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The Lancet. Global Health Feb 2021To contribute to the WHO initiative, VISION 2020: The Right to Sight, an assessment of global vision impairment in 2020 and temporal change is needed. We aimed to... (Meta-Analysis)
Meta-Analysis
BACKGROUND
To contribute to the WHO initiative, VISION 2020: The Right to Sight, an assessment of global vision impairment in 2020 and temporal change is needed. We aimed to extensively update estimates of global vision loss burden, presenting estimates for 2020, temporal change over three decades between 1990-2020, and forecasts for 2050.
METHODS
We did a systematic review and meta-analysis of population-based surveys of eye disease from January, 1980, to October, 2018. Only studies with samples representative of the population and with clearly defined visual acuity testing protocols were included. We fitted hierarchical models to estimate 2020 prevalence (with 95% uncertainty intervals [UIs]) of mild vision impairment (presenting visual acuity ≥6/18 and <6/12), moderate and severe vision impairment (<6/18 to 3/60), and blindness (<3/60 or less than 10° visual field around central fixation); and vision impairment from uncorrected presbyopia (presenting near vision
FINDINGS
In 2020, an estimated 43·3 million (95% UI 37·6-48·4) people were blind, of whom 23·9 million (55%; 20·8-26·8) were estimated to be female. We estimated 295 million (267-325) people to have moderate and severe vision impairment, of whom 163 million (55%; 147-179) were female; 258 million (233-285) to have mild vision impairment, of whom 142 million (55%; 128-157) were female; and 510 million (371-667) to have visual impairment from uncorrected presbyopia, of whom 280 million (55%; 205-365) were female. Globally, between 1990 and 2020, among adults aged 50 years or older, age-standardised prevalence of blindness decreased by 28·5% (-29·4 to -27·7) and prevalence of mild vision impairment decreased slightly (-0·3%, -0·8 to -0·2), whereas prevalence of moderate and severe vision impairment increased slightly (2·5%, 1·9 to 3·2; insufficient data were available to calculate this statistic for vision impairment from uncorrected presbyopia). In this period, the number of people who were blind increased by 50·6% (47·8 to 53·4) and the number with moderate and severe vision impairment increased by 91·7% (87·6 to 95·8). By 2050, we predict 61·0 million (52·9 to 69·3) people will be blind, 474 million (428 to 518) will have moderate and severe vision impairment, 360 million (322 to 400) will have mild vision impairment, and 866 million (629 to 1150) will have uncorrected presbyopia.
INTERPRETATION
Age-adjusted prevalence of blindness has reduced over the past three decades, yet due to population growth, progress is not keeping pace with needs. We face enormous challenges in avoiding vision impairment as the global population grows and ages.
FUNDING
Brien Holden Vision Institute, Fondation Thea, Fred Hollows Foundation, Bill & Melinda Gates Foundation, Lions Clubs International Foundation, Sightsavers International, and University of Heidelberg.
Topics: Aged; Aged, 80 and over; Blindness; Cataract; Eye Diseases; Female; Forecasting; Glaucoma; Global Burden of Disease; Global Health; Humans; Macular Degeneration; Male; Middle Aged; Presbyopia; Vision, Low; Visual Acuity
PubMed: 33275950
DOI: 10.1016/S2214-109X(20)30425-3 -
Scientific Reports Dec 2015The relative effects of internal fixation strategies for intertrochanteric fracture after operation remain uncertain. We conducted a systematic review and meta-analysis... (Meta-Analysis)
Meta-Analysis Review
The relative effects of internal fixation strategies for intertrochanteric fracture after operation remain uncertain. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to address this important issue. We searched PubMed, EMBASE and CENTRAL for RCTs that compared different internal fixation implants in patients with intertrochanteric fracture at 6-month follow-up or longer. We ultimately included 43 trials enrolling 6911 patients; most trials were small in sample sizes and events. Their risk of bias was generally unclear due to insufficient reporting. Because of these, no statistically significant differences were present from most of the comparisons across all the outcomes, and no definitive conclusions can be made. However, a number of trials compared two commonly used internal fixation strategies, gamma nail (GN) and sliding hip screw (SHS). There is good evidence suggesting that, compared to SHS, GN may increase the risk of cut out (OR = 1.87, 95% CI, 1.08 to 3.21), re-operation (OR = 1.61, 95% CI, 1.02 to 2.53), intra-operative (OR = 3.14, 95% CI, 1.34 to 7.35) and later fractures (OR = 3.67, 95% CI, 1.37 to 9.83). Future randomized trials or observational studies that are carefully designed and conducted are warranted to establish the effects of alternative internal fixation strategies for intertrochanteric fracture.
