scholarly journals 18 Years of Medication-Related Osteonecrosis of the Jaw (MRONJ) Research: Where Are We Now?—An Umbrella Review

2021 ◽  
Vol 11 (19) ◽  
pp. 8818
Author(s):  
Roberto Sacco ◽  
Monica Diuana Calasans-Maia ◽  
Julian Woolley ◽  
Oladapo Akintola ◽  
Carlos Fernando de Almeida Barros Mourão ◽  
...  
Keyword(s):  
Systematic Reviews ◽  
Case Reports ◽  
Case Series ◽  
Osteonecrosis Of The Jaw ◽  
Umbrella Review ◽  
Severe Condition ◽  
Manual Search ◽  
Number Of Patients ◽  
Retrospective Cohort Studies ◽  
Study Designs

Background: Osteonecrosis of the jaw (ONJ) is a condition affecting patients exposed to medications used to treat benign and malignant conditions of bone tissue. Many studies have highlighted that ONJ is a severe condition, which is very challenging to manage, especially in individuals with oncologic disease. The aim of this umbrella review is to analyze all available interventional and non-interventional systematic reviews published on medication-related osteonecrosis of the jaw (MRONJ) and summarize this evidence. Material and methods: A multi-database search (PubMed, MEDLINE, EMBASE and CINAHL) was performed to identify related multi-language papers published from January 2003 until June 2021. An additional manual search was also performed in systematic review registries (PROSPERO, INPLASY, JBI and OFS) to identify possible missing reviews. Data were extracted from relevant papers and analyzed according to the outcomes selected in this review. Results: The search generated 25 systematic reviews eligible for the analysis. The total number of patients included in the analysis was 80,840. Of the reviews, 64% (n = 16) were non-interventional and 36% (n = 9) were interventional. Study designs included case series 20.50% (n = 140), retrospective cohort studies 12.30% (n = 84) and case reports 12.20% (n = 83). It was unclear what study design was used for 277 studies included in the 25 systematic reviews. Conclusions: The data reviewed confirmed that the knowledge underpinning MRONJ in the last 20 years is still based on weak evidence. This umbrella review highlighted a widespread low-level quality of studies and many poorly designed reviews.

scholarly journals A Review of Cases of Human Cysticercosis in Canada

2012 ◽  
Vol 39 (3) ◽  
pp. 319-322 ◽  
Author(s):  
Oscar H. Del Brutto
Keyword(s):  
Case Reports ◽  
Clinical Manifestations ◽  
Case Series ◽  
Parasitic Disease ◽  
Striated Muscles ◽  
Citizenship Status ◽  
Household Contacts ◽  
The Past ◽  
Manual Search ◽  
Number Of Patients

Objective:Review of human cysticercosis in Canada, to estimate the magnitude of the disease and to describe the pattern of disease expression in this country.Methods:MEDLINE and manual search of case reports and case series of patients with cysticercosis diagnosed in Canada. Abstracted data included year of diagnosis, citizenship status, clinical manifestations, and form of cysticercosis.Findings:A total of 21 articles reporting 60 patients were found. Forty (67%) of these patients were diagnosed in the past two decades. Most cases came from Ontario (n=43) and Quebec (n=14). Immigrants accounted for 96% of the 28 cases in whom citizenship information was available. Neurocysticercosis was observed in 55 patients, and isolated compromise of striated muscles in the remaining five. Seizures was the primary or sole manifestation of the disease in 72% of patients, and most of them had parenchymal brain cysticerci (either viable cysts or calcifications). Two of seven patients were positive for Taenia eggs. In no case were household contacts of the patients investigated for taeniasis.Conclusions:An increasing number of patients with cysticercosis have been reported from Canada in the past two decades, suggesting that the prevalence of this parasitic disease may be on the rise. While most cases occur in immigrants, it is possible that at least some of these patients had acquired the disease in Canada.

scholarly journals Axillary Web Syndrome in Breast Cancer: A Prevalent But Under-Recognized Postoperative Complication

