.21% (95% CI, 11.46-26.97) and 36.02% (CI: 26.68-45.36), respectively. The meta-analyses revealed that Apgar score < 7 (OR: 2.4, 95% CI: 1.6-3.5), meconium in the amniotic fluid (OR: 2.9, 95% CI: 1.8-4.5), prolonged rupture of membranes >12 h (OR: 2.8, 95% CI: 1.9-4.1), male sex (OR: 1.2, 95% CI: 1.1-1.4), intrapartum fever (OR: 2.4, 95% CI: 1.5-3.7), and history of urinary tract infection in the mother (OR: 2.7, 95% CI: 1.4-5.2) are factors associated with neonatal sepsis. Rural residence (OR: 2.3, 95% CI: 1.01-10.9), parity (OR: 0.5, 95% CI: 0.3-0.7), prolonged labor (OR: 3.4, 95% CI: 1.6-6.9), and multiple digital vaginal examinations (OR: 4.4, 95% CI: 1.3-14.3) were significantly associated with maternal sepsis.
CONCLUSION
The prevalence of maternal and neonatal sepsis was high in sub-Saharan Africa. Multiple factors associated with neonatal and maternal sepsis were identified. These factors could help in the prevention and development of strategies to combat maternal and neonatal sepsis. Given the high risk of bias and high heterogeneity, further high-quality research is needed in the sub-Saharan African context, including a meta-analysis of individual data. PROSPERO (ID: CRD42022382050).
Topics: Pregnancy; Humans; Female; Infant, Newborn; Male; Neonatal Sepsis; Prevalence; Africa South of the Sahara; Mothers; Pregnancy Complications, Infectious
PubMed: 38327574
DOI: 10.3389/fpubh.2024.1272193 -
International Journal of Surgery... Apr 2024Chronic steroid (CS) therapy was reportedly linked to increased vascular complications following percutaneous coronary intervention. However, its association with... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Chronic steroid (CS) therapy was reportedly linked to increased vascular complications following percutaneous coronary intervention. However, its association with vascular complications after transcatheter aortic valve replacement (TAVR) remained uncertain, with conflicting results being reported.
OBJECTIVE
The authors aimed to compare the rate of vascular complications and outcomes between patients with and without CS use after TAVR.
METHODS
The authors conducted a comprehensive literature search in PubMed, Embase, and Cochrane databases from their inception until 18th April 2022 for relevant studies. Endpoints were described according to Valve Academic Research Consortium-2 definitions. Effect sizes were pooled using DerSimonian and Laird random-effects model as risk ratio (RR) with 95% CI.
RESULTS
Five studies with 6136 patients undergoing TAVR were included in the analysis. The included studies were published between 2015 and 2022. The mean ages of patients in both study groups were similar, with the CS group averaging 80 years and the nonsteroid group averaging 82 years. Notably, a higher proportion of patients in the CS group were female (56%) compared to the nonsteroid group (54%). CS use was associated with a significantly higher risk of major vascular complications (12.5 vs. 6.7%, RR 2.32, 95% CI: 1.73-3.11, P <0.001), major bleeding (16.8 vs. 13.1%, RR 1.61, 95% CI: 1.27-2.05, P <0.001), and aortic annulus rupture (2.3 vs. 0.6%, RR 4.66, 95% CI: 1.67-13.01, P <0.001). There was no significant difference in terms of minor vascular complications (RR 1.43, 95% CI: 1.00-2.04, P =0.05), in-hospital mortality (2.3 vs. 1.4%, RR 1.86, 95% CI: 0.74-4.70, P =0.19), and 30-day mortality (2.9 vs. 3.1%, RR 1.14, 95% CI: 0.53-2.46, P =0.74) between both groups.
CONCLUSION
Our study showed that CS therapy is associated with increased major vascular complications, major bleeding, and annulus rupture following TAVR. Further large multicenter studies or randomized controlled trials are warranted to validate these findings.
Topics: Humans; Transcatheter Aortic Valve Replacement; Postoperative Complications; Aortic Valve Stenosis; Steroids; Vascular Diseases; Female; Aged, 80 and over; Male
PubMed: 38320107
DOI: 10.1097/JS9.0000000000001132 -
Journal of Orthopaedic Surgery and... Feb 2024Relevant evidence suggests that angiogenic factors contribute significantly to fibril matrix reconstruction following physical injuries to tendon ligaments. Vascular... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Relevant evidence suggests that angiogenic factors contribute significantly to fibril matrix reconstruction following physical injuries to tendon ligaments. Vascular endothelial growth factor A (VEGFA), with its potent angiogenic effect, has been studied extensively, and its functional polymorphisms, including rs699947, rs1570360, and rs2010963, have been the focus of numerous investigations. Some scholars have explored the association between gene polymorphisms in the VEGFA and the risk of tendon ligament injury, but the findings are not entirely consistent.
OBJECTIVES
The purpose of this study was to investigate the association between rs699947, rs1570360, and rs2010963 gene polymorphisms in VEGFA and the risk of tendon and ligament injuries.
METHODS
After including articles about the association of VEGFA rs699947, rs1570360, and rs2010963 polymorphisms with tendon and ligament injuries according to the search strategy, we assessed their quality and conducted meta-analyses to examine the link between these polymorphisms and the risk of tendon and ligament injuries using odds ratios and 95% confidence intervals.
