A SYSTEMATIC REVIEW OF COMPLICATIONS AND RECURRENCE RATE OF ARTHROSCOPIC RESECTION OF VOLAR WRIST GANGLION

Hand Surgery ◽  
2014 ◽  
Vol 19 (03) ◽  
pp. 475-480 ◽  
Author(s):  
Carlos Henrique Fernandes ◽  
Cesar Dario Oliveira Miranda ◽  
João Baptista Gomes dos Santos ◽  
Flavio Faloppa
Keyword(s):  
Systematic Review ◽  
Recurrence Rate ◽  
Operative Procedure ◽  
Arthroscopic Surgery ◽  
Surgical Techniques ◽  
Inclusion Criteria ◽  
Recurrence Rates ◽  
Level I ◽  
English Articles ◽  
Midcarpal Joint

The purpose of this systematic review is to determine the incidence of complications and the recurrence rate of a volar wrist ganglion following arthroscopic resection. We performed a systematic review of English and non-English articles using Google Scholar, Medline, and Web of Knowledge. Articles were screened for study inclusion by three independent reviewers using the terms "arthroscopic treatment of volar wrist ganglion" and "arthroscopic resection of volar wrist ganglion". Inclusion criteria: (1) level I–V evidence, (2) documentation of the number of wrists subjected to surgery, (3) documentation of surgical techniques used on wrists, and (4) documentation of surgical or post-surgical complications and recurrence rate of a volar wrist ganglion after arthroscopic resection. A complication was defined as an adverse outcome that was directly related to the operative procedure. Between 2001 and 2012, 13 articles met the inclusion criteria. Two articles were excluded and 11 were reviewed. A total of 232 wrists underwent arthroscopic surgery with 14 recurrences. The recurrence rate ranged from 0 to 20%, with mean of 6.03%. There were 16 (6.89%) complications. There was no connection with the ganglion in six wrists, three haematomas, three cases of neuropraxia of the dorsal radial nerve, two partial lesions of the median nerve, and two lesions of a branch of the radial artery. Patients did not have a decrease in the arc range of motion. Treatment of volar ganglia of the midcarpal joint was technically difficult and associated with a higher number of complications. In general, arthroscopic resection results in fewer complications and lower recurrence rates than an open surgical approach, but there is no clear evidence of such an advantage for arthroscopic resection of a volar wrist ganglion. Additional prospective, controlled clinical trials will be essential to address this important issue.

Recurrence Rate of Lumbar Disc Herniation After Standard Discectomy and Microdiscectomy: A 5-Year Study

2019 ◽  
Vol 12 (2) ◽  
pp. 139-146
Author(s):  
Mladen E. Ovcharov ◽  
Iliya V. Valkov ◽  
Milan N. Mladenovski ◽  
Nikolay V. Vasilev
Keyword(s):  
Recurrence Rate ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Surgical Techniques ◽  
Reoperation Rate ◽  
University Hospital ◽  
Recurrence Rates ◽  
Chi Square ◽  
Common Procedure

Summary Lumbar disc herniation (LDH) is the most common pathology in young people, as well as people of active age. Despite sophisticated and new minimally invasive surgical techniques and approaches, reoperations for recurrent lumbar disc herniation (rLDH) could not be avoided. LDH recurrence rates, reported in different studies, range from 5 to 25%. The purpose of this study was to estimate the recurrence rates of LDH after standard discectomy (SD) and microdiscectomy (MD), and compare them to those reported in the literature. Retrospectively, operative reports for the period 2012-2017 were reviewed on LDH surgeries performed at the Neurosurgery Clinic of Dr Georgi Stranski University Hospital in Pleven. Five hundred eighty-nine single-level lumbar discectomies were performed by one neurosurgeon. The diagnoses of recurrent disc herniation were based on the development of new symptoms and magnetic resonance/computed tomography (MRI/CT) images showing compatible lesions in the same lumbar level as the primary lumbar discectomies. The recurrence rate was determined by using chi-square tests and directional measures. SD was the most common procedure (498 patients) followed by MD (91 patients). The cumulative reoperation rate for rLDH was 7.5%. From a total number of reoperations, 26 were males (59.1%) and 18 were females (40.9%). Reoperation rates were 7.6% and 6.6% after SD and MD respectively. The recurrence rate was not significantly higher for SD. Our recurrence rate was 7.5%, which makes it comparable with the rates of 5-25% reported in the literature.

