Von Meyenburg Complexes and Malignancy: A Systematic Review

Von Meyenburg Complexes (VMC) are benign lesions secondary to ductal plate malformations. These are relatively rare in adults and are often asymptomatic, with many lesions being diagnosed on imaging. Despite these benign characteristics, VMC have the potential to undergo malignant changes leading to conditions such as cholangiocarcinoma and other cancers. The objective of the review is to report and analyze the cases of biliary hamartomas which were associated with malignancy. We performed a structured systematic review of literature and identified 31 cases of biliary duct hamartomas associated with malignancy. The mean age at onset was 61 years +/- 13 (min 19 to max 88) with the majority of the patients being male (64.5%). Of all cases, 41.9% reported symptoms (13/31 cases) with the most common symptom being abdominal pain (32.3%). Biopsies reported malignancy in 77.4% of cases (24/31 cases) with the most common reported associated malignancy being cholangiocarcinoma 54.8% (17/31). 93.3% of the cases underwent surgical intervention (28/30 cases). VMC are an important entity with malignancy potential which is under-reported. Presence of red flag symptoms such as weight loss and obstructive jaundice in patients with diagnosed biliary hamartomas should prompt an evaluation for malignancy. Key-words: Von meyenburg complexes; cholangiocarcinoma; malignancy; biliary hamartomas

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The efficacy of placebo for the treatment of cancer-related fatigue: A systematic review and meta-analysis.

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.15_suppl.e23157 ◽

2019 ◽

Vol 37 (15_suppl) ◽

pp. e23157-e23157

Author(s):

Carmelia Maria Noia Barreto ◽

Pedro Nazareth Aguiar ◽

Daniel de Iracema Gomes Cubero ◽

Auro Del Giglio

Keyword(s):

Systematic Review ◽

Clinical Trials ◽

Response Rate ◽

Meta Analysis ◽

Common Symptom ◽

Future Studies ◽

Patients With Cancer ◽

Cancer Related Fatigue ◽

Brief Fatigue Inventory ◽

The Mean

e23157 Background: Cancer-related fatigue (CRF) is a common symptom among patients with cancer. The efficacy of placebo, however, was never the main objective of any meta-analysis. Predicting the efficacy of placebo may facilitate researchers in designing future clinical trials for the treatment of CRF. Methods: We performed a systematic review searching for prospective clinical trials comparing any treatment versus placebo for the treatment of CRF. We included studies that enrolled patients with any primary site of neoplasia and any stage of cancer. We excluded all studies that assessed fatigue related to any treatment. The primary endpoint of this study is the mean effect of placebo on fatigue according to the Functional Assessment of Chronic Illness (FACIT-F) and Brief Fatigue Inventory (BFI) scales. The secondary endpoint was the proportion of patients who reported improvement in fatigue (response rate). Results: We found 520 studies, and 29 studies with 3,758 participants were included in the meta-analysis. Placebo had a mean effect of +4.88 (95%CI +2.45 to +7.29) using the FACIT-F scale, although it was statistically worse than the interventions studied (p = 0.005). Using the BFI scale, placebo had an average effect of +0.64 (95%CI +0.02 to +1.30), although it was also worse than the other interventions studied (p = 0.002). In terms of the response rate, 29% (95%CI 25%–32%) of patients taking a placebo reported a significant improvement in CRF compared to 36% of patients treated with other interventions (p = 0.030). Conclusions: Placebo treatments had a significant effect on CRF, and predicting these effects may help design future studies for CRF.

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INTERVENTION OF THIRSTY IN CONGESTIVE HEART FAILURE (CHF) PATIENTS TO INCREASED ADHERENCE OF FLUID RESTRICTION: A SYSTEMATIC REVIEW

Nurscope Jurnal Penelitian dan Pemikiran Ilmiah Keperawatan ◽

10.30659/nurscope.3.1.7-18 ◽

2017 ◽

Vol 3 (1) ◽

pp. 7

Author(s):

DIAN HUDIYAWATI

Keyword(s):

