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Obesity Reviews : An Official Journal... Mar 2022Long-term glucocorticoids (HairGC) measured in scalp hair have been associated with body mass index (BMI), waist circumference (WC), and waist-hip-ratio (WHR) in several... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Long-term glucocorticoids (HairGC) measured in scalp hair have been associated with body mass index (BMI), waist circumference (WC), and waist-hip-ratio (WHR) in several cross-sectional studies. We aimed to investigate the magnitude, strength, and clinical relevance of these relations across all ages.
METHODS
We performed a systematic review and meta-analysis (PROSPERO registration CRD42020205187) searching for articles relating HairGC to measures of obesity. Main outcomes were bivariate correlation coefficients and unadjusted simple linear regression coefficients relating hair cortisol (HairF) and hair cortisone (HairE) to BMI, WC, and WHR.
RESULTS
We included k = 146 cohorts (n = 34,342 individuals). HairGC were positively related to all anthropometric measurements. The strongest correlation and largest effect size were seen for HairE-WC: pooled correlation 0.18 (95%CI 0.11-0.24; k = 7; n = 3,158; I = 45.7%) and pooled regression coefficient 11.0 cm increase in WC per point increase in 10-log-transformed HairE (pg/mg) on liquid-chromatography-(tandem) mass spectrometry (LC-MS) (95%CI 10.1-11.9 cm; k = 6; n = 3,102). Pooled correlation for HairF-BMI was 0.10 (95%CI 0.08-0.13; k = 122; n = 26,527; I = 51.2%) and pooled regression coefficient 0.049 kg/m per point increase in 10-log-transformed HairF (pg/mg) on LC-MS (95%CI 0.045-0.054 kg/m ; k = 26; n = 11,635).
DISCUSSION
There is a consistent positive association between HairGC and BMI, WC, and WHR, most prominently and clinically relevant for HairE-WC. These findings overall suggest an altered setpoint of the hypothalamic-pituitary-adrenal axis with increasing central adiposity.
Topics: Body Mass Index; Cross-Sectional Studies; Glucocorticoids; Hair; Humans; Hypothalamo-Hypophyseal System; Obesity; Pituitary-Adrenal System; Risk Factors; Waist Circumference; Waist-Hip Ratio
PubMed: 34811866
DOI: 10.1111/obr.13376 -
Brain Sciences Sep 2021Neurofeedback has been proposed as a treatment for Parkinson's disease (PD) motor symptoms by changing the neural network activity directly linked with movement.... (Review)
Review
BACKGROUND
Neurofeedback has been proposed as a treatment for Parkinson's disease (PD) motor symptoms by changing the neural network activity directly linked with movement. However, the effectiveness of neurofeedback as a treatment for PD motor symptoms is unclear.
AIM
To systematically review the literature to identify the effects of neurofeedback in people with idiopathic PD; as defined by measurement of brain activity; motor function; and performance.
DESIGN
A systematic review. Included Sources and Articles: PubMed; MEDLINE; Cinhal; PsychoInfo; Prospero; Cochrane; ClinicalTrials.gov; EMBASE; Web of Science; PEDro; OpenGrey; Conference Paper Index; Google Scholar; and eThos; searched using the Population-Intervention-Comparison-Outcome (PICO) framework. Primary studies with the following designs were included: randomized controlled trials (RCTs), non-RCTs; quasi-experimental; pre/post studies; and case studies.
RESULTS
This review included 11 studies out of 6197 studies that were identified from the literature search. Neuroimaging methods used were fMRI; scalp EEG; surface brain EEG; and deep brain EEG; where 10-15 Hz and the supplementary motor area were the most commonly targeted signatures for EEG and fMRI, respectively. Success rates for changing one's brain activity ranged from 47% to 100%; however, both sample sizes and success criteria differed considerably between studies. While six studies included a clinical outcome; a lack of consistent assessments prevented a reliable conclusion on neurofeedback's effectiveness. Narratively, fMRI neurofeedback has the greatest potential to improve PD motor symptoms. Two main limitations were found in the studies that contributed to the lack of a confident conclusion: (1) insufficient clinical information and perspectives (e.g., no reporting of adverse events), and (2) limitations in numerical data reporting (e.g., lack of explicit statistics) that prevented a meta-analysis.