Emotion Recognition Deficits in Psychiatric Disorders as a Target of Non-invasive Neuromodulation: A Systematic Review

2021 ◽  
pp. 155005942199168
Author(s):  
Yuji Yamada ◽  
Takuma Inagawa ◽  
Naotsugu Hirabayashi ◽  
Tomiki Sumiyoshi
Keyword(s):  
Systematic Review ◽  
Social Cognition ◽  
Emotion Recognition ◽  
Psychiatric Disorders ◽  
Parietal Lobe ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Inclusion Criteria ◽  
Cognitive Benefits ◽  
The Right ◽  
English Articles

Background. Social cognition deficits are a core feature of psychiatric disorders, such as schizophrenia and mood disorder, and deteriorate the functionality of patients. However, no definite strategy has been established to treat social cognition (eg, emotion recognition) impairments in these illnesses. Here, we provide a systematic review of the literature regarding transcranial direct current stimulation (tDCS) and repetitive transcranial magnetic stimulation (rTMS) for the treatment of social cognition deficits in individuals with psychiatric disorders. Methods. A literature search was conducted on English articles identified by PubMed, PsycINFO, and Web of Science databases, according to the guidelines of the PRISMA statement. We defined the inclusion criteria as follows: (1) randomized controlled trials (RCTs), (2) targeting patients with psychiatric disorders (included in F20-F39 of the 10th revision of the International Statistical Classification of Diseases and Related Health Problems [ICD-10]), (3) evaluating the effect of tDCS or rTMS, (4) reporting at least one standardized social cognition test. Results. Five papers (3 articles on tDCS and 2 articles on rTMS) met the inclusion criteria which deal with schizophrenia or depression. The significant effects of tDCS or rTMS targeting the left dorsolateral prefrontal cortex on the emotion recognition domain were reported in patients with schizophrenia or depression. In addition, rTMS on the right inferior parietal lobe was shown to ameliorate social perception impairments of schizophrenia. Conclusions. tDCS and rTMS may enhance some domains of social cognition in patients with psychiatric disorders. Further research is warranted to identify optimal parameters to maximize the cognitive benefits of these neuromodulation methods.

Abstract 16680: Endovascular Therapy of Svc Syndrome-a Systematic Review

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Abdul Hussain Azizi ◽  
Irfan Shafi ◽  
Matthew Zhao ◽  
Vladimir Lakhter ◽  
Riyaz Bashir
Keyword(s):  
Systematic Review ◽  
Success Rate ◽  
Recurrence Rate ◽  
Endovascular Therapy ◽  
Meta Analysis ◽  
Restenosis Rate ◽  
Technical Success ◽  
Recurrence Rates ◽  
Technical Success Rate ◽  
Svc Syndrome

