scholarly journals Urethral Diverticulum following Polypropylene Mesh Midurethral Slings: A Literature Review

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Elizabeth Pacer ◽  
Omar Felipe Duenas-Garcia ◽  
Lekha Hota ◽  
Kristan Hornsby ◽  
Robert Shapiro
Keyword(s):  
Polypropylene Mesh ◽  
Case Reports ◽  
Urethral Diverticulum ◽  
Cochrane Library ◽  
Midurethral Slings ◽  
Autoimmune Conditions ◽  
Urethral Diverticula ◽  
Sling Placement ◽  
Tract Infections ◽  
The Cochrane Library

Aims. It is currently unknown whether an association exists between polypropylene mesh and urethral diverticulum formation following placement of polypropylene midurethral slings (MUS) for the treatment of stress urinary incontinence (SUI). We aimed to examine the literature associating MUS with the occurrence of urethral diverticula. Methods. Multiple online research databases, including PubMed, Google Scholar, EBSCOhost, and the Cochrane Library, were searched, from January 2019 to February 2019, for evidence related to the occurrence of urethral diverticula following polypropylene MUS procedures. Results. Four case reports were published demonstrating the occurrence of urethral diverticula following the use of polypropylene mesh for surgical treatment of SUI. Subjects of these cases were menopausal and had an elevated body mass index (BMI), recurrent urinary tract infections (UTIs), autoimmune conditions, or prior pelvic floor surgeries. A thorough urologic workup, including imaging prior to sling placement, was not always performed. Conclusion. No clear association exists between polypropylene MUS placement and subsequent urethral diverticulum formation. Factors that diminish polypropylene mesh biocompatibility include elevated BMI, menopause, recurrent UTIs, prior pelvic surgeries, and preexisting medical conditions. Symptoms associated with urethral diverticula should prompt a complete urologic workup prior to MUS placement.

scholarly journals Efficacy and safety of urate-lowering therapy in people with kidney impairment: a GCAN-initiated literature review

2021 ◽  
Author(s):  
Hamish Farquhar ◽  
Ana B Vargas-Santos ◽  
Huai Leng Pisaniello ◽  
Mark Fisher ◽  
Catherine Hill ◽  
...  
Keyword(s):  
Renal Function ◽  
Renal Impairment ◽  
Case Reports ◽  
Serum Urate ◽  
Cochrane Library ◽  
Future Studies ◽  
Kidney Impairment ◽  
The Cochrane Library ◽  
Study Designs ◽  
Different Levels

Abstract Objectives To evaluate the efficacy, defined as achieving target serum urate <6.0 mg/dl, and safety of urate-lowering therapies (ULT) for people with gout and CKD stages 3–5. Methods PubMed, The Cochrane Library, and EMBASE, were searched from 1 January 1959 to 31 January 2018 for studies that enrolled people with gout, who had an estimated glomerular filtration rate (eGFR) or creatinine clearance (CrCl) of < 60 mL/min, and exposure to allopurinol, febuxostat, probenecid, benzbromarone, lesinurad or pegloticase. All study designs other than case reports were included, except for people on dialysis, for which we did include case reports. Results There were 36 reports with an analysis of efficacy and/or safety based upon renal function – allopurinol (n = 12), febuxostat (n = 10), probenecid (n = 3), benzbromarone (n = 5), lesinurad (n = 5), and pegloticase (n = 1). There were 108 reports that involved people with gout and renal impairment but did not contain any analysis on efficacy and/or safety based upon renal function – allopurinol (n = 84), febuxostat (n = 14), benzbromarone (n = 1), lesinurad (n = 3), and pegloticase (n = 6). Most studies excluded people with more severe degrees of renal impairment (eGFR or CrCl of < 30mL/min). For allopurinol in particular, there was significant variability in the dose of drug used, and efficacy in terms of urate lowering, across all levels of renal impairment. Conclusion There is a lack of evidence regarding efficacy and/or safety of currently used ULT according to different levels of renal function. Future studies should include patients with CKD and should report study outcomes stratified by renal function.