Heart Failure ◽

Systematic Review ◽

Congestive Heart Failure ◽

Intervention Studies ◽

Cold Water ◽

Fluid Restriction ◽

Common Symptom ◽

Oral Swab ◽

Hand Search ◽

Effective Interventions

Introduction. Thirst is a common symptom of chronic heart failure (CHF) patients. Difficulties to adherence with fluid restrictions are among the effects of thirst in HF patients and therefore have an impact on worsening condition, but intervention studies aimed specifically at reducing thirst in CHF are lacking.Purpose. Purpose of this manuscript is to assess the effective intervention to reduce thirst intensity in CHF patients.Methods. Medline, Pubmed, EBSCO and hand search were searched using the key words thirst, intervention, heart failure, CHF, fluis restriction, therapy.Result.� Eighteen articles were found, six studies were inluded. Any kind of interventions in each articles, include: drink cold water 5oC, chewing gum, saliva substitute, sucking ice cubes and three bundle of interventions (oral swab, water sprays and menthol moisturizer).Conclusions. The most effective interventions to alleviate thirst was sucking ice cubes. But, no intervention studies were found in congestive heart failure patients. So investigations in people with heart failure is needed.�Keywords: thirst, intervention, heart failure, systematic review

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Outcomes of Oblique Lateral Interbody Fusion for Adult Spinal Deformity: A Systematic Review and Meta-Analysis

Global Spine Journal ◽

10.1177/2192568220979145 ◽

2021 ◽

pp. 219256822097914

Author(s):

Lei Zhu ◽

Jun-Wu Wang ◽

Liang Zhang ◽

Xin-Min Feng

Keyword(s):

Systematic Review ◽

Lumbar Lordosis ◽

Interbody Fusion ◽

Perioperative Complications ◽

Adult Spinal Deformity ◽

Meta Analysis ◽

Fusion Rate ◽

The Mean ◽

Oblique Lateral Interbody Fusion ◽

Lateral Interbody

Study Design: A systematic review and meta-analysis. Objectives: To evaluate clinical and radiographic outcomes, and perioperative complications of oblique lateral interbody fusion (OLIF) for adult spinal deformity (ASD). Methods: We performed a systematic review and meta-analysis of related studies reporting outcomes of OLIF for ASD. The clinical outcomes were assessed by visual analogue scale (VAS) and Oswestry Disability Index (ODI). The radiographic parameters were evaluated by sagittal vertical axis (SVA), pelvic tilt (PT), sacral slope (SS), thoracic kyphosis (TK), lumbar lordosis (LL), pelvic incidence-lumbar lordosis (PI-LL), Cobb angle and fusion rate. A random effects model and 95% confidence intervals (CI) were performed to investigate the results. Results: A total of 16 studies involving 519 patients were included in the present study. The mean difference of VAS-back score, VAS-leg score and ODI score before and after surgery was 5.1, 5.0 and 32.3 respectively. The mean correction of LL was 20.6°, with an average of 6.9° per level and the mean correction of Cobb was 16.4°, with an average of 4.7° per level. The mean correction of SVA, PT, SS, TK and PI-LL was 59.3 mm, 11.7°, 6.9°, 9.4° and 20.6° respectively. The mean fusion rate was 94.1%. The incidence of intraoperative and postoperative complications was 4.9% and 29.6% respectively. Conclusions: OLIF is an effective and safe surgery method in the treatment of mild or moderate ASD and it has advantages in less intraoperative blood loss and lower perioperative complications.

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Pancreas-Preserving Total Duodenectomy: A Systematic Review

Digestive Surgery ◽

10.1159/000515718 ◽

2021 ◽

pp. 1-12

Author(s):

Miguel Cantalejo-Díaz ◽

José Manuel Ramia-Ángel ◽

Ana Palomares-Cano ◽

Mario Serradilla-Martín

Keyword(s):

Systematic Review ◽

Postoperative Morbidity ◽

Operating Time ◽

Pancreatic Head ◽

Cochrane Library ◽

Morbidity Rate ◽

Intraoperative Bleeding ◽

Risks And Benefits ◽

Duodenal Lesions ◽

The Mean

Background: The management of the pancreas in patients with duodenal trauma or duodenal tumors remains a controversial issue. Pancreas-preserving total duodenectomy (PPTD) requires a meticulous surgical technique. The most common indication is familial duodenal adenomatous polyposis (FAP). The aims of this study are to carry out a systematic review of the literature on the indications for PPTD and to highlight the risks and benefits compared with other more aggressive procedures. Summary: A systematic literature review was performed following PRISMA recommendations of studies published in PubMed, Embase, and Cochrane library until May 2019. Thirty articles describing 211 patients were chosen. The mean age was 48 years. The surgical indication in 75% of patients was FAP. The mean operating time was 329 min and mean intraoperative bleeding 412 mL. Postoperative morbidity rate was 49.7% (76% Clavien-Dindo <IIIa), and mortality rate was 1.4%. The mean hospital stay was 22 days. Overall survival at 1–3–5 years was >97.8%. Key Messages: PPTD is indicated for patients with benign and premalignant duodenal lesions without involvement of the pancreatic head. It is a feasible procedure offering an alternative to other more aggressive procedures in selected patients. Mortality is below 1.5%.