Background: Superior vena cava (SVC) syndrome is caused by the occlusion of the SVC and can result in significant morbidity and mortality. Recently, endovascular therapy (ET) has become the standard of care for majority of these patients. We performed a systematic review of available literature to assess the contemporary technical success rate, restenosis rate, and recurrence rate of SVC syndrome following endovascular intervention. Methods: We searched PubMed, Cochrane Library, and Embase databases from 1988 to 2019 for studies on Endovascular Therapy for SVC syndrome. After screening 709 records, 13 studies were included. Screening was conducted using Rayyan QCRI software for systemic reviews. Studies included full-length journal articles on SVC syndrome and ET among adults (18+ years). Case reports, or case series with <20 patients were excluded. Data analysis was performed using OpenMeta software. Proportions and 95% confidence intervals (CIs) were calculated using random effects models. Heterogeneity among studies was assessed using Q and I 2 statistics. We evaluated the end-points of the technical success, restenosis rate and recurrence rates in SVC syndrome patients after endovascular stenting Results: A meta-analysis of 13 studies included a total of 1024 patients. The results of our meta-analysis show a weighted technical success rate of 98.6% (95% CI 0.97 – 0.99) (Fig. 1A), restenosis rate of 11.8% (95 CI 0.08-0.14) (Fig 1B) and recurrence rate of 9.9% (95% CI 0.06-0.13) (Fig 1C). Our studies had a substantial heterogeneity (I 2 ) of 52-80%. Figures:Figure 1A Figure 1B Figure 1C Conclusions: Our systematic review revealed high technical success rate, low restenosis, and recurrence rates after endovascular therapy supporting the paradigm of endovascular therapy as first line treatment for patients with SVC syndrome. Disclosures: Dr. Bashir has equity interest in Thrombolex Inc.

Anatomically Contoured Anterior Plating for Isolated Tibiotalar Arthrodesis: A Systematic Review

2017 ◽  
Vol 10 (4) ◽  
pp. 352-358 ◽  
Author(s):  
Nicholas Kusnezov ◽  
John C. Dunn ◽  
Logan R. Koehler ◽  
Justin D. Orr
Keyword(s):  
Systematic Review ◽  
Functional Outcomes ◽  
Surgical Techniques ◽  
Wound Complications ◽  
Posttraumatic Arthritis ◽  
Complication Rates ◽  
Inclusion Criteria ◽  
Tibiotalar Arthrodesis ◽  
Anterior Plating

Introduction. We performed a systematic review of the published literature to characterize patient demographic, surgical techniques, and functional outcomes to elucidate the complication and revision rates following isolated tibiotalar arthrodesis with anatomically contoured anterior plating. Methods. A comprehensive literature search was performed. Inclusion criteria were peer-reviewed studies in English, after 1990, at least 10 patients, and reporting clinical outcomes following contoured anterior plating and with follow-up of at least 80% and 1 year. Primary outcomes were fusion rate, time to fusion, return to activities, satisfaction, and functional outcome scores. Complication rates, reoperation, and revision were also extracted. Results. Eight primary studies with 164 patients met the inclusion criteria. The average sample size was 21 ± 10.0 patients and average age was 49.2 years with 61.6% male. Posttraumatic arthritis (49.4%) was the most common operative indication, followed by primary osteoarthrosis (18.9%). The average follow-up was 21.1 months. At this time, 97.6% of patients went on to uneventful union at a weighted average time of 18.7 weeks postoperatively. AOFAS scores improved significantly ( P < .05). 25% complication rate was reported with wound complication (7.9%) and hardware irritation (6.7%) most common. Overall, 21.3% of patients underwent reoperation; 4 for revision arthrodesis following nonunion. Conclusion. Isolated tibiotalar arthrodesis utilizing anatomically contoured anterior plating demonstrates excellent clinical and functional outcomes at short-term follow-up. Overall, 97.6% of patients went on to fusion and functional outcomes consistently improved following surgery. Furthermore, while one-quarter of patients experienced complications, wound complications were relatively uncommon and less than one-quarter of these required surgical intervention. Levels of Evidence: Level IV: Systematic Review

scholarly journals Recurrence Rates After Microvascular Decompression in Patients With Primary Trigeminal Neuralgia and Its Influencing Factors: A Systematic Review and Meta-Analysis Based on 8,172 Surgery Patients

2021 ◽  
Vol 12 ◽  
Author(s):  
Fangyu Chen ◽  
Yuming Niu ◽  
Fan Meng ◽  
Pan Xu ◽  
Chao Zhang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Trigeminal Neuralgia ◽  
Recurrence Rate ◽  
Influencing Factors ◽  
Microvascular Decompression ◽  
Meta Analysis ◽  
Postoperative Recurrence ◽  
Recurrence Rates ◽  
Primary Trigeminal Neuralgia

