A Systematic Review of Surgical Techniques for Management of Severe Rhinophyma

2021 ◽  
pp. 194338752098311
Author(s):  
Sarah Benyo ◽  
Robert A. Saadi ◽  
Scott Walen ◽  
Jessyka G. Lighthall
Keyword(s):  
Systematic Review ◽  
Literature Review ◽  
Study Design ◽  
Current Literature ◽  
Meta Analysis ◽  
Treatment Algorithm ◽  
Surgical Techniques ◽  
Operative Management ◽  
Search Term ◽  
Functional Deficits

Study Design: Systematic review of the literature. Objective: The goal of this study is to review the current literature on severe rhinophyma requiring operative management for significant cosmetic deformity or nasal obstruction. We aim to provide a treatment algorithm for the various surgical techniques employed in the treatment of severe rhinophyma. Methods: Independent searches of the PubMed and MEDLINE databases were performed. Articles from the period of 2010 to 2020 were collected. All studies which described surgical treatment of severe rhinophyma using the Boolean method and relevant search term combinations, including “rhinophyma,” “severe,” “operative” and “surgery” were collected. Results: A total of 111 relevant unique articles met criteria for eligibility analysis. Of these, 85 articles were deemed inappropriate for the literature review due to exclusion criteria. The remaining 26 articles were included in the literature review. Due to variability in study design and outcome measures, formal synthesis of data in the form of a meta-analysis was not possible. Conclusions: Severe rhinophyma may present a reconstructive challenge to reestablish normal contour and patent nasal airway. Significant deformity necessitates surgical correction. The present article reviews the current literature and provides a summary and stepwise explanation of established surgical techniques for addressing the cosmetic and functional deficits these patients encounter.

scholarly journals SARS-CoV-2 genome and antibodies in breastmilk: a systematic review and meta-analysis

2021 ◽  
pp. fetalneonatal-2020-321074
Author(s):  
Faith Zhu ◽  
Carlos Zozaya ◽  
Qi Zhou ◽  
Charmaine De Castro ◽  
Prakesh S Shah
Keyword(s):  
Systematic Review ◽  
Outcome Measures ◽  
Study Design ◽  
Web Of Science ◽  
Meta Analysis ◽  
Respiratory Support ◽  
Common Finding ◽  
Rt Pcr

ObjectiveTo systematically review and meta-analyse the rate of SARS-CoV-2 genome identification and the presence of SARS-CoV-2 antibodies in breastmilk of mothers with COVID-19.DesignA systematic review of studies published between January 2019 and October 2020 without study design or language restrictions.SettingData sourced from Ovid Embase Classic+Embase, PubMed, Web of Science, Scopus, relevant bibliographies and the John Hopkins University COVID-19 database.PatientsMothers with confirmed COVID-19 and breastmilk tested for SARS-CoV-2 by RT-PCR or for anti-SARS-CoV-2 antibodies.Main outcome measuresPresence of SARS-CoV-2 genome and antibodies in breastmilk.ResultsWe included 50 articles. Twelve out of 183 women from 48 studies were positive for SARS-CoV-2 genome in their breastmilk (pooled proportion 5% (95% CI 2% to 15%; I2=48%)). Six infants (50%) of these 12 mothers tested positive for SARS-CoV-2, with one requiring respiratory support. Sixty-one out of 89 women from 10 studies had anti-SARS-CoV-2 antibody in their breastmilk (pooled proportion 83% (95% CI 32% to 98%; I2=88%)). The predominant antibody detected was IgA.ConclusionsSARS-CoV-2 genome presence in breastmilk is uncommon and is associated with mild symptoms in infants. Anti-SARS-CoV-2 antibodies may be a more common finding. Considering the low proportion of SARS-CoV-2 genome detected in breastmilk and its lower virulence, mothers with COVID-19 should be supported to breastfeed.