CONCLUSIONS
While fMRI neurofeedback was narratively the most effective treatment; the omission of clinical outcome measures in studies using other neurofeedback approaches limits comparison. Therefore, no single neurofeedback type can currently be identified as an optimal treatment for PD motor symptoms. This systematic review highlights the need to improve the inclusion of clinical information and more robust reporting of numerical data in future work. Neurofeedback appears to hold great potential as a treatment for PD motor symptoms. However, this field is still in its infancy and needs high quality RCTs to establish its effectiveness. Review Registration: PROSPERO (ID: CRD42020191097).
PubMed: 34679358
DOI: 10.3390/brainsci11101292 -
Journal of Plastic, Reconstructive &... Dec 2021Auricular reconstruction for microtia is most frequently performed using autologous costal cartilage (ACC) or porous polyethylene (PPE) implants. Short-term results are...
BACKGROUND
Auricular reconstruction for microtia is most frequently performed using autologous costal cartilage (ACC) or porous polyethylene (PPE) implants. Short-term results are generally promising, but long-term results remain unclear. Long-term outcomes were explored in this systematic review, and minimal reporting criteria were suggested for future original data studies.
METHODS
A systematic literature search was conducted in MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials from inception through October 14, 2020. Articles on auricular reconstruction in patients with microtia using ACC or PPE were included if postsurgical follow-up was at least 1 year. Outcome reporting was split into separate publications, and results on complications were reported previously. This publication focused on long-term aesthetic, patient-reported, and sensitivity outcomes.
RESULTS
Forty-one publications reported on these outcomes. Both materials led to aesthetically pleasing results and high rates of patient satisfaction. ACC frameworks grew similarly to contralateral ears, and the anterior surface of auricles regained sensitivity. Furthermore, postoperative health-related quality of life (HRQoL) outcomes were generally good. Data synthesis was limited due to considerable variability between studies and poor study quality. No conclusions could be drawn on the superiority of either method due to the lack of comparative analyses.
CONCLUSION
Future studies should minimally report (1) surgical efficacy measured using the tool provided in the UK Care Standards for the Management of Patients with Microtia and Atresia; (2) complications including framework extrusion or exposure, graft loss, framework resorption, wire exposure and scalp/auricular scar complications and (3) HRQoL before and after treatment using the EAR-Q patient-reported outcome measure (PROM).
Topics: Congenital Microtia; Costal Cartilage; Esthetics; Humans; Patient Reported Outcome Measures; Patient Satisfaction; Postoperative Complications; Prostheses and Implants; Plastic Surgery Procedures
PubMed: 34489212
DOI: 10.1016/j.bjps.2021.08.004 -
European Review For Medical and... Aug 2021The aim of the study was to compare the risk of chemotherapy induced alopecia among patients with scalp cooling therapy, compared to those that did not receive scalp... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
The aim of the study was to compare the risk of chemotherapy induced alopecia among patients with scalp cooling therapy, compared to those that did not receive scalp cooling.
MATERIALS AND METHODS
A systematic search was conducted in the PubMed, Scopus, Cochrane Database of Systematic Reviews and Google scholar databases. Studies, preferably randomized controlled trials, that compared scalp cooling with no scalp cooling (control) for risk of alopecia or hair loss in patients undergoing chemotherapy were considered for inclusion. The strength of association was presented in the form of pooled adjusted relative risk (RR) for categorical outcomes and weighted mean difference (WMD) for continuous outcomes. Statistical analysis was done using STATA version 16.0.