Background: Primary trigeminal neuralgia (PTN) is known to reoccur following microvascular decompression (MVD) surgery. However, the rates and contributing factors related to PTN recurrence remain controversial. The purpose of this study was to explore the postoperative recurrence rates and related influencing factors of patients with PTN after MVD. Additionally, recurrence rates after different treatments were compared to provide guidelines for clinicians.Methods: We conducted systematic reviews and meta-analyses in accordance with the preferred reporting items of the PRISMA guidelines. We searched nine databases, namely, the PubMed, EMBASE, Cochrane Library, Web of Science, CINAHL, CBM, CNKI, VIP, and Wanfang databases, from establishment to July 13, 2020, selecting for studies about the long-term postoperative efficacy of MVD in the treatment of PTN. Factors associated with higher recurrence rates after MVD and long-term postoperative results of other treatments underwent formal meta-analysis, where odds ratios (ORs) with the corresponding 95% confidence intervals (CIs) were calculated. The dose-response model was used to inspect the associations between several factors and higher recurrence rates.Results: Seventy-four studies (8,172 patients, 32 case series studies, and 42 non-randomized controlled trials) were analyzed in our research. Overall, 956 out of 8,172 patients relapsed, and the pooled recurrence rate was 0.096 (0.080–0.113). Influencing factors of relatively higher recurrence rates included atypical trigeminal neuralgia symptoms, lack of nerve groove, non-arterial compression, patients who were 50–60 years old, and longer disease duration. Dose–response analysis showed that the recurrence rate had a significant trend with the published year and the follow-up time. Simultaneously, the recurrence rate of MVD treatment was much lower than that of conventional drug treatment, gamma knife surgery, percutaneous balloon compression, and radiofrequency thermocoagulation. When the surgical technique was improved or combined with partial sensory rhizotomy (PSR), the postoperative recurrence rates were significantly reduced.Conclusions: Even for PTN patients who have a successful operation, ~10% of them will still relapse. This research identifies several factors that can affect the recurrence rate. Compared with other operations, MVD has a relatively lower recurrence rate. Our analysis suggests that improved surgical techniques and combining PSR and MVD will yield better results.Systematic Review Registration:https://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42020159276.

scholarly journals Prevalence and incidence of type 1 diabetes in the world: a systematic review and meta-analysis

2020 ◽  
Vol 10 (2) ◽  
pp. 98-115 ◽  
Author(s):  
Majid Mobasseri ◽  
Masoud Shirmohammadi ◽  
Tarlan Amiri ◽  
Nafiseh Vahed ◽  
Hossein Hosseini Fard ◽  
...  
Keyword(s):  
Systematic Review ◽  
Type 1 Diabetes ◽  
Web Of Science ◽  
Meta Analysis ◽  
Inclusion Criteria ◽  
Glucose Levels ◽  
The World ◽  
Multiple Levels ◽  
English Articles

Background: Diabetes is referred to a group of diseases characterized by high glucose levels in blood. It is caused by a deficiency in the production or function of insulin or both, which can occur because of different reasons, resulting in protein and lipid metabolic disorders. The aim of this study was to systematically review the prevalence and incidence of type 1 diabetes in the world. Methods: A systematic search of resources was conducted to investigate the prevalence and incidence of type 1 diabetes in the world. The databases of Medline (via PubMed and Ovid),ProQuest, Scopus, and Web of Science from January 1980 to September 2019 were searched to locate English articles. The located articles were screened in multiple levels of title, abstract,and full-text and final studies that met the inclusion criteria were retrieved and included in the study. Results: From 1202 located articles, 193 studies were included in this systematic review. The results of meta-analysis showed that the incidence of type 1 diabetes was 15 per 100,000 people and the prevalence was 9.5% (95% CI: 0.07 to 0.12) in the world, which was statistically significant. Conclusion: According to the results, the incidence and prevalence of type 1 diabetes are increasing in the world. As a result, insulin will be difficult to access and afford, especially in underdeveloped and developing countries.