Systematic review and meta-analysis of surgical options for recurrent or persistent carpal tunnel syndrome: simple decompression versus coverage of the median nerve

2021 ◽  
pp. 175319342110017
Author(s):  
Saskia F. de Roo ◽  
Philippe N. Sprangers ◽  
Erik T. Walbeehm ◽  
Brigitte van der Heijden
Keyword(s):  
Systematic Review ◽  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Meta Analysis ◽  
Surgical Techniques ◽  
Open Release ◽  
Flap Coverage ◽  
Tunnel Syndrome

We performed a systematic review on the success of different surgical techniques for the management of recurrent and persistent carpal tunnel syndrome. Twenty studies met the inclusion criteria and were grouped by the type of revision carpal tunnel release, which were simple open release, open release with flap coverage or open release with implant coverage. Meta-analysis showed no difference, and pooled success proportions were 0.89, 0.89 and 0.85 for simple open carpal tunnel release, additional flap coverage and implant groups, respectively. No added value for coverage of the nerve was seen. Our review indicates that simple carpal tunnel release without additional coverage of the median nerve seems preferable as it is less invasive and without additional donor site morbidity. We found that the included studies were of low quality with moderate risk of bias and did not differentiate between persistent and recurrent carpal tunnel syndrome.

scholarly journals Gunshot Wounds to the Lumbosacral Spine: Systematic Review and Meta-Analysis

2021 ◽  
pp. 219256822110308
Author(s):  
Andrew Platt ◽  
Mostafa H. El Dafrawy ◽  
Michael J. Lee ◽  
Martin H. Herman ◽  
Edwin Ramos
Keyword(s):  
Systematic Review ◽  
Random Effects ◽  
Surgical Intervention ◽  
Meta Analysis ◽  
Gunshot Wounds ◽  
Operative Management ◽  
Operative Intervention ◽  
Lumbosacral Spine ◽  
Random Effects Model ◽  
Significant Difference

Study Design: Systematic review and meta-analysis. Objectives: Indications for surgical decompression of gunshot wounds to the lumbosacral spine are controversial and based on limited data. Methods: A systematic review of literature was conducted to identify studies that directly compare neurologic outcomes following operative and non-operative management of gunshot wounds to the lumbosacral spine. Studies were evaluated for degree of neurologic improvement, complications, and antibiotic usage. An odds ratio and 95% confidence interval were calculated for dichotomous outcomes which were then pooled by random-effects model meta-analysis. Results: Five studies were included that met inclusion criteria. The total rate of neurologic improvement was 72.3% following surgical intervention and 61.7% following non-operative intervention. A random-effects model meta-analysis was carried out which failed to show a statistically significant difference in the rate of neurologic improvement between surgical and non-operative intervention (OR 1.07; 95% CI 0.45, 2.53; P = 0.88). In civilian only studies, a random-effects model meta-analysis failed to show a statistically significant difference in the rate of neurologic improvement between surgical and non-operative intervention (OR 0.75; 95% CI 0.21, 2.72; P = 0.66). Meta-analysis further failed to show a statistically significant difference in the rate of neurologic improvement between patients with either complete (OR 4.13; 95% CI 0.55, 30.80; P = 0.17) or incomplete (OR 0.38; 95% CI 0.10, 1.52; P = 0.17) neurologic injuries who underwent surgical and non-operative intervention. There were no significant differences in the number of infections and other complications between patients who underwent surgical and non-operative intervention. Conclusions: There were no statistically significant differences in the rate of neurologic improvement between those who underwent surgical or non-operative intervention. Further research is necessary to determine if surgical intervention for gunshot wounds to the lumbosacral spine, including in the case of retained bullet within the spinal canal, is efficacious.

scholarly journals Interventional radiology versus operative management for splenic injuries: a study protocol for a systematic review and meta-analysis

BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e028172
Author(s):  
Masahiro Kashiura ◽  
Noritaka Yada ◽  
Kazuma Yamakawa
Keyword(s):  
Systematic Review ◽  
Interventional Radiology ◽  
Meta Analysis ◽  
Operative Management ◽  
Sensitivity Analyses ◽  
Definitive Treatment ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Statistical Heterogeneity ◽  
Non Operative Management