Topics: Blood Loss, Surgical; Fracture Fixation, Internal; Hip Fractures; Hospitalization; Humans; Prospective Studies; Quality of Life; Randomized Controlled Trials as Topic; Retreatment; Treatment Outcome
PubMed: 26657600
DOI: 10.1038/srep18195 -
Hand (New York, N.Y.) Jan 2023Proximal interphalangeal joint (PIPJ) arthrodesis is a salvage option in the management of end-stage PIPJ arthropathy. Numerous techniques have been described, including... (Review)
Review
Proximal interphalangeal joint (PIPJ) arthrodesis is a salvage option in the management of end-stage PIPJ arthropathy. Numerous techniques have been described, including screws, Kirschner wires, tension band wiring, intramedullary devices, and plate fixation. There remains no consensus as to the optimum method, and no recent summary of the literature exists. A literature search was conducted using the MEDLINE, EMBASE, and PubMed databases. English-language articles reporting PIPJ arthrodesis outcomes were included and presented in a systematic review. Pearson χ and 2-sample proportion tests were used to compare fusion time, nonunion rate, and complication rate between arthrodesis techniques. The mean fusion time ranged from 5.1 to 12.9 weeks. There were no statistically significant differences in fusion time between arthrodesis techniques. Nonunion rates ranged from 0.0% to 33.3%. Screw arthrodesis demonstrated a lower nonunion rate than wire fusion (3.0% and 8.5% respectively; = .01). Complication rates ranged from 0.0% to 22.1%. Aside from nonunions, there were no statistically significant differences in complication rates between arthrodesis techniques. The available PIPJ arthrodesis techniques have similar fusion time, nonunion rate, and complication rate outcomes. The existing data have significant limitations, and further research would be beneficial to elucidate any differences between techniques.
Topics: Humans; Bone Wires; Bone Screws; Arthrodesis; Joint Diseases; Finger Joint
PubMed: 33682483
DOI: 10.1177/1558944721998019 -
PloS One 2014Transforaminal lumbar interbody fusion (TLIF) has become one of the most widely used procedures for lumbar spinal disorders. However, it is still unclear whether TLIF... (Comparative Study)
Comparative Study Meta-Analysis Review
BACKGROUND
Transforaminal lumbar interbody fusion (TLIF) has become one of the most widely used procedures for lumbar spinal disorders. However, it is still unclear whether TLIF with unilateral pedicle screw (PS) fixation is as effective as that with bilateral PS fixation. We performed a meta-analysis of the literatures and aimed to gain a better understanding of whether TLIF with unilateral PS fixation was safe and effective for lumbar diseases.
METHODOLOGY/PRINCIPAL FINDINGS
We systematically searched Ovid, Springer, and Medline databases for relevant randomized controlled trials (RCTs) that compared the clinical and radiological outcomes of unilateral versus bilateral PS fixation in TLIF. Risk of bias in included studies was assessed using the Cochrane Risk of Bias tool. We generated pooled risk ratios or weighted mean differences across studies. According to our predefined inclusion criteria, seven RCTs with a total of 441 patients were included in this study. Baseline characteristics were similar between the unilateral and bilateral groups. Our meta-analysis showed that no significant difference was detected between the two groups in terms of postoperative clinical function, fusion status, reoperation rate, complication rate, and hospital stay (p>0.05). Pooled estimates revealed that the unilateral group was associated with significantly reduced implant cost, operative time and blood loss (p<0.05).
CONCLUSIONS/SIGNIFICANCES
Our meta-analysis suggested TLIF with unilateral PS fixation was as safe and effective as that with bilateral PS fixation for lumbar diseases in selected patients. Despite these findings, our meta-analysis was based on studies with small sample size and different study characteristics that might lead to the inconsistent results such as various functional outcomes among the included studies. Therefore, high-quality randomized controlled trials with larger sample size are also needed to further clarify these issues and to provide the long-term outcomes.