scholarly journals Neurological manifestations and neuroimaging findings in patients with SARS-CoV2—a systematic review

2021 ◽  
Vol 57 (1) ◽  
Author(s):  
Nikita Mohan ◽  
Muhammad Ali Fayyaz ◽  
Christopher del Rio ◽  
Navpreet Kaur Rajinder Singh Khurana ◽  
Sampada Sandip Vaidya ◽  
...  
Keyword(s):  
Neurological Diseases ◽  
Case Reports ◽  
Healthcare Providers ◽  
Case Series ◽  
Altered Mental Status ◽  
Common Finding ◽  
Cochrane Library ◽  
Neurological Manifestations ◽  
The Cochrane Library ◽  
Ct And Mri

Abstract Background The COVID-19 pandemic has drastically affected everyone in a hit or miss manner. Since it began, evidence of the neuro-invasive potential of the virus has been intensifying significantly. Several pathways have been hypothesized to elucidate the neurotropic nature of SARS-CoV2. It is the need of the hour to collect vital information. Objective To evaluate and correlate the neuro-radiological and neurological manifestations in patients diagnosed with SARS-CoV2. To identify neuro-invasive pathways of COVID infection. Methods Relevant studies were identified through four databases—the Cochrane Library, PubMed, Science Direct, and Web of Science. These were searched using relevant keywords—“COVID-19,” “SARS-CoV2,” “neurological manifestations,” “neuroimaging,” “CT,” and “MRI.” Relevant articles were screened according to a pre-defined inclusion and exclusion criteria from December 2019 to August 2020. Results Our review included a total of 63 full text publications with 584 patients, composed mainly of observational studies, case reports, and case series. The most common neurological manifestations associated with COVID-19 were altered mental status, stroke, and paralysis. About 17.85% patients who underwent neuroimaging were found to be having ischemic changes suggestive of a stroke. This was followed by hemorrhagic changes as the second most common finding. The most commonly involved vessel was the Middle Cerebral Artery. Besides stroke, we found that SARS-CoV2 could be the cause for new-onset seizures, Guillain-Barre Syndrome, encephalitis, and many other severe neurological diseases. Conclusion The information that we have obtained so far will prove dynamic to healthcare providers working against the COVID-19 pandemic. It is necessary to be aware of these atypical neurological findings for the early diagnosis and treatment of COVID-19 infected patients. However, to completely understand the connection between SARS-CoV2 and the nervous system, further research is necessary.

New types of diaphragms and cervical caps versus older types of diaphragms and different gels for contraception: a systematic review

2020 ◽  
pp. bmjsrh-2020-200632
Author(s):  
Ingela Lindh ◽  
Jwan Othman ◽  
Mariann Hansson ◽  
Ann-Catrin Ekelund ◽  
Therese Svanberg ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Pregnancy Rate ◽  
Urinary Tract Infections ◽  
Primary Objective ◽  
Cochrane Library ◽  
Acid Buffering ◽  
Randomised Controlled ◽  
Tract Infections ◽  
The Cochrane Library ◽  
Single Size

IntroductionOur primary objective was to evaluate whether new types of single-size diaphragms or cervical caps differ in prevention of pregnancy compared with older types of diaphragms, and whether different types of gels differ in their ability to prevent pregnancy. A secondary aim was to evaluate method discontinuation and complications.MethodsA comprehensive search was conducted in PubMed, Embase and the Cochrane Library. The certainty of evidence was assessed according to the GRADE system.ResultsFour randomised controlled studies were included in the assessment. When comparing the new and old types of female barrier contraceptives the 6-month pregnancy rate varied between 11%–15% and 8%–12%, respectively. More women reported inability to insert or remove the FemCap device (1.1%) compared with the Ortho All-Flex diaphragm (0%) (p<0.0306). Urinary tract infections were lower when using the single-size Caya, a difference of −6.4% (95% CI −8.9 to −4.09) compared with the Ortho All-Flex diaphragm. The 6-month pregnancy rate for acid-buffering gel and spermicidal nonoxynol-9 gel varied between 10% and 12%. The discontinuation rate was lower in women who used acid-buffering gel compared with nonoxynol-9 gel (risk ratio (RR) 0.77, 95% CI 0.68 to 0.97).ConclusionsPregnancy rates were generally high in women using female barrier contraceptives. There was no difference in the efficacy for pregnancy prevention between the new types of diaphragms and cervical caps and the older diaphragms. The new types of diaphragms and cervical caps resulted in fewer urinary tract infections. Acid-buffering gels did not differ from spermicidal nonoxynol-9 gels regarding pregnancies but seemed to be better tolerated.