IntroductionOver the past decades, the treatment for blunt splenic injuries has shifted from operative to non-operative management. Interventional radiology such as splenic arterial embolisation generally increases the success rate of non-operative management. However, the type of intervention, such as the first definitive treatment for haemostasis (interventional radiology or surgery) in blunt splenic injuries is unclear. Therefore, we aim to clarify whether interventional radiology improves mortality in patients with blunt splenic trauma compared with operative management by conducting a systematic review and meta-analysis.Methods and analysisWe will search the following electronic bibliographic databases to retrieve relevant articles for the literature review: Medline, Embase and the Cochrane Central Register of Controlled Trials. We will include controlled trials and observational studies published until September 2018. We will screen search results, assess the study population, extract data and assess the risk of bias. Two review authors will extract data independently, and discrepancies will be identified and resolved through a discussion with a third author where necessary. Data from eligible studies will be pooled using a random-effects meta-analysis. Statistical heterogeneity will be assessed by using the Mantel-Haenszel χ² test and the I² statistic, and any observed heterogeneity will be quantified using the I² statistic. We will conduct sensitivity analyses according to several factors relevant for the heterogeneity.Ethics and disseminationOur study does not require ethical approval as it is based on the findings of previously published articles. This systematic review will provide guidance on selecting a method for haemostasis of splenic injuries and may also identify knowledge gaps that could direct further research in the field. Results will be disseminated through publication in a peer-reviewed journal and presentations at relevant conferences.PROSPERO registration numberCRD42018108304.

scholarly journals Diaphragmatic herniation after esophagogastric surgery: systematic review and meta-analysis

2021 ◽  
Author(s):  
Davide Bona ◽  
Francesca Lombardo ◽  
Kazuhide Matsushima ◽  
Marta Cavalli ◽  
Valerio Panizzo ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Treatment Algorithm ◽  
Pulmonary Complications ◽  
Morbidity And Mortality ◽  
Current Evidence ◽  
Esophageal Hiatus ◽  
Pooled Prevalence ◽  
Increased Risk ◽  
Esophagogastric Surgery

Abstract Introduction The anatomy of the esophageal hiatus is altered during esophagogastric surgery with an increased risk of postoperative hiatus hernia (HH). The purpose of this article was to examine the current evidence on the surgical management and outcomes associated with HH after esophagogastric surgery for cancer. Materials and methods Systematic review and meta-analysis. Web of Science, PubMed, and EMBASE data sets were consulted. Results Twenty-seven studies were included for a total of 404 patients requiring surgical treatment for HH after esophagogastric surgery. The age of the patients ranged from 35 to 85 years, and the majority were males (82.3%). Abdominal pain, nausea/vomiting, and dyspnea were the commonly reported symptoms. An emergency repair was required in 51.5%, while a minimally invasive repair was performed in 48.5%. Simple suture cruroplasty and mesh reinforced repair were performed in 65% and 35% of patients, respectively. The duration between the index procedure and HH repair ranged from 3 to 144 months, with the majority (67%) occurring within 24 months. The estimated pooled prevalence rates of pulmonary complications, anastomotic leak, overall morbidity, and mortality were 14.1% (95% CI = 8.0–22.0%), 1.4% (95% CI = 0.8–2.2%), 35% (95% CI = 20.0–54.0%), and 5.0% (95% CI = 3.0–8.0%), respectively. The postoperative follow-up ranged from 1 to 110 months (mean = 24) and the pooled prevalence of HH recurrence was 16% (95% CI = 13.0–21.6%). Conclusions Current evidence reporting data for HH after esophagogastric surgery is narrow. The overall postoperative pulmonary complications, overall morbidity, and mortality are 14%, 35%, and 5%, respectively. Additional studies are required to define indications and treatment algorithm and evaluate the best technique for crural repair at the index operation in an attempt to minimize the risk of HH.

scholarly journals A systematic review and meta-analysis of angiotensin-converting enzyme inhibitor use and psoriasis incidence