Surgical management of acquired anterior glottic web: a systematic review

2019 ◽  
Vol 133 (10) ◽  
pp. 867-874
Author(s):  
J M Fussey ◽  
D Borsetto ◽  
S Pelucchi ◽  
A Ciorba
Keyword(s):  
Systematic Review ◽  
Mitomycin C ◽  
Outcome Measures ◽  
Surgical Management ◽  
Medical Literature ◽  
Surgical Techniques ◽  
Success Rates ◽  
Inclusion Criteria ◽  
Significant Challenge ◽  
Anterior Glottic Web

AbstractBackgroundAcquired anterior glottic web poses a significant challenge to laryngologists given its propensity to recur following treatment, and there are a wide variety of described techniques.MethodsA systematic review of the medical literature was undertaken in order to identify all articles pertaining to the management of acquired anterior glottic web.ResultsThirteen studies meeting the inclusion criteria were identified and analysed. All were retrospective series, with varying surgical techniques and outcome measures. Only two studies reported on the use of topical mitomycin C.ConclusionMucosal graft techniques and keel placement appear to improve success rates, but both carry risks and disadvantages. Based on the available evidence, the use of topical agents such as mitomycin C cannot be recommended in the management of acquired anterior glottic web.

A systematic review of the incidence of venous thromboembolism (VTE) and effectiveness of prophylaxis in patients with multiple myeloma (MM) receiving thalidomide

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 9056-9056
Author(s):  
C. M. Wu ◽  
A. Y. Lee
Keyword(s):  
Systematic Review ◽  
Low Dose ◽  
Low Molecular Weight ◽  
Limited Data ◽  
Inclusion Criteria ◽  
Control Groups ◽  
Randomized Controlled ◽  
Dose Warfarin ◽  
Routine Prophylaxis ◽  
Level I

9056 Background: Thalidomide (T) is effective for treating MM but is associated with an increased incidence of VTE, especially when combined with other agents. Consequently, prophylaxis in patients receiving T-containing regimens has been recommended. However, the true risk of VTE is uncertain and the effectiveness of prophylaxis has not been established. We performed a systematic review to determine the incidence of VTE and the effect of prophylaxis in MM patients receiving T-containing regimens. Methods: MEDLINE and EMBASE were searched from 1966 to 11/16/2006. Only randomized controlled trials (RCT) and prospective cohort studies (PC) were included. Studies evaluating post-transplant maintenance therapy were excluded. Both authors independently screened and reviewed identified publications, and extracted data of pre-specified variables. Incidence estimates were calculated as proportions along with 95% CI. Results: 363 papers were identified but only 80 were relevant and reviewed. 45 studies (6 RCT and 39 PC) involving 1,886 patients receiving T-containing regimens met inclusion criteria. 9 studies clearly stated objective testing was used to confirm a diagnosis of VTE. The incidence of VTE is summarized in the table . We found 12 trials that used prophylaxis. None included appropriate control groups to allow assessment of effectiveness. Based on limited data, the incidences of VTE with prophylaxis were: ASA 13.9% (95% CI 9.1–19.9%), fixed low- dose warfarin 21.9% (95% CI 16.9–27.5%), therapeutic-dose warfarin 0% (95% CI 0–5.5%), and low molecular weight heparin 13.3% (95% CI 10.5- 16.6%). Conclusions: The incidence of VTE in MM patients receiving T-containing regimens ranges from 3% to 22%, depending on the patient type and agents used. Given the lack of level I/II evidence, recommendation for routine prophylaxis for patients receiving T- containing regimens is premature. A safe and effective antithrombotic regimen has yet to be identified. [Table: see text] No significant financial relationships to disclose.