scholarly journals Proportion of NAFLD patients with normal ALT value in overall NAFLD patients: a systematic review and meta-analysis

2020 ◽  
Author(s):  
Xuefeng Ma ◽  
Shousheng Liu ◽  
Jie Zhang ◽  
Mengzhen Dong ◽  
Yifen Wang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Diagnostic Method ◽  
Case Reports ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Random Effects Model ◽  
Hepatic Inflammation ◽  
Normal Alt ◽  
Study Type ◽  
The Cochrane Library

Abstract Background: ALT value is often used to reflect the hepatic inflammation and injury in NAFLD patients, but many studies proved that ALT values were normal in many NAFLD patients. The aim of this study was to identify the summarized proportion of NAFLD patients with normal ALT value in the overall NAFLD patients. Methods: Electronic databases PubMed, EMBASE, Ovid, and the Cochrane Library were searched for potential studies published from January 1, 2000 to September 30, 2019. Studies that have reported the number of NAFLD or NASH patients with normal and abnormal ALT value were included and analyzed. Abstracts, reviews, case reports, and letters were excluded. Results: A total of 11 studies with 4084 patients were included for assessing the summarized proportion of NAFLD patients with normal ALT in overall NAFLD patients. As the results shown, the summarized proportion of NAFLD patients with normal ALT value in overall NAFLD patients was 25% (95%CI: 20%-31%) which was calculated by the random-effects model. The summarized proportion of NASH patients with normal ALT value in overall NASH patients was 19% (95%CI: 13%-27%). Subgroup analysis includes region, study type, diagnostic method, and group size were conducted to investigate the resource of heterogeneity in the summarized proportion of NAFLD and NASH patients with normal ALT value. Conclusions: 25% NAFLD patients and 19% NASH patients possess the normal ALT value in the clinical manifestation. The value of ALT in the clinical diagnosis of NAFLD and NASH remains need be further testified.

scholarly journals Intracranial hematoma and abscess after neuraxial analgesia and anesthesia: a review of the literature describing 297 cases

2021 ◽  
pp. rapm-2020-102154
Author(s):  
Elke ME Bos ◽  
Koen van der Lee ◽  
Johan Haumann ◽  
Marcel de Quelerij ◽  
W Peter Vandertop ◽  
...  
Keyword(s):  
Single Case ◽  
Case Reports ◽  
Cochrane Library ◽  
Cerebrospinal Fluid Leakage ◽  
Intracranial Hematoma ◽  
Epidural Catheter Placement ◽  
Neuraxial Block ◽  
Blood Patch ◽  
Intracranial Complications ◽  
The Cochrane Library