Topics: Blood Loss, Surgical; Bone Screws; Humans; Lumbar Vertebrae; Randomized Controlled Trials as Topic; Risk; Spinal Diseases; Spinal Fusion; Treatment Outcome
PubMed: 24489929
DOI: 10.1371/journal.pone.0087501 -
Journal of Vascular Surgery Jun 2008Suprarenal fixation is widely used in endovascular aneurysm repair. Numerous small, underpowered studies have concluded that it does not increase the risk of renal... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Suprarenal fixation is widely used in endovascular aneurysm repair. Numerous small, underpowered studies have concluded that it does not increase the risk of renal impairment compared with infrarenal fixation. A recent meta-analysis demonstrated that renal infarction is more common with suprarenal fixation, but the effect on renal function remains unclear.
METHODS
Electronic abstract databases, article reference lists, and conference proceedings were searched for series reporting renal function data after suprarenal fixation. There was considerable study heterogeneity with respect to key factors such as pre-existing renal dysfunction and length of follow-up. Authors were contacted to obtain individual patient data for a pooled reanalysis using standardized criteria.
RESULTS
Of 46 potentially relevant citations, only 11 were eligible for inclusion in the meta-analysis. Complete data sets were available for four studies (1065 patients), with a median follow-up of 33 months. Kaplan-Meier curves were constructed for postoperative renal impairment in the suprarenal fixation and infrarenal fixation groups and compared by the log-rank test. Median time free of renal impairment was 38.5 months in the infrarenal fixation group compared with 32.4 months in the suprarenal fixation group (P = .0038). However, to account for significant methodologic differences, further analysis was required using a Weibull regression model fitted in open Bayesian inference using Gibbs sampling (BUGS). The pooled hazard ratio for deterioration of renal function after suprarenal fixation was 0.6 (95% confidence interval, 0.3-10).
CONCLUSION
Currently available data are insufficient to determine the precise effect of suprarenal fixation on medium-term renal function. Conventional Kaplan-Meier analysis of the pooled data set suggested that suprarenal fixation increased the risk of renal dysfunction; however, the effect disappeared when sophisticated statistical modelling was performed to account for study heterogeneity. A randomised controlled trial of suprarenal fixation may resolve this issue.
Topics: Aortic Aneurysm, Abdominal; Bayes Theorem; Blood Vessel Prosthesis; Blood Vessel Prosthesis Implantation; Evidence-Based Medicine; Humans; Kaplan-Meier Estimate; Kidney; Kidney Diseases; Risk Assessment; Time Factors; Treatment Outcome
PubMed: 18280095
DOI: 10.1016/j.jvs.2007.11.029 -
Craniomaxillofacial Trauma &... Sep 2021Systematic review and meta-analysis. (Review)
Review
Is the Use of Intermaxillary Fixation Screws an Alternative to Erich Arch Bars for Maxillomandibular Fixation During Management of Maxillofacial Fractures? A Systematic Review and Meta-Analysis.
STUDY DESIGN
Systematic review and meta-analysis.
OBJECTIVE
Maxillomandibular fixation (MMF) is a step of paramount importance during the management of maxillofacial trauma. Erich arch bars are being used for this purpose for decades but with advances in maxillofacial trauma management, intermaxillary fixation screws came into existence and are being used routinely. The present study was designed to identify if the intermaxillary fixation screws are really an alternative to Erich arch bars for management of maxillofacial trauma.
METHODOLOGY
An exhaustive literature search was conducted in May 2020 on various electronic databases and studies comparing Erich arch bars and intermaxillary fixation screws were recruited for the analysis. Random-effects model with Mantel Haenszel statistics was used to analyze oral hygiene and duration of achieving MMF.
RESULTS
A total of 96 studies were identified, out of which 8 studies were included in the meta-analysis. There was no statistically significant difference in oral hygiene status of the patients in both the groups. Intermaxillary fixations screws required statistically significantly less time in achieving MMF. Needle stick injury was prominently seen with the use of Erich arch bar whereas other complications like mucosal coverage, root injury, screw loosening and screw fracture makes the use of intermaxillary fixation screws questionable.
CONCLUSION
The present meta-analysis suggests that there is not enough evidence to recommend the use of intermaxillary fixation screws as an alternative to Erich arch bars. Further research with large sample size, high quality evidence and better methodology is recommended in this direction.