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Gonjin Song ◽  
Ji Yea Kim ◽  
Ha Young Yoon ◽  
Jeong Yee ◽  
Hye Sun Gwak
Keyword(s):  
Systematic Review ◽  
Literature Review ◽  
Angiotensin Converting Enzyme ◽  
Subgroup Analysis ◽  
Ace Inhibitor ◽  
Web Of Science ◽  
Enzyme Inhibitor ◽  
Meta Analysis ◽  
Temperate Climate ◽  
Converting Enzyme

AbstractAlthough a considerable volume of data supporting induction or aggravation of psoriasis because of angiotensin-converting enzyme (ACE) inhibitor use exists, it remains insufficient for definitive conclusions. Therefore, we aimed to evaluate the association between ACE inhibitor use and psoriasis incidence through a systematic literature review and meta-analysis. We searched for qualifying studies across PubMed, Web of Science, and Embase. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to evaluate the strength of the association between ACE inhibitor use and psoriasis incidence. Eight studies with a total of 54,509 patients with a psoriasis diagnosis were included in this meta-analysis. The pooled OR for psoriasis incidence among ACE inhibitor users was 1.52 (95% CI, 1.16–2.00) compared to that among non-users. From subgroup analysis by continent, the OR for ACE inhibitor users versus non-users was 2.37 (95% CI 1.28–4.37) in Asia. Per the subgroup analysis by climate, the OR for ACE inhibitor users vs non-users in dry climate was 3.45 (95% CI: 2.05–5.79) vs 1.32 (95% CI 1.01–1.73) in temperate climate. Our results reveal a significant association between ACE inhibitor use and psoriasis incidence.

Systematic Reviews are Rarely Used to Inform Study Design - a Systematic Review and Meta-analysis

2022 ◽  
Author(s):  
Birgitte Nørgaard ◽  
Eva Draborg ◽  
Jane Andreasen ◽  
Carsten Bogh Juhl ◽  
Jennifer Yost ◽  
...  
Keyword(s):  
Systematic Review ◽  
Study Design ◽  
Systematic Reviews ◽  
Meta Analysis

Surgical treatment of rectovaginal fistulas (systematic literature review)

2021 ◽  
pp. 30-48
Author(s):  
Andrei Anatolevich Mudrov ◽  
Aleksandr Yur’evich Titov ◽  
Mariyam Magomedovna Omarova ◽  
Sergei Alekseevich Frolov ◽  
Ivan Vasilevich Kostarev ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Literature Review ◽  
Systematic Literature Review ◽  
Meta Analysis ◽  
High Recurrence Rate ◽  
Surgical Interventions ◽  
Rectovaginal Fistulas ◽  
Surgical Treatments

Despite the large number of available surgical interventions aimed at the treatment of rectovaginal fistulas, the results of their use remain extremely disappointing, associated with the high recurrence rate of the disease reaching 80 %, as well as the lack of a single tactic to minimize the risk of anal incontinence and the need for colostomy. Objective: to conduct a systematic literature review in order to summarize information related to the rectovaginal fistulas surgery. The systematic review includes the results of an analysis of 97 clinical trials selected from 756 publications found in databases. Inclusion criteria: a full-text article, the presence of at least 5 patients in the study, as well as data on the outcome of surgery. Clinical trials with different surgical treatments were identified and classified into the following categories: elimination of the rectovaginal septal defect with a displaced flap (rectal and vaginal); Martius surgery; gracilis muscle transposition; transperineal procedure; abdominal procedure including endoscopic and laparoscopic methods; use of biological or biocompatible materials. Treatment outcomes vary significantly from 0 % to > 80 %. None of the studies were randomized. Due to the low quality of the identified studies, comparison of results and meta-analysis conduction were not possible. Conclusion: as a result of the systematic review, data for the analysis and development of any strategic and tactical algorithms for the treatment of RVF were not obtained. The most important questions still remain open: what and when surgical method to choose, is it necessary to form a disconnecting stoma?

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