BackgroundBesides spinal complications, intracranial hematoma or abscess may occur after neuraxial block. Risk factors and outcome remain unclear.ObjectiveThis review evaluates characteristics, treatment and recovery of patients with intracranial complications after neuraxial block.Evidence reviewWe systematically searched MEDLINE, Embase and the Cochrane Library from their inception to May 2020 for case reports/series, cohort studies and reviews of intracranial hematoma or abscess associated with neuraxial block. Quality of evidence was assessed using the critical appraisal of a case study checklist by Crombie.FindingsWe analyzed 232 reports, including 291 patients with hematoma and six patients with abscess/empyema. The major part of included studies comprised single case reports with a high risk of bias. Of the patients with hematoma, 48% concerned obstetric patients, the remainder received neuraxial block for various perioperative indications or pain management. Prior dural puncture was reported in 81%, either intended (eg, spinal anesthesia) or unintended (eg, complicated epidural catheter placement). Headache was described in 217 patients; in 101 patients, symptoms resembled postdural puncture headache (PDPH). After treatment, 11% had partial or no recovery and 8% died, indicating the severity of this complication. Intracranial abscess after neuraxial block is seldom reported; six reports were found.ConclusionDiagnosis of intracranial hematoma is often missed initially, as headache is assumed to be caused by cerebrospinal hypotension due to cerebrospinal fluid leakage, known as PDPH. Prolonged headache without improvement, worsening symptoms despite treatment or epidural blood patch, change of headache from postural to non-postural or new neurological signs should alert physicians to alternative diagnoses.

scholarly journals Evolution of Stage 1 Twin-to-Twin Transfusion Syndrome (TTTS): Systematic Review and Meta-Analysis

2016 ◽  
Vol 19 (3) ◽  
pp. 207-216 ◽  
Author(s):  
Asma Khalil ◽  
Emily Cooper ◽  
Rosemary Townsend ◽  
Basky Thilaganathan
Keyword(s):  
Laser Surgery ◽  
Case Reports ◽  
Meta Analysis ◽  
Survival Rates ◽  
Cochrane Library ◽  
Case Control Studies ◽  
Definitive Answer ◽  
Registration Number ◽  
The Cochrane Library ◽  
Stage 1

Objectives: The natural history of stage 1 Twin-to-twin transfusion syndrome (TTTS) remains unclear and its optimal management is yet to be established. The main aims of this meta-analysis were to quantify the incidence of progression in stage 1 TTTS and to ascertain survival in these pregnancies.Methods: MEDLINE, EMBASE, and The Cochrane Library were searched. Reference lists within each article were hand-searched for additional reports. The outcomes included incidence of progression and survival in stage 1 TTTS. Randomized controlled trials, cohort and case-control studies were included. Case reports, studies including three or fewer cases of stage 1 TTTS, and editorials were excluded. Proportion meta-analysis was used for analysis (Registration number: CRD42016036190).Results: The search yielded 3,085 citations; 18 studies were included in the review (172 pregnancies to assess progression and 433 pregnancies to assess the survival). The pooled incidence of progression in stage 1 TTTS was 27% [95% CI 16–39%]. The pooled overall survival, double survival and at least one survival in the pregnancies managed expectantly were 79% [95% CI 62–92%], 70% [95% CI 54–84%] and 87% [95% CI 69–98%], respectively. In those undergoing amnioreduction, the corresponding figures were 77% [95% CI 68–85%], 67% [95% CI 57–76%] and 86% [95% CI 76–94%], respectively. The survival rates were 68% [95% CI 54–81%], 54% [95% CI 36–72%], and 81% [95% CI 69–90%], when laser surgery was performed.Conclusions: The optimal initial management of stage 1 TTTS remains in equipoise. The ongoing randomized trial comparing immediate laser surgery versus conservative management should provide a definitive answer.

SAFETY OF LAMOTRIGINE IN PAEDIATRICS: A SYSTEMIC REVIEW

2015 ◽  
Vol 101 (1) ◽  
pp. e1.68-e1
Author(s):  
Oluwaseun Egunsola ◽  
Imti Choonara ◽  
Helen Sammons
Keyword(s):  
Case Reports ◽  
Treatment Discontinuation ◽  
Common Reason ◽  
Systemic Review ◽  
Cochrane Library ◽  
Original Research ◽  
Paediatric Patients ◽  
Randomised Controlled ◽  
The Uk ◽  
The Cochrane Library