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Natural history and treatment options of radiation-induced brain cavernomas: a systematic review

Neurosurgical Review ◽

10.1007/s10143-021-01598-y ◽

2021 ◽

Author(s):

Gildas Patet ◽

Andrea Bartoli ◽

Torstein R. Meling

Keyword(s):

Systematic Review ◽

Natural History ◽

Radiation Treatment ◽

Neurological Deficits ◽

Cochrane Library ◽

Average Dose ◽

Cavernous Malformations ◽

Radiation Induced ◽

The Mean

AbstractRadiation-induced cavernous malformations (RICMs) are delayed complications of brain irradiation during childhood. Its natural history is largely unknown and its incidence may be underestimated as RCIMS tend to develop several years following radiation. No clear consensus exists regarding the long-term follow-up or treatment. A systematic review of Embase, Cochrane Library, PubMed, Google Scholar, and Web of Science databases, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, was performed. Based on our inclusion/exclusion criteria, 12 articles were included, totaling 113 children with RICMs, 86 were treated conservatively, and 27 with microsurgery. We were unable to precisely define the incidence and natural history from this data. The mean age at radiation treatment was 7.3 years, with a slight male predominance (54%) and an average dose of 50.0 Gy. The mean time to detection of RICM was 9.2 years after radiation. RICM often developed at distance from the primary lesion, more specifically frontal (35%) and temporal lobe (34%). On average, 2.6 RICMs were discovered per child. Sixty-seven percent were asymptomatic. Twenty-one percent presented signs of hemorrhage. Clinical outcome was favorable in all children except in 2. Follow-up data were lacking in most of the studies. RICM is most often asymptomatic but probably an underestimated complication of cerebral irradiation in the pediatric population. Based on the radiological development of RICMs, many authors suggest a follow-up of at least 15 years. Studies suggest observation for asymptomatic lesions, while surgery is reserved for symptomatic growth, hemorrhage, or focal neurological deficits.

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Noise in Otolaryngology – Head and Neck Surgery operating rooms: a systematic review

Journal of Otolaryngology - Head and Neck Surgery ◽

10.1186/s40463-020-00487-6 ◽

2021 ◽

Vol 50 (1) ◽

Author(s):

Gianluca Sampieri ◽

Amirpouyan Namavarian ◽

Marc Levin ◽

Justine Philteos ◽

Jong Wook Lee ◽

...

Keyword(s):

Systematic Review ◽

Head And Neck ◽

Patient Outcomes ◽

Noise Level ◽

Neck Surgery ◽

Operating Rooms ◽

Head And Neck Surgery ◽

Noise Levels ◽

Surgical Performance ◽

The Mean

Abstract Objective Noise in operating rooms (OR) can have negative effects on both patients and surgical care workers. Noise can also impact surgical performance, team communication, and patient outcomes. Such implications of noise have been studied in orthopedics, neurosurgery, and urology. High noise levels have also been demonstrated in Otolaryngology-Head and Neck Surgery (OHNS) procedures. Despite this, no previous study has amalgamated the data on noise across all OHNS ORs to determine how much noise is present during OHNS surgeries. This study aims to review all the literature on noise associated with OHNS ORs and procedures. Methods Ovid Medline, EMBASE Classic, Pubmed, SCOPUS and Cochrane databases were searched following PRISMA guidelines. Data was collected on noise measurement location and surgery type. Descriptive results and statistical analysis were completed using Stata. Results This search identified 2914 articles. Final inclusion consisted of 22 studies. The majority of articles analyzed noise level exposures during mastoid surgery (18/22, 82%). The maximum noise level across all OHNS ORs and OHNS cadaver studies were 95.5 a-weighted decibels (dBA) and 106.6 c-weighted decibels (dBC), respectively (P = 0.2068). The mean noise level across all studies was significantly higher in OHNS cadaver labs (96.9 dBA) compared to OHNS ORs (70.1 dBA) (P = 0.0038). When analyzed together, the mean noise levels were 84.9 dBA. Conclusions This systematic review demonstrates that noise exposure in OHNS surgery exceeds safety thresholds. Further research is needed to understand how noise may affect team communication, surgical performance and patient outcomes in OHNS ORs. Graphical abstract

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COVID-19 in People Living with HIV: A Systematic Review and Meta-Analysis

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18073554 ◽

2021 ◽

Vol 18 (7) ◽

pp. 3554

Author(s):