PubMed: 34471480
DOI: 10.1177/1943387520971410 -
Current Reviews in Musculoskeletal... Dec 2019The purpose of this systematic review was to assess the outcomes and complications of described cartilage restoration techniques for cartilage defects (grades I to IV)... (Review)
Review
PURPOSE OF REVIEW
The purpose of this systematic review was to assess the outcomes and complications of described cartilage restoration techniques for cartilage defects (grades I to IV) in the adolescent knee.
RECENT FINDINGS
Eleven studies satisfied the inclusion criteria comprising 307 patients with a mean follow-up of 4.6 years (range 1-18.9 years). Study patients were treated with autologous chondrocyte implantation (ACI) (n = 98, mean age 16.0), microfracture (MFx) (n = 36, mean age 15.4), internal fixation (n = 71, mean age 13.1), osteochondral allograft (OCA) transplantation (n = 78, mean age 16.4), and cartillage and excision (n = 24; mean age 14.2). ACI, MFx, OCA transplantation, and internal fixation showed significant improvement in knee functionality scores. The overall complication rate was 10.6% (n = 31). OCA transplantation had the highest complication rate (26.9%; n = 21/78). In summary, our review shows that ACI was the most commonly used technique. Furthermore, ACI, MFx, OCA transplantation, and internal fixation show the most promise in treating the adolescent population due to positive postoperative functional outcomes and low complication rates. However, future studies with large sample sizes, standardized outcome documentation, and long-term follow-up are required to confirm these preliminary results.
PubMed: 31773480
DOI: 10.1007/s12178-019-09595-x -
Consciousness and Cognition Mar 2023Strange face illusions describe a range of visual apparitions that occur when an observer gazes at their image reflected in a mirror or at another person's face in a... (Review)
Review
BACKGROUND
Strange face illusions describe a range of visual apparitions that occur when an observer gazes at their image reflected in a mirror or at another person's face in a dimly lit room. The illusory effects range from mild alterations in colour, or contrast, to the perception of distorted facial features, or new strange faces.The current review critically evaluates studies investigating strange face illusions, their methodological quality, and existing interpretations.
METHOD
Searches conducted using Scopus, PubMed, ScienceDirect and the grey literature until June 2022 identified 21 studies (N = 1,132; healthy participants n = 1,042; clinical participants n = 90) meeting the inclusion criteria (i.e., providing new empirical evidence relating to strange face illusions). The total sample had a mean age of 28.3 years (SD = 10.31) and two thirds (67 %) of participants tested to date are female. Results are reported using the Preferred Reporting Items for Systematic Reviews and meta-Analyses (PRISMA) guidelines. The review was preregistered at the Open Science Framework (OSF: https://osf.io/ek48d).
RESULTS
Pooling data across studies, illusory new strange faces are experienced by 58% (95%CI 48 to 68) of nonclinical participants. Study quality as assessed by the Appraisal Tool for Cross-Sectional Studies (AXIS) revealed that 3/21 (14.28%) studies were rated as high, 9/21 (42.86%) as moderate and 9/21 (42.86%) as low quality. Whilst the items relating specifically to reporting quality scored quite highly, those relating to study design and possible biases were lower and more variable. Overall, study quality accounted for 87% of the variance in reporting rates for strange faces, with higher quality being associated with lower illusion rates. The prevalence of illusions was also significantly greater in samples that were older, had higher proportions of female participants and for the interpersonal dyad (IGDT) compared to the mirror gaze paradigm (MGT). The moderating impact of study quality persisted in a multiple meta-regression involving participant age, paradigm type (IGDT vs MGT) and level of feature distortion. Our review point to the importance of reduced light levels, face stimuli and prolonged eye fixation for strange face illusions to emerge.
CONCLUSION
Strange face illusions reliably occur in both mirror-gazing and interpersonal gazing dyad paradigms. Further research of higher quality is required to establish the prevalence and particularly, the mechanisms underpinning strange face illusions.
Topics: Humans; Female; Adult; Male; Illusions; Cross-Sectional Studies; Face; Fixation, Ocular; Dissociative Disorders
PubMed: 36764163
DOI: 10.1016/j.concog.2023.103480 -
Orthopaedic Journal of Sports Medicine Apr 2021Compared with extracortical suspensory fixation, the close-to-joint transcondylar cross-pin fixation method in anterior cruciate ligament reconstruction (ACLR) is... (Review)
Review
BACKGROUND
Compared with extracortical suspensory fixation, the close-to-joint transcondylar cross-pin fixation method in anterior cruciate ligament reconstruction (ACLR) is believed to entail less intratunnel graft motion and subsequently lead to less tunnel widening.