Breast Care ◽  
2018 ◽  
Vol 13 (2) ◽  
pp. 129-132 ◽  
Author(s):  
Susan R. Harris
Keyword(s):  
Breast Cancer ◽  
Cohort Studies ◽  
Systematic Reviews ◽  
Nurse Practitioners ◽  
Case Reports ◽  
Case Series ◽  
Diagnosis And Management ◽  
Oncology Nurse ◽  
Management Interventions ◽  
Axillary Web Syndrome

The purpose of this review is to define axillary web syndrome (AWS) and describe its diagnosis and management. The following databases were searched through July 2017: PubMed, EMBASE (OvidSP), Cumulative Index for Nursing and Allied Health Literature, Physiotherapy Evidence Database, and Cochrane Database of Systematic Reviews. Search terms included ‘axillary web syndrome', ‘axillary cording', and ‘lymphatic cording'. 49 articles were identified; 8 did not relate to breast cancer, and 3 were not in English. Of the remaining articles, the majority were case reports, case series, or descriptive reviews. 2 systematic reviews were located as well as 1 randomized trial, 6 prospective cohort studies, and 2 retrospective cohort studies. Although a common sequela after axillary surgery for breast cancer staging, AWS has been poorly described in the medical literature as to the underlying pathophysiology, diagnosis, and management. Interventions range from patient education and simple reassurance that the syndrome will resolve spontaneously to active physical or manual therapies to maintain upper extremity range-of-motion, especially adequate motion for undergoing radiation therapy. Oncologists, breast surgeons, family physicians, and oncology nurse practitioners that work with patients with breast cancer should educate them about this prevalent complication and inform them preoperatively about what to anticipate.

scholarly journals Manipulative and Manual Therapies in the Management of Patients with Prior Lumbar Surgery: A Systematic Review

2020 ◽  
Author(s):  
Clinton J Daniels ◽  
Zachary A. Cupler ◽  
Jordan A Gliedt ◽  
Sheryl Walters ◽  
Alec L Schielke ◽  
...  
Keyword(s):  
Systematic Reviews ◽  
Clinical Decision Making ◽  
Case Reports ◽  
Data Extraction ◽  
Case Series ◽  
Clinical Decision ◽  
Manual Therapies ◽  
Lumbar Surgery ◽  
Pilot Studies ◽  
Surgical Interventions

Abstract BackgroundThe purpose was to identify, summarize, and rate scholarly literature that describes manipulative and manual therapy following lumbar surgery.MethodsThe review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and was registered with PROSPERO. PubMed, Cochrane Database of Systematic Reviews, ICL, CINAHL, and PEDro were searched through July 2019. Articles were screened independently by at least two reviewers for inclusion. Articles included described the practice, utilization, and/or clinical decision making to post surgical intervention with manipulative and/or manual therapies. Data extraction consisted of principal findings, pain and function/disability, patient satisfaction, opioid/medication consumption, and adverse events. Scottish Intercollegiate Guidelines Network critical appraisal checklists were utilized to assess study quality.ResultsLiterature search yielded 1916 articles, 348 duplicates were removed, 109 full-text articles were screened and 50 citations met inclusion criteria. There were 37 case reports/case series, 3 randomized controlled trials, 3 pilot studies, 5 systematic/scoping/narrative reviews, and 2 commentaries. ConclusionThe findings of this review may help inform practitioners who utilize manipulative and/or manual therapies regarding levels of evidence for patients with prior lumbar surgery. Following lumbar surgery, the evidence indicated inpatient neural mobilization does not improve outcomes. There is inconclusive evidence to recommend for or against most manual therapies after most surgical interventions.Trial registrationProspectively registered with PROSPERO (#CRD42020137314). Registered 24 January 2020.

scholarly journals Oral White Lesions: An Updated Clinical Diagnostic Decision Tree