Kai Wei Lee ◽

Sook Fan Yap ◽

Yun Fong Ngeow ◽

Munn Sann Lye

Keyword(s):

Systematic Review ◽

Laboratory Testing ◽

Meta Analysis ◽

Clinical Signs ◽

Adverse Outcomes ◽

People Living With Hiv ◽

Common Symptom ◽

Chest Imaging ◽

Wide Range ◽

Epidemiological Characteristics

COVID-19 is a global health emergency. People living with human immunodeficiency virus (PLHIV) have concerns about whether they have a higher risk of getting the infection and suffer worse COVID-19 outcomes. Findings from studies on these questions have largely been inconsistent. We aimed to determine the epidemiological characteristics, clinical signs and symptoms, blood parameters, and clinical outcomes among PLHIV who contracted COVID-19. Relevant studies were identified through Medline, Cinahl, and PubMed databases. A random-effects model was used in meta-analyses with a 95% confidence interval. Eighty-two studies were included in the systematic review and sixty-seven studies for the meta-analysis. The pooled incidence proportion of COVID-19 among PLHIV was 0.9% (95% CI 0.6%, 1.1%) based on the data from seven cohort studies. Overall, 28.4% were hospitalised, of whom, 2.5% was severe-critical cases and 3.5% needed intensive care. The overall mortality rate was 5.3%. Hypertension was the most commonly reported comorbidity (24.0%). Fever (71.1%) was the most common symptom. Chest imaging demonstrated a wide range of abnormal findings encompassing common changes such as ground glass opacities and consolidation as well as a spectrum of less common abnormalities. Laboratory testing of inflammation markers showed that C-reactive protein, ferritin, and interleukin-6 were frequently elevated, albeit to different extents. Clinical features as well as the results of chest imaging and laboratory testing were similar in highly active antiretroviral therapy (HAART)-treated and non-treated patients. PLHIV were not found to be at higher risk for adverse outcomes of COVID-19. Hence, in COVID-19 management, it appears that they can be treated the same way as HIV negative individuals. Nevertheless, as the pandemic situation is rapidly evolving, more evidence may be needed to arrive at definitive recommendations.

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The analgesic efficacy of liposomal bupivacaine compared with bupivacaine hydrochloride for the prevention of postoperative pain: a systematic review and meta-analysis with trial sequential analysis

Regional Anesthesia and Pain Medicine ◽

10.1136/rapm-2020-102427 ◽

2021 ◽

pp. rapm-2020-102427

Author(s):

Hanns-Christian Dinges ◽

Thomas Wiesmann ◽

Berit Otremba ◽

Hinnerk Wulf ◽

Leopold H Eberhart ◽

...

Keyword(s):

Systematic Review ◽

Postoperative Pain ◽

Pain Score ◽

Meta Analysis ◽

End Points ◽

Liposomal Bupivacaine ◽

Bupivacaine Hydrochloride ◽

Pain Scores ◽

Score Difference ◽

The Mean

Background/ImportanceLiposomal bupivacaine (LB) is a prolonged release formulation of conventional bupivacaine designed for prolonging local or peripheral regional single injection anesthesia. To this day, the benefit of the new substance on relevant end points is discussed controversial.ObjectiveThe objective was to determine whether there is a difference in postoperative pain scores and morphine consumption between patients treated with LB and bupivacaine hydrochloride in a systematic review and meta-analysis.Evidence reviewRandomized controlled trials (RCT) were identified in Embase, CENTRAL, MEDLINE and Web of Science up to May 2020. Risk of bias was assessed using Cochrane methodology. Primary end points were the mean pain score difference and the relative morphine equivalent (MEQ) consumption expressed as the ratio of means (ROM) 24 and 72 hours postoperatively.Findings23 RCTs including 1867 patients were eligible for meta-analysis. The mean pain score difference at 24 hours postoperatively was significantly lower in the LB group, at −0.37 (95% CI −0.56 to −0.19). The relative MEQ consumption after 24 hours was also significantly lower in the LB group, at 0.85 (0.82 to 0.89). At 72 hours, the pain score difference was not significant at −0.25 (−0.71 to 0.20) and the MEQ ratio was 0.85 (0.77 to 0.95).ConclusionThe beneficial effect on pain scores and opioid consumption was small but not clinically relevant, despite statistical significance. The effect was stable among all studies, indicating that it is independent of the application modality.

