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Vascular Medicine (London, England) Apr 2024This study aimed to review the current literature exploring the utility of noninvasive ocular imaging for the diagnosis of peripheral artery disease (PAD). Our search... (Review)
Review
This study aimed to review the current literature exploring the utility of noninvasive ocular imaging for the diagnosis of peripheral artery disease (PAD). Our search was conducted in early April 2022 and included the databases Medline, Scopus, Embase, Cochrane, and others. Five articles were included in the final review. Of the five studies that used ocular imaging in PAD, two studies used retinal color fundus photography, one used optical coherence tomography (OCT), and two used optical coherence tomography angiography (OCTA) to assess the ocular changes in PAD. PAD was associated with both structural and functional changes in the retina. Structural alterations around the optic disc and temporal retinal vascular arcades were seen in color fundus photography of patients with PAD compared to healthy individuals. The presence of retinal hemorrhages, exudates, and microaneurysms in color fundus photography was associated with an increased future risk of PAD, especially the severe form of the disease. The retinal nerve fiber layer (RNFL) was significantly thinner in the nasal quadrant in patients with PAD compared to age-matched healthy individuals in OCT. Similarly, the choroidal thickness in the subfoveal region was significantly thinner in patients with PAD compared to controls. Patients with PAD also had a significant reduction in the retinal and choroidal circulation in OCTA compared to healthy controls. As PAD causes thinning and ischemic changes in retinal vessels, examination of the retinal vessels using retinal imaging techniques can provide useful information about early microvascular damage in PAD. Ocular imaging could potentially serve as a biomarker for PAD. .
Topics: Humans; Optic Disk; Tomography, Optical Coherence; Photography; Peripheral Arterial Disease; Biomarkers; Retinal Vessels
PubMed: 38054219
DOI: 10.1177/1358863X231210866 -
Journal of Orthopaedic Surgery and... Jul 2018The open microdiscectomy is the most common surgical procedure for the decompression of radiculopathy caused by lumbar disk herniation. To date, a variety of minimally... (Comparative Study)
Comparative Study Meta-Analysis
BACKGROUND
The open microdiscectomy is the most common surgical procedure for the decompression of radiculopathy caused by lumbar disk herniation. To date, a variety of minimally invasive (MI) techniques have been developed. In the last decades, endoscopic techniques have been developed to perform discectomy. The transforaminal endoscopic discectomy (TED) with posterolateral access evolved out of the development of endoscopic techniques.
METHODS
A systematic literature search was performed using the PubMed, EMBASE, and Cochrane Library databases for trials written in English. The randomized trials and observational studies that met our inclusion criteria were subsequently included. Two reviewers respectively extracted data and estimated the risk of bias. All statistical analyses were performed using Review Manager 5.3.
RESULTS
Five prospective and four retrospective studies involving 1527 patients were included. The results of the meta-analysis indicated that there were significant differences between the two groups in length of hospital stay (MD = - 8.41, 95% CI - 10.26, - 6.56; p value < 0.00001). However, there were no significant differences in the leg visual analog scale (VAS) scores, the Oswestry Disability Index (ODI) scores, and the incidence of complications and recurrence.
CONCLUSIONS
The transforaminal endoscopic discectomy is superior to open microdiscectomy in the length of hospital stay. However, there were no differences in leg pain, functional recovery, and incidence of complications between TED and MD in treating LDH.
Topics: Decompression, Surgical; Diskectomy; Endoscopy; Humans; Intervertebral Disc Displacement; Lumbar Vertebrae; Prospective Studies; Retrospective Studies; Treatment Outcome
PubMed: 29976224
DOI: 10.1186/s13018-018-0868-0 -
Ophthalmic Research 2023Although internal limiting membrane (ILM) peeling facilitates macular hole (MH) closure and reduces late hole reopening, it brings some detrimental consequences to the... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Although internal limiting membrane (ILM) peeling facilitates macular hole (MH) closure and reduces late hole reopening, it brings some detrimental consequences to the retinal microstructure and functional outcomes. So far, previous studies have not reached a consensus on the optimal ILM peeling size.
OBJECTIVES
The objective of this study was to evaluate the outcomes of different ILM peeling sizes for idiopathic MHs.
METHODS
PubMed, Embase, Cochrane Library, Web of Science, CNKI, and WANFANG were searched until April 10, 2022. Studies in English or Chinese that compare the effects of two ILM peeling sizes (>2 disk diameters [DDs] vs. ≤2DD) for idiopathic MHs were included. The overall closure rate, postoperative best-corrected visual acuity (BCVA), type 1 closure, and adverse events were extracted. BCVA was converted to logarithm of the minimum angle of resolution (LogMAR).