BackgroundLamotrigine has been increasingly used for the treatment of paediatric epilepsy. It is the most commonly prescribed new generation antiepileptic drug in the UK.ObjectivesTo identify adverse drug reactions associated with lamotrigine in children, compare the safety profile with other antiepileptic drugs and identify all clinical studies and case reports involving lamotrigine safety in children.MethodsDatabases EMBASE (1974-November 2013), Medline (1946-November 2013), PubMed and the Cochrane library for randomised controlled trials were searched for original research or reports in which paediatric patients received at least a single dose of lamotrigine for the treatment of epilepsy, with safety as an outcome measure.ResultsA total of 76 articles involving 2,184 paediatric patients were identified. There were 1,952 adverse events (AEs) reported. Fifty two of these AEs were from 49 case reports. Rash was most commonly reported, with a risk of 8.96 per 100 patients. Other common AEs included headache, fever, somnolence, vomiting, seizure aggravation, dizziness, cough, aggression, ataxia and insomnia. There were significantly higher risks of dizziness [RR 4.57, 95% CI: 1.88–11.12, p<0.001], abdominal pain [RR: 2.53, 95% CI: 1.12–5.70, p=0.03] and nausea [RR: 5.94, 95% CI: 1.59–22.13, p=0.008] with lamotrigine than placebo. When compared with valproic acid, the risk of somnolence and vomiting was significantly lower for lamotrigine [RR: 0.35, 95% CI: 0.13–0.89, p=0.04] and [RR: 0.20, 95% CI: 0.04–0.89, p=0.03]. Discontinuation due to an adverse drug reaction was recorded in 72 children (3.2% of all treated patients). Rash was the most common reason, with 58% of treatment discontinuation attributed to different forms of rash.ConclusionRash is the most common adverse reaction of lamotrigine, seen in around 9% of patients, and it is the most common reason for treatment discontinuation.

scholarly journals Evidências na prática do cateterismo urinário: Revisão Integrativa

2016 ◽  
Vol 1 (4) ◽  
pp. 52
Author(s):  
Mayron Morais Almeida ◽  
Francisco Wharleson Torres ◽  
Ângela Maria Lindoso ◽  
Rosalba Maria da Costa Pessôa
Keyword(s):  
Urinary Tract ◽  
Scientific Production ◽  
Cochrane Library ◽  
Nursing Interventions ◽  
Urinary Catheterization ◽  
Main Question ◽  
Inclusion Criteria ◽  
Catheterization Technique ◽  
Tract Infections ◽  
The Cochrane Library

Objective: to discuss from the national and international scientific production the best evidence related to urinary catheterization technique in preventing urinary tract infection. Method: integrative descriptive review, in order to answer the main question: what are the best evidence available in the literature related to urinary catheterization technique? Selected bases were LILACS, SciELO and Cochrane. Results: 242 articles were found in the Cochrane Library, 81 articles on LILACS and 49 in SciELO base, adding to 372 articles. Of these, 10 articles were analyzed that met the previously established inclusion criteria. Conclusion: in search of the best available evidence, for the efficient nursing interventions for the prevention of urinary tract infections, it is understood that taking the nurse's decision on the use of devices should be carried out based on detailed and individualized assessment for every patient.  

Intracranial microhemorrhages in the setting of COVID-19: what we know so far

2021 ◽  
pp. 197140092110041
Author(s):  
John C Benson ◽  
Christopher H Hunt ◽  
James P Klaas ◽  
David F Kallmes
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Case Reports ◽  
Severity Of Illness ◽  
Cochrane Library ◽  
Resonance Imaging ◽  
Patient Demographics ◽  
Characteristic Features ◽  
The Cochrane Library ◽  
Multiple Patients