2019 ◽  
Vol 7 (1) ◽  
pp. 15 ◽  
Author(s):  
Hamed Mortazavi ◽  
Yaser Safi ◽  
Maryam Baharvand ◽  
Soudeh Jafari ◽  
Fahimeh Anbari ◽  
...  
Keyword(s):  
Decision Tree ◽  
English Language ◽  
Case Reports ◽  
Case Series ◽  
Oral Diseases ◽  
Diagnostic Decision ◽  
General Search ◽  
Retrospective Cohort Studies ◽  
Special Pattern ◽  
Meta Analyses

Diagnosis of oral white lesions might be quite challenging. This review article aimed to introduce a decision tree for oral white lesions according to their clinical features. General search engines and specialized databases including PubMed, PubMed Central, EBSCO, Science Direct, Scopus, Embase, and authenticated textbooks were used to find relevant topics by means of MeSH keywords such as “mouth disease”, “oral keratosis”, “oral leukokeratosis”, and “oral leukoplakia”. Related English-language articles published since 2000 to 2017, including reviews, meta-analyses, and original papers (randomized or nonrandomized clinical trials; prospective or retrospective cohort studies), case reports, and case series about oral diseases were appraised. Upon compilation of data, oral white lesions were categorized into two major groups according to their nature of development: Congenital or acquired lesions and four subgroups: Lesions which can be scraped off or not and lesions with the special pattern or not. In total, more than 20 entities were organized in the form of a decision tree in order to help clinicians establish a logical diagnosis by a stepwise progression method.

Cholinesterase Inhibitors and Memantine: Best Practices

CNS Spectrums ◽  
2008 ◽  
Vol 13 (S16) ◽  
pp. 34-35 ◽  
Author(s):  
Rachelle S. Doody
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Best Practices ◽  
Cholinesterase Inhibitors ◽  
Treatment Guidelines ◽  
Case Reports ◽  
Case Series ◽  
Added Value ◽  
Case Control Studies ◽  
Number Of Patients

Today’s therapies must be put in the context of both currently available treatments as well as treatment trials with exciting potential for use in the near future. Current clinical trial methodologies do not allow for clear separation of symptomatic treatments from disease-modifying therapies; it may be unproductive to maintain this distinction given the current range of treatments available. A more currently relevant focus is added value. Therapies should aim to provide added value through incremental benefits above and beyond existing treatments, as well as enduring benefits.Alzheimer’s disease (AD) treatment guidelines are not used by physicians only. Healthcare payers often make use of these guidelines to delimit coverage. Cost concerns will also impact AD treatments after generic cholinesterase inhibitors are made available; it is widely believed that a great number of patients will switch to generics. Therefore, treatment guidelines must account for the possible adverse effects of switching therapies as well as the desirability of persistent treatment. There are many AD treatment guidelines, among them the American Academy of Neurology (AAN) Management of Dementia Guidelines, which are currently being revised. The Institute for the Study on Aging (ISOA) Management of Alzheimer’s Disease in Managed Care Guideline also presents a different approach for a different audience.The first step to creating evidence-based best practices guidelines is to determine what is meant by “evidence.” A system of classification exists for examining forms of evidence: Class I evidence is provided by one or more well-designed, randomized, controlled clinical trials, including overviews or meta-analyses of such trials. Class II evidence is provided by well-designed observational studies with concurrent controls; for example, case-control studies that generate hypotheses about epidemiologic associations. Class III evidence is provided by expert opinion, case series, case reports, and studies with historical controls.

scholarly journals The Involvement of Hypothalamus–Pituitary–Adrenal (HPA) Axis in Suicide Risk

2020 ◽  
Vol 10 (9) ◽  
pp. 653 ◽  
Author(s):  
Isabella Berardelli ◽  
Gianluca Serafini ◽  
Natalia Cortese ◽  
Federica Fiaschè ◽  
Rory C O’Connor ◽  
...  
Keyword(s):  
Hpa Axis ◽  
Systematic Reviews ◽  
Suicidal Behavior ◽  
Suicide Risk ◽  
Case Reports ◽  
Number Of Patients ◽  
Hpa Axis Dysregulation ◽  
New Treatment ◽  
Meta Analyses ◽  
Hpa Axis Activity