RESULTS
Seven eligible studies (560 eyes) including 3 randomized clinical trials, 3 prospective trials, and one retrospective cohort were included. Pooled results showed a significantly better postoperative BCVA (mean difference = -0.16; 95% confidence interval [CI]: -0.27 to -0.04; LogMAR) and higher type 1 closure rate (risk ratio [RR] = 1.24; 95% CI: 1.08-1.43) in eyes with ILM peeling >2DD than those with peeling ≤2DD. No significant difference was found in overall closure rate and adverse events between the two groups. Subgroup analysis indicated that in MHs >400 μm, peeling >2DD helped obtain a better postoperative BCVA (mean difference = -0.17; 95% CI: -0.29 to -0.04; LogMAR) and higher frequency of type 1 closure (RR = 1.25; 95% CI: 1.03-1.51).
CONCLUSIONS
Peeling >2DD shares similar safety level with peeling ≤2DD and has a superiority of facilitating visual recovery. Larger ILM peeling may be more beneficial for large MHs.
Topics: Humans; Retinal Perforations; Retrospective Studies; Prospective Studies; Vitrectomy; Treatment Outcome; Visual Acuity; Basement Membrane; Epiretinal Membrane; Tomography, Optical Coherence
PubMed: 37586342
DOI: 10.1159/000531510 -
PloS One 2019To comprehensively determine the prevalence of MRSA in healthy Chinese population, the influencing factors of MRSA colonization and its antibiotic resistance. (Meta-Analysis)
Meta-Analysis
OBJECTIVE
To comprehensively determine the prevalence of MRSA in healthy Chinese population, the influencing factors of MRSA colonization and its antibiotic resistance.
METHODS
Articles that studied prevalence or influencing factors of MRSA carriage in healthy Chinese population were retrieved from PubMed, Ovid database, three Chinese electronic databases. The pooled prevalence of MRSA, its antibiotic resistance and influencing factors were analyzed by STATA12.0.
RESULTS
37 studies were included. The pooled prevalence of MRSA was 21.2% (95% CI: 18.5%-23.9%), and the prevalence of S.aureus was 15% (95% CI: 10%-19%), with a significant heterogeneity (MRSA: I2 = 97.6%, P<0.001; S.aureus: I2 = 98.4%, P < 0.001). In subgroup analysis, the pooled prevalence of MRSA was 28% (95%CI: 10%-51%) for Livestock-related workers, 18% (95%CI: 11%-26%) for children, 20% (95%CI: 12%-29%) for healthcare workers, 7% (95%CI: 3%-13%) for community residents. The prevalence of MRSA in studies with oxacillin disk diffusion method (28%, 95%CI: 21%-35%) seemed higher than that with the mecA gene method(12%, 95%CI: 7%-19%). MRSA in studies conducted in Taiwan was more common than in Mainland China and Hong Kong. Similar results were found in meta-regression. Influencing factors for MRSA colonization were noted in seven eligible studies, they included younger age (OR: 3.54, 95% CI: 2.38-5.26; OR: 2.24, 95% CI: 1.73-2.9), attending day care centers (DCCs) (OR: 1.95, 95% CI: 1.4-2.72; OR: 1.53, 95% CI: 1.2-1.95), flu vaccination (OR:1.73, 95% CI: 1.28-2.35), using antibiotics within the past year (OR: 2.05, 95% CI:1.35-3.11), residing in northern Taiwan (OR: 1.45, 95% CI: 1.19-1.77), regular visits to health care facility (OR: 23.83, 95% CI: 2.72-209.01), household member working in health care facility (OR: 8.98, 95% CI:1.4-55.63), and contact with livestock (OR: 6.31, 95% CI: 3.44-11.57). Moreover, MRSA was found to be highly resistant to penicillin, ampicillin, erythromycin, and clindamycin, with a pooled resistance ratio of 100, 93, 88, and 75%, respectively. However, no resistance were noted to vancomycin.
CONCLUSION
The pooled prevalence of MRSA was considerably high in health Chinese population. Additionally, these strains showed extreme resistance to penicillin, ampicillin, erythromycin and clindamycin. Public MRSA protection measures and the surveillance of MRSA should be strengthened to reduce the spread of MRSA among hospitals, communities, and livestock.
Topics: Carrier State; Healthy Volunteers; Humans; Methicillin-Resistant Staphylococcus aureus; Odds Ratio; Population Surveillance; Prevalence; Staphylococcal Infections
PubMed: 31647842
DOI: 10.1371/journal.pone.0223599 -
Global Spine Journal Feb 2016Study Design Systematic review. Clinical Questions Among athletes who undergo surgery of the cervical spine, (1) What proportion return to play (RTP) after their...