PURPOSE
To assess femoral tunnel widening via the transcondylar cross-pin method or the suspensory femoral fixation method in patients who had undergone ACLR.
STUDY DESIGN
Systematic review; Level of evidence, 4.
METHODS
This review focused on studies on femoral-tunnel widening after single-bundle ACLR with cross-pin (Rigidfix or Transfix) and/or Endobutton closed loop (CL). Two reviewers independently recorded data from each study, including the sample size and magnitude of tunnel widening after ACLR.
RESULTS
Overall, 19 studies were included in this meta-analysis. There was no significant difference between cross-pin and Endobutton CL fixations in the pooled absolute change in tunnel widening from the immediate postoperative period to the final follow-up; this was true at both the tunnel aperture (2.48 mm [95% CI, 1.76-3.2 mm] vs 2.93 mm [95% CI, 1.73-4.13 mm], respectively; = .527) and the midpoint of the femoral tunnel (2.43 mm [95% CI, 1.77-3.1 mm] vs 2.54 mm [95% CI, -0.33 to 5.42 mm], respectively; = .937). No significant difference was found in the relative percentage of femoral-tunnel widening between the 2 fixation methods (cross-pin, 43.3% [95% CI, 25.8%-60.8%] vs Endobutton CL, 42.0% [95% CI, 34.1%-49.9%]; = .965).
CONCLUSION
No significant difference in femoral tunnel widening was found to be associated with the use of either cross-pin or extracortical suspensory fixation in patients who underwent single-bundle ACLR.
PubMed: 33869645
DOI: 10.1177/2325967121993811 -
Journal of ISAKOS : Joint Disorders &... Dec 2023Lisfranc injuries remain a significant, but often misdiagnosed, orthopaedic injury. Alongside the traditional methods of surgical fixation, including arthrodesis and... (Review)
Review
IMPORTANCE
Lisfranc injuries remain a significant, but often misdiagnosed, orthopaedic injury. Alongside the traditional methods of surgical fixation, including arthrodesis and open reduction and internal fixation with screws, suture button fixation is an emerging technique.
OBJECTIVES
The purpose of this study is to investigate the efficacy of suture button fixation for treatment of Lisfranc injuries through a systematic review.
EVIDENCE REVIEW
A comprehensive literature review was conducted according to the preferred reporting items for systematic reviews using PubMed, Embase, Web of Science, and Cochrane databases for original, English-language studies observing outcomes of Lisfranc injury until August 19, 2022. The clinical studies with evidence level I-IV and at least a 12 month follow-up after the index surgery were included if they examined quantifiable outcomes of Lisfranc injury treated with suture button. Articles were excluded if they included case reports, systematic reviews, comments, editorials, surveys, animal studies, or biomechanical/cadaveric studies. Variables extracted from text and figures include demographic information, return to sport measures, patient reported outcomes, and complications.
FINDINGS
Of the 10 studies included, there were 186 total patients with an age range of 13-72. In every study, all patients were able to return to sport or activity with a return time averaging from 10.8 to 25.9 weeks. Postoperative American Orthopaedic Foot and Ankle Society scores ranged from 83.5 to 97.0 while pain Visual Analogue Scale ranged from 0.6 to 2.5. Complications were reported in four studies at a rate of 7.7% including two cases of diastasis, two cases of paraesthesia, one case of button irritation, and one of postoperative degenerative joint disease, with no reported revisions.
CONCLUSIONS AND RELEVANCE
In our systematic review, suture button fixation shows high levels of patient reported outcomes, return to sport, and stable fixation in isolated Lisfranc injuries. This surgical technique provides a physiologic reduction across the Lisfranc joint and reduces the need for reoperation including removal of hardware. However, further evidence such as large sample size high-quality randomized controlled trials is needed to draw a definitive conclusion regarding the best treatment for Lisfranc injuries.
LEVEL OF EVIDENCE
Level IV, Systematic Review of Level III and IV studies.
Topics: Humans; Return to Sport; Fracture Fixation, Internal; Fractures, Bone; Patient Reported Outcome Measures; Sutures
PubMed: 37611870
DOI: 10.1016/j.jisako.2023.08.004