Stress and Hypothalamic–Pituitary–Adrenal (HPA) axis dysregulation play a major role in various pathophysiological processes associated with both mood disorders and suicidal behavior. We conducted a systematic review with the primary aim of clarifying the nature and extent of HPA axis activity and suicidal behavior. The second aim of this review was to investigate whether potential biomarkers related to HPA axis abnormalities act as individual susceptibility factors for suicide. The PRISMA statement for reporting systematic reviews was used. Only articles published in English peer-reviewed journals were considered for possible inclusion; we excluded case reports, meta-analyses, and systematic reviews, and studies that did not clearly report statistical analysis, diagnostic criteria, or the number of patients included. Overall, 36 articles on HPA axis and suicide risk met inclusion criteria and were reviewed. Studies that investigated tests detecting biomarkers and the role of early life stressors in suicide risk were also included. We found that HPA axis activity is involved in suicide risk, regardless of the presence or absence of psychiatric conditions. The HPA axis abnormalities, mainly characterized by hyperactivity of the HPA axis, may exert an important modulatory influence on suicide risk. Impaired stress response mechanisms contribute to suicide risk. Targeting HPA axis dysregulation might represent a fruitful strategy for identifying new treatment targets and improving suicide risk prediction.

scholarly journals Emergency Management of Paraphimosis

2003 ◽  
Vol 10 (4) ◽  
pp. 253-257 ◽  
Author(s):  
Ch Chung
Keyword(s):  
Case Reports ◽  
Data Extraction ◽  
Treatment Options ◽  
Case Series ◽  
Treatment Modalities ◽  
Invasive Treatment ◽  
Manual Search ◽  
Study Selection ◽  
Library Network ◽  
Randomised Controlled

Objective To review the treatment modalities available for paraphimosis, with special emphasis on those applicable to the emergency department. Data source Relevant medical literature was searched through MEDLINE, EMBASE, CINAHL, and Cochrane Database. Manual search was performed in books on Urology, General Surgery and Emergency Medicine available in the Hospital Library. Further information was obtained through the Internet at < www.infoseek.com >. References cited in articles were also retrieved. Study selection Key words for the literature, Internet and textbook search were ‘paraphimosis’ and ‘treatment’. All available years of study were reviewed. Data extraction Relevant full text articles were obtained through the hospital library network. Original articles, review papers, medical practice, case reports, and relevant book chapters were reviewed. Data synthesis There were no prospective, randomised, controlled studies available. The majority were case series and expert experience or opinions only. Currently, a multitude of non-invasive and invasive treatment options are available, including manual reduction, help of non-crushing tissue forceps, puncture technique and dorsal slit. Conclusion All treatment methods are within the capability of the emergency physician. Hospitalization should rarely be required, unless there are serious complications.

scholarly journals Methodological quality and synthesis of case series and case reports

2018 ◽  
Vol 23 (2) ◽  
pp. 60-63 ◽  
Author(s):  
Mohammad Hassan Murad ◽  
Shahnaz Sultan ◽  
Samir Haffar ◽  
Fateh Bazerbachi
Keyword(s):  
Methodological Quality ◽  
Medical Literature ◽  
Case Reports ◽  
Case Series ◽  
Evidence Based ◽  
Level Of Evidence ◽  
Increased Risk ◽  
Study Designs ◽  
Inform Decision Making

Case reports and case series are uncontrolled study designs known for increased risk of bias but have profoundly influenced the medical literature and continue to advance our knowledge. In this guide, we present a framework for appraisal, synthesis and application of evidence derived from case reports and case series. We propose a tool to evaluate the methodological quality of case reports and case series based on the domains of selection, ascertainment, causality and reporting and provide signalling questions to aid evidence-based practitioners and systematic reviewers in their assessment. We suggest using evidence derived from case reports and case series to inform decision-making when no other higher level of evidence is available.