Study Design Systematic review. Clinical Questions Among athletes who undergo surgery of the cervical spine, (1) What proportion return to play (RTP) after their cervical surgery? (2) Does the proportion of those cleared for RTP depend on the type of surgical procedure (artificial disk replacement, fusion, nonfusion foraminotomies/laminoplasties), number of levels (1, 2, or more levels), or type of sport? (3) Among those who return to their presurgery sport, how long do they continue to play? (4) Among those who return to their presurgery sport, how does their postoperative performance compare with their preoperative performance? Objectives To evaluate the extent and quality of published literature on the topic of return to competitive athletic completion after cervical spinal surgery. Methods Electronic databases and reference lists of key articles published up to August 19, 2015, were searched to identify studies reporting the proportion of athletes who RTP after cervical spine surgery. Results Nine observational, retrospective series consisting of 175 patients were included. Seven reported on professional athletes and two on recreational athletes. Seventy-five percent (76/102) of professional athletes returned to their respective sport following surgery for mostly cervical herniated disks. Seventy-six percent of recreational athletes (51/67) age 10 to 42 years RTP in a variety of sports following surgery for mostly herniated disks. No snowboarder returned to snowboarding (0/6) following surgery for cervical fractures. Most professional football players and baseball pitchers returned to their respective sport at their presurgery performance level. Conclusions RTP decisions after cervical spine surgery remain controversial, and there is a paucity of existing literature on this topic. Successful return to competitive sports is well described after single-level anterior cervical diskectomy and fusion surgery for herniated disk. RTP outcomes involving other cervical spine diagnoses and surgical procedures remain unclear. Additional quality research is needed on this topic.
PubMed: 26835207
DOI: 10.1055/s-0035-1570460 -
SAS Journal 2008This study is a systematic review of published biomechanical studies involving pedicle screw-based posterior dynamic stabilization devices (PDS) with a special focus on...
STUDY DESIGN
This study is a systematic review of published biomechanical studies involving pedicle screw-based posterior dynamic stabilization devices (PDS) with a special focus on kinematics and load transmission through the functional spine unit (FSU).
METHODS
A literature search was performed via the PubMed online database from 1990 to 2008 using the following key words: "biomechanics," "lumbar dynamic stabilization," "Graf system," "Dynesys," and "posterior dynamic implant." Citations were limited to papers describing biomechanics of pedicle screw-based PDS devices currently available for clinical use. Studies describing clinical experience, radiology, and in vivo testing were excluded from the review. Parameters measured included kinematics of the FSU (range of motion (ROM), neutral zone (NZ), and location of the center of rotation) and load transmission through the disk, facets, and instrumentation.
RESULTS
A total of 27 publications were found that concerned the biomechanical evaluation of lumbar pedicle screw-based dynamic stabilization instrumentation. Nine in vitro experimental studies and 4 finite element analyses satisfied the inclusion criteria. The Dynesys implant was the most investigated pedicle screw-based PDS system. In vitro cadaveric studies mainly focused on kinematics comparing ROM of intact versus instrumented spines whereas finite element analyses allowed analysis of load transmission at the instrumented and adjacent levels.
CONCLUSION
Biomechanical studies demonstrate that pedicle screw-based PDS devices limit intervertebral motion while unloading the intervertebral disk. The implant design and the surgical technique have a significant impact on the biomechanical behavior of the instrumented spinal segment. The posterior placement of such devices results in non-physiologic intervertebral kinematics with a posterior shift of the axis of rotation. Biomechanical studies suggest that the difference at the adjacent level between investigated dynamic devices and rigid stabilization systems may not be as high as reported. Finally, additional investigations of semirigid devices are needed to further evaluate their biomechanical properties compared to soft stabilization PDS systems.
PubMed: 25802618
DOI: 10.1016/SASJ-2008-0010-LR -
Acta Ophthalmologica Sep 2020A growing number of studies have reported a link between vascular damage and glaucoma based on optical coherence tomography angiography (OCTA) imaging. This multitude of...