RESULTS
A total of 14 articles were identified, of which 9 were included in the meta-analysis and for the remaining 5 articles, the findings were synthesized descriptively. Compared to control group patients, those that received scalp cooling had 41% lower risk of alopecia [RR 0.59, 95% CI: 0.53, 0.66]. The overall quality of pooled evidence for the risk of alopecia was judged "moderate". There were no differences in the anxiety score [WMD 0.57, 95% CI: -0.55, 1.69], depression score [WMD 0.31, 95% CI: -1.19, 1.80], score reflecting emotional functioning [WMD 0.06, 95% CI: -1.37, 1.49] and social functioning [WMD -8.37, 95% CI: -25.7, 8.93] among the two groups of patients. The pooled evidence suggests that around 66% (95% CI: 37-95%) of the subjects reported some discomfort with use of scalp cooling system. The commonly reported complaints included headache, scalp and neck pain, discomfort due to chill, nausea/vomiting and dizziness.
CONCLUSIONS
Findings suggest that the use of scalp cooling, compared to no scalp cooling, reduces the risk of significant hair loss. The acceptability of this cooling system might be limited by a high incidence of reported complaints.
Topics: Alopecia; Antineoplastic Agents; Humans; Hypothermia, Induced; Randomized Controlled Trials as Topic; Scalp
PubMed: 34486683
DOI: 10.26355/eurrev_202108_26520 -
Journal of Plastic, Reconstructive &... Dec 2021Microtia is a rare disorder characterized by malformation or even complete absence of the auricle. Reconstruction is often performed using autologous costal cartilage...
BACKGROUND
Microtia is a rare disorder characterized by malformation or even complete absence of the auricle. Reconstruction is often performed using autologous costal cartilage (ACC) or porous polyethylene implants (PPE). However, the long-term outcomes of both methods are unclear.
OBJECTIVE
This systematic review aimed to analyze long-term complications and suggest minimal reporting criteria for future original data studies.
METHODS
A systematic literature search was conducted in MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials from inception through October 14, 2020. Articles on auricular reconstruction in patients with microtia using ACC or PPE were included provided that the follow-up period was at least one year. This publication focused on long-term complications reported in patients with a postoperative follow-up period of at least one year.
RESULTS
Twenty-nine publications reported on complications during long-term follow-up. Overall long-term complication rates were not reported. The incidence of individual complications during long-term follow-up was less than 10% after ACC reconstruction and less than 15% in PPE reconstruction. Framework resorption and wire exposure were reported even after an extended follow-up of more than five years after ACC reconstruction, while reports on the extended long-term results of PPE reconstruction are limited. Data synthesis was limited due to heterogeneity and poor study quality.
CONCLUSIONS
Future studies should report on long-term complications including framework exposure or extrusion, graft loss, framework resorption, wire exposure and scalp and auricular scar complications. We recommend a surgical follow-up of at least five years.
Topics: Congenital Microtia; Costal Cartilage; Humans; Postoperative Complications; Prostheses and Implants; Plastic Surgery Procedures
PubMed: 34481742
DOI: 10.1016/j.bjps.2021.08.001 -
Dermatology (Basel, Switzerland) 2022The common inflammatory scalp diseases, such as psoriasis, seborrheic dermatitis, lichen planopilaris, discoid lupus erythematosus, contact dermatitis, or pemphigus may... (Review)
Review
BACKGROUND
The common inflammatory scalp diseases, such as psoriasis, seborrheic dermatitis, lichen planopilaris, discoid lupus erythematosus, contact dermatitis, or pemphigus may share similar clinical features.
OBJECTIVE
To identify and systematically review the available evidence on the accuracy of trichoscopy in inflammatory scalp disorders.
METHODS
A systematic review was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A total of 58 articles were included in the analysis.
RESULTS
The following trichoscopy features were found to show the highest specificity for the respective diseases: in psoriasis: diffuse scaling, simple and twisted red loops, red dots and globules, and glomerular vessels; in seborrheic dermatitis: atypical vessels, thin arborizing vessels, and structureless red areas; in discoid lupus erythematosus: follicular plugs and erythema encircling follicles; in lichen planopilaris: milky red areas or fibrotic patches; in contact dermatitis: twisted red loops; in pemphigus foliaceus: white polygonal structures and serpentine vessels; in pemphigus vulgaris: red dots with whitish halo and lace-like vessels; and in dermatomyositis: lake-like vascular structures.