A Systematic Review of Definitive Treatment for Inverted Papilloma Attachment Site and Associations With Recurrence

2021 ◽  
pp. 019459982110519
Author(s):  
Monica S. Trent ◽  
Khodayar Goshtasbi ◽  
Lily Hui ◽  
John A. Gerka Stuyt ◽  
Nithin D. Adappa ◽  
...  
Keyword(s):  
Systematic Review ◽  
Frozen Section ◽  
Surgical Techniques ◽  
Attachment Site ◽  
Inverted Papilloma ◽  
Definitive Treatment ◽  
Recurrence Rates ◽  
Eligibility Criteria ◽  
Level Of Evidence ◽  
Choice Of Technique

Objective Inverted papilloma (IP) is the most common benign neoplasm of the nasal cavity with known risk of recurrence. There is no standardized approach to definitive treatment for attachment sites. This systematic review aims to determine whether surgeon choice of technique differs by anatomic attachment site and whether different surgical techniques contribute to reduced rates of recurrence. Data Sources PubMed and Ovid Medline. Review Methods A systematic review was conducted for studies reporting on IP. Those that included IP recurrence rates and primary tumor attachment site were reviewed. Results Of 122 published studies, 14 met eligibility criteria, representing 585 patients and a recurrence rate of 5.8%. The maxillary sinus (50.9%) was the most common primary attachment site, and the sphenoid sinus was associated with the highest rate of recurrence (10.4%). The most utilized technique included debulking the tumor, removing mucosa over the attachment site, and drilling the underlying bone. The most common Krouse stage represented was T3 (53.3%). No single technique predicted a propensity for recurrence, but certain techniques are favored depending on IP attachment site. Finally, frozen sections to obtain evidence of clear margins intraoperatively significantly reduced rates of recurrence (3.4% vs 7.3%, P = .045). Conclusion Based on the current literature, the most common technique to address site of attachment involves resecting mucosa and drilling the tumor base. Choice of technique appears to differ for various sites of attachment. Use of intraoperative frozen section analysis appears to be associated with decreased recurrence overall. Level of Evidence 3.

scholarly journals Exercise prescription for overhead athletes with shoulder pathology: a systematic review with best evidence synthesis

2017 ◽  
Vol 52 (4) ◽  
pp. 231-237 ◽  
Author(s):  
Alexis A Wright ◽  
Eric J Hegedus ◽  
Daniel T Tarara ◽  
Samantha C Ray ◽  
Steven L Dischiavi
Keyword(s):  
Systematic Review ◽  
Upper Extremity ◽  
Exercise Prescription ◽  
Evidence Synthesis ◽  
Inclusion Criteria ◽  
Single Plane ◽  
Overhead Athletes ◽  
Shoulder Pathology ◽  
Best Evidence Synthesis ◽  
Level I

ObjectiveTo produce a best evidence synthesis of exercise prescription used when treating shoulder pathology in the overhead athlete.DesignA systematic review of exercises used in overhead athletes including case studies and clinical commentaries.Data sourcesMEDLINE, PubMed, SPORTDiscus and CINAHL from database inception through July 8, 2016.MethodsWe examined data from randomised controlled trials and prospective cohort (level I–IV evidence) studies that addressed exercise intervention in the rehabilitation of the overhead athlete with shoulder pathology. Case studies and clinical commentaries (level V evidence) were examined to account for expert opinion-based research. Data were combined using best evidence synthesis and graded (A–F) recommendations (Centre for Evidence-Based Medicine).ResultsThere were 33 unique exercises in six level I–IV studies that met our inclusion criteria. Most exercises were single-plane, upper extremity exercises performed below 90oof elevation. There were 102 unique exercises in 33 level V studies that met our inclusion criteria. These exercises emphasised plyometrics, kinetic chain and sport-specific training.Conclusions and relevanceOverall, evidence for exercise interventions in overhead athletes with shoulder pathology is dominated by expert opinion (grade D). There is great variability between exercise approaches suggested by experts and those investigated in research studies and the overall level of evidence is low. The strongest available evidence (level B) supports the use of single-plane, open chain upper extremity exercises performed below 90° of elevation and closed chain upper extremity exercises. Clinical expert pieces support a more advanced, global treatment approach consistent with the complex, multidimensional nature of sport.

Sign in / Sign up

Export Citation Format

Share Document