A growing number of studies have reported a link between vascular damage and glaucoma based on optical coherence tomography angiography (OCTA) imaging. This multitude of studies focused on different regions of interest (ROIs) which offers the possibility to draw conclusions on the most discriminative locations to diagnose glaucoma. The objective of this work was to review and analyse the discriminative capacity of vascular density, retrieved from different ROIs, on differentiating healthy subjects from glaucoma patients. PubMed was used to perform a systematic review on the analysis of glaucomatous vascular damage using OCTA. All studies up to 21 April 2019 were considered. The ROIs were analysed by region (macula, optic disc and peripapillary region), layer (superficial and deep capillary plexus, avascular, whole retina, choriocapillaris and choroid) and sector (according to the Garway-Heath map). The area under receiver operator characteristic curve (AUROC) and the statistical difference (p-value) were used to report the importance of each ROI for diagnosing glaucoma. From 96 screened studies, 43 were eligible for this review. Overall, the peripapillary region showed to be the most discriminative region with the highest mean AUROC (0.80 ± 0.09). An improvement of the AUROC from this region is observed when a sectorial analysis is performed, with the highest AUROCs obtained at the inferior and superior sectors of the superficial capillary plexus in the peripapillary region (0.86 ± 0.03 and 0.87 ± 0.10, respectively). The presented work shows that glaucomatous vascular damage can be assessed using OCTA, and its added value as a complementary feature for glaucoma diagnosis depends on the region of interest. A sectorial analysis of the superficial layer at the peripapillary region is preferable for assessing glaucomatous vascular damage.
Topics: Glaucoma; Humans; Macula Lutea; Microcirculation; Optic Disk; ROC Curve; Retinal Vessels; Tomography, Optical Coherence; Visual Fields
PubMed: 32180360
DOI: 10.1111/aos.14392 -
Reumatologia Clinica May 2006To perform a systematic review to analyze the efficacy on which the use of ozone therapy in musculoskeletal diseases is based.
OBJECTIVE
To perform a systematic review to analyze the efficacy on which the use of ozone therapy in musculoskeletal diseases is based.
METHODS
A literature search was performed in PubMed, Embase and the Cochrane Library using highly sensitive search terms to identify all studies on ozone therapy. All studies showing the efficacy or effectiveness of ozone therapy in any musculoskeletal disease were selected.
RESULTS
Only 6 relevant studies were identified, 5 in lumbar disk herniation and 1 in Raynaud's syndrome. Of the 5 studies in disk herniation, only 3 were clinical trials and none used random allocation. Study participants were generally patients with symptomatic small discal hernias. There was wide variability in the dose of ozone injected as well as in the controls used for comparison. All outcome measures were subjective and there was no blinded evaluation of the results. The study in Raynaud's syndrome included only 4 patients. Adverse effects were not evaluated in detail.
CONCLUSIONS
The use of ozone therapy in musculoskeletal diseases is based on poor quality studies. Currently, data supporting an adequate risk/benefit ratio for ozone therapy in rheumatic diseases is lacking.
PubMed: 21794314
DOI: 10.1016/S1699-258X(06)73032-7 -
The Angle Orthodontist Feb 2003The purpose of this systematic review was to evaluate the effect of bilateral sagittal split mandibular osteotomy (BSSO) with rigid internal fixation (RIF) on... (Meta-Analysis)
Meta-Analysis
The purpose of this systematic review was to evaluate the effect of bilateral sagittal split mandibular osteotomy (BSSO) with rigid internal fixation (RIF) on temporomandibular joint (TMJ) morphology. Controlled trials of BSSO with RIF treatment of Class II patients using transcranial radiographs, submental vertex (SMV) radiographs, tomographic radiography, computed tomography (CT) scan, or magnetic resonance imaging (MRI) to assess TMJ morphology were identified by Medline (1966-2001) and PubMed. Case reports were excluded. On the basis of our search only six studies were included in this review. All studies used internal controls with pre- and posttreatment imaging. Two studies used SMV, one used transcranial radiographs, one used tomography, two used CT scan and one used MRI. Methodological deficiencies prevent major conclusions regarding osseous remodeling and disk status. There was a wide range of individual variability in condyle position change. The reviewed studies have highlighted the importance of further research. Prospective controlled studies using serial MRI and tomography or CT scan are required to establish effect of BSSO with RIF on TMJ morphology.
Topics: Adult; Bone Remodeling; Controlled Clinical Trials as Topic; Female; Humans; Internal Fixators; Magnetic Resonance Imaging; Male; Malocclusion, Angle Class II; Mandible; Mandibular Advancement; Mandibular Condyle; Orthopedic Fixation Devices; Osteotomy; Prospective Studies; Temporomandibular Joint; Temporomandibular Joint Disc; Tomography, X-Ray; Tomography, X-Ray Computed
PubMed: 12607859
DOI: 10.1043/0003-3219(2003)073<0079:TJMCWM>2.0.CO;2