Care of the Cocaine User with Nasal Deformity

2017 ◽  
Vol 33 (04) ◽  
pp. 411-418 ◽  
Author(s):  
Anil Joshi ◽  
Alwyn D'Souza ◽  
Abigail Walker
Keyword(s):  
Surgical Approach ◽  
Case Reports ◽  
Case Series ◽  
Careful Consideration ◽  
Western World ◽  
Free Text ◽  
Nasal Deformity ◽  
Psychiatric Comorbidities ◽  
Operative Care ◽  
Number Of Patients

AbstractCocaine is the most commonly used stimulant in the Western world, and its use is increasing not only in young people but also in people older than 40 years. Intranasal use is associated with several pathologies, ranging from crusting and blockage, to fibrosis and scarring, to destruction of the osteocartilaginous structures of the midface. As its use becomes more prevalent in society, the reconstructive surgeon can accordingly expect to be faced with an increasing number of patients with cocaine-related nasal deformity. However, the use of cocaine adds a significant layer of complexity to the perioperative and operative care that requires careful consideration by the whole health care team. We present a practical evidence-based guide to management of reconstruction of the cocaine nose, taking in all aspects of periprocedural care. Finally, we present a model for surgical approach based on best evidence and the experience of the senior author. A search was performed of the Medline, Embase, and Cochrane Collection database using both MeSH keywords and free text words, identifying key articles on the epidemiology, pathophysiology, and medical and psychiatric comorbidities of cocaine users. Both case series and case reports reporting cocaine-associated defects and their reconstruction were reviewed together with the senior authors (A.D.S., A.J.), and a series of recommendations synthesized based on these recommendations. The nasal deformities associated with cocaine use represent only the tip of the iceberg of underlying associated pathology. The surgeon who embarks upon reconstruction of the cocaine nose should be aware of possible coexisting medical and psychiatric comorbidities that may complicate both the patient's motivations for surgery and their fitness to undergo anesthesia. Ultimately, successful reconstructive outcomes are critically dependent on holistic perioperative care and the surgeon's ability to be flexible in their surgical approach.

scholarly journals The emerging role of laparoscopic nephrectomy in the operative management of renal trauma: is less really more?

2021 ◽  
Vol 8 (7) ◽  
pp. 2140
Author(s):  
Akram A. Bokhari ◽  
Jared McDowall ◽  
Zakiyah Gaibie ◽  
Sunil Sinha ◽  
Maeyane S. Moeng ◽  
...  
Keyword(s):  
Systematic Reviews ◽  
Case Reports ◽  
Case Series ◽  
Laparoscopic Nephrectomy ◽  
Renal Trauma ◽  
Cochrane Library ◽  
Trauma Patients ◽  
Renal Surgery ◽  
Select Group

The role of laparoscopic nephrectomy (LN) is well established in the operative armamentarium of renal surgery and has also extended to the resection of benign and malignant renal neoplasms. Despite growing evidence advocating conservative management of renal trauma, the role of LN in the management of renal trauma is not well defined. Thus, a systematic review was conducted to better define the role of LN in the subgroup of renal trauma patients requiring operative nephrectomy. In accordance with the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines, a comprehensive literature search was performed (March 2020), using the following databases: Cochrane library of systematic reviews, EMBASE, PubMed, Scopus, and web of science. Included studies were further assessed for relevance and quality using the Oxford 2010 critical appraisal skills program (CASP). A total of 620 studies were identified, non-relevant and non-English articles were excluded which resulted in 4 relevant articles being included. Due to a relative lack of data, case reports and case series were also included. The role of LN is a viable option in a select group of cases when operative intervention is already planned for advanced renal injury. The special considerations and relative contraindications to laparoscopy must be adhered to when selecting this modality in the setting of renal trauma. Future prospective studies are required to better define this relationship.

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