Background Diffuse intracranial susceptibility abnormalities have recently been described among patients with coronavirus disease 2019 (COVID-19), although prior studies have consisted of case reports and/or series. This brief literature review seeks to compile and catalogue the available data to elucidate characteristic features of such findings. Materials and methods Scientific articles and studies on intracranial microhemorrhages in the setting of COVID-19 were searched on PubMed, Google Scholar, and the Cochrane Library. Included studies described intracranial microbleed(s) on magnetic resonance imaging in patients with COVID-19. If multiple patients were described, only patients with intracranial microhemorrhage on magnetic resonance imaging were included for analysis. Patient demographics, severity of illness (e.g. intensive care unit admission and/or intubation), time from diagnosis of COVID-19 to magnetic resonance imaging, and location(s) of any observed microhemorrhages were noted. Results A total of 39 patients with suspected intracranial microhemorrhages have been described in prior studies. The average age of patients was 64.7 years; 21.9% were women. The average time between COVID-19 diagnosis and magnetic resonance imaging was 31.7 days. All patients in the cohort were admitted to critical care and were either intubated or treated with extracorporeal membrane oxygenation during their clinical course. Microhemorrhages were most commonly located in the subcortical/juxtacortical white matter and corpus callosum. Conclusions Intracranial microbleeds are a well-documented finding in patients with severe COVID-19, and are most commonly callosal and subcortical/juxtacortical in location.

The Coexistence of Psoriasis and Vitiligo: A review

2012 ◽  
Vol 16 (5) ◽  
pp. 300-305 ◽  
Author(s):  
Michael Sawchuk ◽  
Frank Spano ◽  
Wei Jing Loo ◽  
Lyn Guenther
Keyword(s):  
Literature Review ◽  
Nous Avons ◽  
English Language ◽  
Case Reports ◽  
Case Series ◽  
Epidemiologic Studies ◽  
Cochrane Library ◽  
Trigger Factors ◽  
Background Population ◽  
The Cochrane Library

Background: Psoriasis and vitiligo are both autoimmune diseases with an increased incidence noted in genetic relatives. They share similar trigger factors and have been observed to coexist in individuals. Objective: The purpose was to review the literature on the coexistence of psoriasis and vitiligo and to determine if there is a higher than expected prevalence of psoriasis in patients with vitiligo and vice versa. Methods: A literature review was conducted using Medline, EMBASE, and the Cochrane Library from 1968 to 2010. All articles that included reports of individuals with both psoriasis and vitiligo in the English language were documented. Results: We identified 338 articles, among which 35 case reports and 7 case series were mentioned. For each case series, the prevalence of psoriasis in patients with vitiligo, or vice versa, falls within the prevalence range of the background population on which the study was based. Conclusion: An increase in the expected prevalence of psoriasis in individuals with vitiligo, or vice versa, was not found in our study, suggesting that the coexistence of the two diseases appears to be due to chance alone. Large epidemiologic studies are required to address with certainty whether psoriasis is more common in individuals with vitiligo and vice versa. Renseignements de base: Le psoriasis et le vitiligo sont deux affections auto-immunes qui ont une incidence accrue observée chez les membres de la famille apparentée. Ils partagent des facteurs déclencheurs similaires, et des études ont démontré leur coexistence chez les personnes. Objectif: Le but était de faire une analyse documentaire sur la coexistence du psoriasis et du vitiligo et de déterminer s'il y a une prévalence plus élevée que prévu du psoriasis chez les patients atteints de vitiligo et vice versa. Méthodes: Une analyse documentaire a été effectuée en utilisant Medline, EMBASE, et la Cochrane Library de 1968 à 2010. Tous les articles comportant des rapports sur des personnes souffrant à la fois de psoriasis et de vitiligo rédigés en anglais ont été documentés. Résultats: Nous avons trouvé 338 articles, parmi lesquels 35 exposés de cas et 7 séries de cas ont été mentionnés. Pour chaque série de cas, la prévalence du psoriasis chez les patients atteints de vitiligo, ou vice versa, s'inscrit dans la fourchette de prévalence de la population de base qui a fait l'objet de l'étude. Conclusion: Notre étude n'a pas démontré une augmentation de la prévalence de psoriasis attendue chez les personnes atteintes de vitiligo, ou vice versa, ce qui suggère que la coexistence des deux affections semble être due au seul hasard. D'importantes études épidémiologiques sont nécessaires pour démontrer avec certitude que le psoriasis est plus fréquent chez les personnes atteintes de vitiligo et vice versa.

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