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Sporting participation following the operative management of chondral defects of the knee at mid-term follow up: a systematic review and meta-analysis

Journal of Experimental Orthopaedics ◽

10.1186/s40634-020-00295-x ◽

2020 ◽

Vol 7 (1) ◽

Author(s):

P. G. Robinson ◽

T. Williamson ◽

I. R. Murray ◽

K. Al-Hourani ◽

T. O. White

Keyword(s):

Systematic Review ◽

Autologous Chondrocyte Implantation ◽

Platelet Rich Plasma ◽

Meta Analysis ◽

Osteochondral Allograft ◽

Chondral Defects ◽

Chondrocyte Implantation ◽

The Mean ◽

Autologous Chondrocyte

Abstract Purpose The purpose of this study was to perform a systematic review of the reparticipation in sport at mid-term follow up in athletes who underwent biologic treatment of chondral defects in the knee and compare the rates amongst different biologic procedures. Methods A search of PubMed/Medline and Embase was performed in May 2020 in keeping with Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. The criteria for inclusion were observational, published research articles studying the outcomes and rates of participation in sport following biologic treatments of the knee with a minimum mean/median follow up of 5 years. Interventions included microfracture, osteochondral autograft transfer (OAT), autologous chondrocyte implantation (ACI), matrix-induced autologous chondrocyte implantation (MACI), osteochondral allograft, or platelet rich plasma (PRP) and peripheral blood stem cells (PBSC). A random effects model of head-to-head evidence was used to determine rates of sporting participation following each intervention. Results There were twenty-nine studies which met the inclusion criteria with a total of 1276 patients (67% male, 33% female). The mean age was 32.8 years (13–69, SD 5.7) and the mean follow up was 89 months (SD 42.4). The number of studies reporting OAT was 8 (27.6%), ACI was 6 (20.7%), MACI was 7 (24.1%), microfracture was 5 (17.2%), osteochondral allograft was 4 (13.8%), and one study (3.4%) reported on PRP and PBSC. The overall return to any level of sport was 80%, with 58.6% returning to preinjury levels. PRP and PBSC (100%) and OAT (84.4%) had the highest rates of sporting participation, followed by allograft (83.9%) and ACI (80.7%). The lowest rates of participation were seen following MACI (74%) and microfracture (64.2%). Conclusions High rates of re-participation in sport are sustained for at least 5 years following biologic intervention for chondral injuries in the knee. Where possible, OAT should be considered as the treatment of choice when prolonged participation in sport is a priority for patients. However, MACI may achieve the highest probability of returning to the same pre-injury sporting level. Level of evidence IV

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A Systematic Review of the Omohyoid Muscle Syndrome (OMS): Clinical Presentation, Diagnosis, and Treatment Options

Annals of Otology Rhinology & Laryngology ◽

10.1177/0003489421995037 ◽

2021 ◽

pp. 000348942199503

Author(s):

Jerome Zhiyi Ong ◽

Alex Chengyao Tham ◽

Jian Li Tan

Keyword(s):

Systematic Review ◽

Botulinum Toxin ◽

Traumatic Event ◽

Botulinum Toxin Injection ◽

Treatment Options ◽

Neck Mass ◽

Good Prognosis ◽

Common Symptom ◽

Management Options ◽

Omohyoid Muscle

Objective: Omohyoid muscle syndrome (OMS) is a condition that causes a X-shaped lateral neck lump on swallowing, caused by the failure of the central tendon of the omohyoid muscle to restrict movement of the muscle during swallowing. We aim to review the etiology, pathophysiology, diagnostic tests, and management options for this condition. Data Sources: Pubmed, MEDLINE, EMBASE, and Cochrane databases were searched for all articles and abstracts related to OMS up to 29th July 2020. Review Methods: A systematic review was performed, data extracted from relevant full text articles. Both quantitative data and qualitative data were analyzed. Results: Twenty cases of OMS were reported. Patients presented at a mean age of 36.0. All cases were Asian. There is a 7:3 ratio of males to females. The most common symptom was a transient neck mass. Most cases were managed conservatively with good prognosis. Open or endoscopic transection of the muscle and ultrasound-guided botulinum toxin injection were 3 treatment options, with no recurrence at 4 years, 6 months, and 6 months respectively. Conclusion: OMS could be genetic as all cases were Asian in ethnicity. The deep cervical fascia which usually envelopes the omohyoid muscle may be weakened by stress as 20% of cases had a preceding traumatic event. Real-time ultrasonography establishes the diagnosis, demonstrating the anterolateral displacement of the sternocleidomastoid muscle by a thickened omohyoid muscle during swallowing. Surgical transection can achieve cure, but due to limited studies available, they should be reserved for patients who are extremely bothered. Intramuscular injection of botulinum toxin is an effective alternative, but recurrence is expected.

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