LIMITATIONS
Different nomenclature and variability in parameters, which were analyzed in different studies.
CONCLUSION
This systemic analysis indicates that trichoscopy may be used with high accuracy in the differential diagnosis of inflammatory scalp diseases.
Topics: Dermatitis, Contact; Dermatitis, Seborrheic; Dermoscopy; Humans; Lichen Planus; Lupus Erythematosus, Discoid; Pemphigus; Psoriasis; Scalp; Scalp Dermatoses
PubMed: 34265772
DOI: 10.1159/000517516 -
Clinical Case Reports Jun 2021Alopecic and aseptic nodule of the scalp/Pseudocyst of the scalp is a rare but probably underdiagnosed nonscarring alopecia with good prognosis and doxycycline is a safe...
Alopecic and aseptic nodule of the scalp/Pseudocyst of the scalp is a rare but probably underdiagnosed nonscarring alopecia with good prognosis and doxycycline is a safe and effective option treatment.
PubMed: 34194753
DOI: 10.1002/ccr3.4153 -
Evidence-based Complementary and... 2021To systematically evaluate the efficacy and safety of scalp acupuncture in the treatment of insomnia. (Review)
Review
OBJECTIVE
To systematically evaluate the efficacy and safety of scalp acupuncture in the treatment of insomnia.
METHODS
CNKI, Wanfang database, CQVIP database, CBM, Web of Science, Cochrane Library, and PubMed were searched for the literature on the treatment of insomnia by scalp acupuncture from the establishment of the database to July 23, 2020. Two researchers independently screened the literatures and extracted the data, then evaluated the quality of the literatures, and used RevMan 5.3 software for statistical analysis.
RESULTS
A total of 21 studies including 1606 cases were included. 21 studies were included in the analysis of effective rate. The heterogeneity test showed that there was no significant heterogeneity. The fixed effect model was used, < 0.00001. The effective rate of scalp acupuncture in the treatment of insomnia was significantly higher than that of the control group. The analysis of PSQI score was finally included in 19 studies. The heterogeneity test showed that there was obvious heterogeneity. The random effect model was used, and the subgroup analysis was conducted according to the different intervention measures of the control group. The values of the drug group and the blank group were both less than 0.05, indicating that the improvement of PSQI score in the scalp acupuncture treatment of insomnia was significantly better than that in the drug group and the blank group; = 0.05 in other acupuncture groups, suggesting in scalp acupuncture treatment, there was no difference between insomnia and other acupuncture in improving the PSQI score. Six studies were included in the analysis of adverse events. The heterogeneity test showed no significant heterogeneity. The fixed effect model was used, = 0.04 < 0.05, indicating that the adverse events of scalp acupuncture in the treatment of insomnia were better than those of the control group. No publication bias analysis was conducted due to the small number of adverse events included. Publication bias was analyzed for effective rate and PSQI score. Egger's TSTs test (effective rate = 0.001, PSQI score = 0.001) and funnel plot showed publication bias.
CONCLUSION
Scalp acupuncture is effective and safe in the treatment of insomnia, which is worthy of clinical application. However, due to the limited number of included literature, the methodology of some studies is slightly low and the quality of literature is slightly poor. In the future, we need to design rigorous, large sample, multiple center randomized controlled study to further verify the conclusion of this study.
PubMed: 34122601
DOI: 10.1155/2021/6621993 -
Chinese Neurosurgical Journal Apr 2021The use of cranial fixation devices in neurosurgery is very common, which is considered to be an important auxiliary method for many craniotomies. However, previous...
Potential risk analysis and experience summarization of unstable factors of cranial fixation devices in neurosurgical operations: three-case reports and systematic review.