RESULTS
Of 86 related articles, six were included in the meta-analysis. Some of these suggest an association between VEGFA rs2010963 and the risk of tendon and ligament injury in the population, with the specific C allele being one of the adverse factors for knee injury. Some studies suggest that VEGFA rs699947 and VEGFA rs1570360 single-nucleotide polymorphisms are associated with anterior cruciate ligament rupture. The risk of non-contact anterior cruciate ligament rupture is nearly doubled in individuals with the rs699947 CC genotype compared to the control group. Our analysis did not find any significant relationship between VEGFA gene polymorphisms (rs699947, rs1570360, and rs2010963) and the chance of tendon and ligament injury without consideration of race. However, the European population reveals that the CC genotype of VEGFA rs699947 can result in a greater risk of tendon and ligament injury, whereas the AG genotype for rs1570360 provides some protection. Additionally, rs2010963 was significantly associated with tendon and ligament injury; individuals with the C allele and the CC genotype had higher risk. False-positive report probability confirmed the high credibility of our results.
CONCLUSION
Overall, this study found no significant association between VEGFA rs699947, rs1570360, and rs2010963 polymorphisms and the risk of tendon ligament injury. However, in subgroup analysis, some genotypes of VEGFA rs699947, rs1570360, and rs2010963 were found to increase the risk of tendon ligament injury in European populations.
Topics: Humans; Anterior Cruciate Ligament Injuries; Case-Control Studies; Genetic Predisposition to Disease; Ligaments; Polymorphism, Single Nucleotide; Tendon Injuries; Tendons; Vascular Endothelial Growth Factor A
PubMed: 38317252
DOI: 10.1186/s13018-024-04589-z -
Journal of Obstetrics and Gynaecology :... Dec 2024Vaginal bleeding during pregnancy has been recognised as a significant risk factor for adverse pregnancy outcomes. This study aimed to investigate the association... (Meta-Analysis)
Meta-Analysis Review
Vaginal bleeding during pregnancy has been recognised as a significant risk factor for adverse pregnancy outcomes. This study aimed to investigate the association between vaginal bleeding during the first trimester of pregnancy and clinical adverse effects using a systematic review and meta-analysis. Databases of Scopus, Web of Science, PubMed (including Medline), Cochrane Library and Science Direct were searched until June of 2023. Data analysis using statistical test fixed- and random-effects models in the meta-analysis, Cochran and meta-regression. The quality of the eligible studies was assessed by using the Newcastle-Ottawa Scale checklist (NOS). A total of 46 relevant studies, with a sample size of 1,554,141 were entered into the meta-analysis. Vaginal bleeding during the first trimester of pregnancy increases the risk of preterm birth (OR: 1.8, CI 95%: 1.6-2.0), low birth weight (LBW; OR: 2.0, CI 95%: 1.5-2.6), premature rupture of membranes (PROMs; OR: 2.3, CI 95%: 1.8-3.0), abortion (OR: 4.3, CI 95%: 2.0-9.0), stillbirth (OR: 2.5, CI 95%: 1.2-5.0), placental abruption (OR: 2.2, CI 95%: 1.4-3.3) and placenta previa (OR: 1.9, CI 95%: 1.5-2.4). Vaginal bleeding in the first trimester of pregnancy is associated with preterm birth, LBW, PROMs, miscarriage, stillbirth, placental abruption and placenta previa. Therefore, physicians or midwives need to be aware of the possibility of these consequences and manage them when they occur.
Topics: Pregnancy; Infant, Newborn; Female; Humans; Stillbirth; Premature Birth; Abruptio Placentae; Placenta Previa; Placenta; Pregnancy Outcome; Abortion, Spontaneous; Uterine Hemorrhage
PubMed: 38305047
DOI: 10.1080/01443615.2023.2288224 -
Heliyon Jan 2024Epidermolysis bullosa (EB) is a genetic syndrome afflicting skin and mucous membranes. The manifestation depends on the form: in mild conditions, occasionally,... (Review)
Review
Dental implant survival in epidermolysis bullosa patients: A systematic review conducted according to PRISMA guidelines and the Cochrane handbook for systematic reviews of interventions.
BACKGROUND
Epidermolysis bullosa (EB) is a genetic syndrome afflicting skin and mucous membranes. The manifestation depends on the form: in mild conditions, occasionally, vesicular-bullous lesions of the oral cavity may be present, which heal spontaneously without leaving scars. Patients following joint rupture have scars that limit food intake and restrict quality of life. This study aims to evaluate the possibility of carrying out an implant therapy and the success rate of this therapy.
METHODS
Until January 3, 2000, PubMed, Web of Science, and Lilacs were searched. Clinical studies were selected that considered implant therapy in patients with epidermolysis bullosa. Articles were therefore selected that addressed oral health and implant survival in patients with epidermolysis, with no differentiation between the various subtypes. A risk of bias assessment was performed through Cochrane.
RESULTS
Twenty-one studies were found after the investigation. Only five were chosen to create the current systematic study; 16 articles were skipped over. 10 papers were disregarded because they had been reviewed; 4 were ignored because they contained case studies; and two were omitted because they were not written in English. The results show that implant survival is at around 97%.
CONCLUSIONS
Patients with epidermolysis bullosa can be treated with implant therapy without the risk of an increased implant failure rate. Indicate the main conclusions or interpretations.
PubMed: 38304847
DOI: 10.1016/j.heliyon.2024.e24208