BACKGROUND
The use of cranial fixation devices in neurosurgery is very common, which is considered to be an important auxiliary method for many craniotomies. However, previous studies have reported complications of using cranial fixation devices, including brain tissue, nerve and blood vessel damage, scalp laceration, subcutaneous hematoma, etc. Some of the complications are serious and even potentially fatal, and the causes of which may be related to the incorrect use of cranial fixation devices. Although there are no serious complications in our review, the cause of that needs to be further summarized and analyzed, as so to minimize the serious consequences caused by the cranial fixation device slippage and ensure the safety of the patients' surgical procedure.
CASE PRESENTATION
In our recent work, we have continuously found three cases of unstable cranial fixation devices, which make us to analyze the possible factors and summarize experience combined with the review of other senior neurosurgeons (more than 3 years of working experience) from different departments of neurosurgery.
CONCLUSIONS
Based on our recent incidents of unstable cranial fixation and the experience of investigating and analyzing senior doctors from different neurosurgery centers, we summarized experience to minimize the risk of unstable cranial fixation. We tried a variety of options, including a safe anatomical location for cranial fixation, teamwork, and communication with anesthesiologists and itinerant nurses, to ensure the stability of the patient's cranial fixation devices. The data obtained in this survey has great limitations, including the doctor's personal prejudice and dependence on anecdotal memories. Therefore, the data should be interpreted with caution. However, there are still some modes that can help to better understand the use of safe cranial fixation. Based on the above research and analysis, we have made recommendations that may help neurosurgeons to avoid preventable complications.
PubMed: 33910652
DOI: 10.1186/s41016-021-00244-2 -
CMAJ : Canadian Medical Association... Apr 2021Cesarean delivery is the most common surgical procedure worldwide. Intrapartum fetal surveillance is routinely offered to improve neonatal outcomes, but the effects of... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Cesarean delivery is the most common surgical procedure worldwide. Intrapartum fetal surveillance is routinely offered to improve neonatal outcomes, but the effects of different methods on the risk of emergency cesarean deliveries remains uncertain. We conducted a systematic review and network meta-analysis to evaluate the effectiveness of different types of fetal surveillance.
METHODS
We searched MEDLINE, Embase and CENTRAL until June 1, 2020, for randomized trials evaluating any intrapartum fetal surveillance method. We performed a network meta-analysis within a frequentist framework. We assessed the quality and network inconsistency of trials. We reported primarily on intrapartum emergency cesarean deliveries and other secondary maternal and neonatal outcomes using risk ratios (RRs) and 95% confidence intervals (CIs).
RESULTS
We included 33 trials (118 863 patients) evaluating intermittent auscultation with Pinard stethoscope/handheld Doppler (IA), cardiotocography (CTG), computerized cardiotocography (cCTG), CTG with fetal scalp lactate (CTG-lactate), CTG with fetal scalp pH analysis (CTG-FBS), CTG with fetal pulse oximetry (FPO-CTG), CTG with fetal heart electrocardiogram (CTG-STAN) and their combinations. Intermittent auscultation reduced the risk of emergency cesarean deliveries compared with other types of surveillance (IA v. CTG: RR 0.83, 95% CI 0.72-0.97; IA v. CTG-FBS: RR 0.71, 95% CI 0.63-0.80; IA v.CTG-lactate: RR 0.77, 95% CI 0.64-0.92; IA v. FPO-CTG: RR 0.75, 95% CI 0.65-0.87; IA v.FPO-CTG-FBS: RR 0.81, 95% CI 0.67-0.99; cCTG-FBS v. IA: RR 1.21, 95% CI 1.04-1.42), except STAN-CTG-FBS (RR 1.17, 95% CI 0.98-1.40). There was a similar reduction observed for emergency cesarean deliveries for fetal distress. None of the evaluated methods was associated with a reduced risk of neonatal acidemia, neonatal unit admissions, Apgar scores or perinatal death.
INTERPRETATION
Compared with other types of fetal surveillance, intermittent auscultation seems to reduce emergency cesarean deliveries in labour without increasing adverse neonatal and maternal outcomes.
Topics: Cesarean Section; Female; Fetal Monitoring; Humans; Pregnancy; Pregnancy Outcome; Randomized Controlled Trials as Topic
PubMed: 33824144
DOI: 10.1503/cmaj.202538