Characteristics of the Middle Cervical Sympathetic Ganglion: A Systematic Review and Meta-Analysis

Background: Understanding the characteristics of the middle cervical sympathetic ganglion (MCSG) may minimize procedure-related complications and maximize efficacy during surgery or ultrasound (US)-guided procedures. The location and detection rate of the MCSG were variable in small population studies. Therefore, a large population study or meta-analysis could give more information about the MCSG. Objectives: We aim to review the published literature and evaluate the anatomical features of the MCSG, including the detection rate, location, size, and a normal variation, and to review the clinical relevance of MCSG for procedures including, US-guided ganglion block, ethanol ablation (EA), or radiofrequency ablation (RFA). Study Design: A systematic review and meta-analysis. The Ovid-MEDLINE and EMBASE databases were searched to find the detection rate, location, and other characteristics of the MCSG. Setting: The pooled proportions for the detection rate of the MCSG were assessed using the DerSimonian-Laird random-effects model. Methods: Heterogeneity among the studies was determined using a chi-square analysis for the pooled estimates and inconsistency index (I2 ). In order to reduce the heterogeneity, sensitivity analyses were performed. Results: A review of 542 studies identified 8 eligible studies, with 273 MCSGs included in the meta-analysis. The pooled proportion for the detection rate of the MCSG was 50.4% (95% confidence interval [CI], 34.5–66.4%). Considerable heterogeneity among the studies was observed (I2 = 94.9%). In the sensitivity analysis, when excluding one study, heterogeneity was reduced with a recalculated pooled proportion of 44.2% (95% CI, 32.1–56.2%; I2 = 86.0%). The location of the MCSG is usually posterior to the carotid sheath and anterior to the longus colli muscle at the level of the C3–C7 vertebrae. There was a variant where the cervical sympathetic trunk was located at the posterior wall of the carotid sheath and was adherent to the sheath. The size of the MCSG is as follows: the width, length, and height ranges were 3.8–6.3 mm, 6.3–10.5 mm, and 1.7–2.1 mm, respectively. A specific type of MCSG, referred to as the “double middle cervical ganglion”, consisting of 2 ganglia, was demonstrated in 3 studies with a detection rate of 2.9–10%. Limitations: This meta-analysis included a relatively small number of studies. Significant heterogeneity was also present in the detection rate of MCSG in these studies. There was a lack of concentrated information about the MCSG, because the majority of the included studies focused on the entire cervical sympathetic chain, not only MCSG primarily. Improving complication rates might be limited due to the approximate 50% detection rate. Conclusion: Understanding the characteristics and variations of the MCSG could minimize complications and maximize efficacy during surgery and US-guided procedures. Key words: Middle cervical sympathetic ganglion, cervical sympathetic trunk, cervical sympathetic chain, ultrasound, nerve block, ethanol ablation, radiofrequency ablation, thyroid, Horner syndrome, meta-analysis

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ENDOCUFF-ASSISTED COLONOSCOPY INCREASES ADENOMA DETECTION RATE: A SYSTEMATIC REVIEW AND META-ANALYSIS

10.1055/s-0039-1681469 ◽

2019 ◽

Author(s):

P Gkolfakis ◽

G Tziatzios ◽

K Triantafyllou

Keyword(s):

Systematic Review ◽

Detection Rate ◽

Meta Analysis ◽

Adenoma Detection Rate ◽

Adenoma Detection

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Detection of three pandemic causing coronaviruses from non-respiratory samples: systematic review and meta-analysis

Scientific Reports ◽

10.1038/s41598-021-95329-4 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Chandan Mishra ◽

Suneeta Meena ◽

Jitendra Kumar Meena ◽

Suman Tiwari ◽

Purva Mathur

Keyword(s):

Systematic Review ◽

Detection Rate ◽

Meta Analysis ◽

Total Sample ◽

Urine Samples ◽

Pathogenic Potential ◽

Clinical Specimens ◽

Qrt Pcr ◽

Corona Virus ◽

Positive Rate

AbstractSARS-CoV-2 has posed an unprecedented challenge to the world. Pandemics have been caused previously by viruses of this family like Middle East Respiratory Corona Virus (MERS CoV), Severe Acute Respiratory Syndrome Corona Virus (SARS CoV). Although these viruses are primarily respiratory viruses, but they have been isolated from non-respiratory samples as well. Presently, the detection rate of SARS‐CoV‐2 RNA from different clinical specimens using Real Time Reverse Transcriptase Polymerized Chain Reaction (qRT‐PCR) after onset of symptoms is not yet well established. Therefore, the aim of this systematic review was to establish the profile of detecting SARS‐CoV‐2, MERS CoV, SARS CoV from different types of clinical specimens other than the respiratory using a standard diagnostic test (qRT‐PCR). A total of 3429 non-respiratory specimens were recorded: SARS CoV (total sample—802), MERS CoV (total sample—155), SARS CoV-2 (total sample—2347). Out of all the samples studied high positive rate was seen for saliva with 96.7% (14/14; 95% CI 87.6–100.0%) for SARS CoV and 57.5% (58/250; 95% CI − 1.2 to 116.2%) for SARS CoV-2, while low detection rate in urine samples for SARS CoV-2 with 2.2% (8/318; 95% CI 0.6–3.7%) and 9.6% (12/61; 95% CI − 0.9 to 20.1%) for SARS CoV but there was relatively higher positivity in urine samples for MERS CoV with detection rate of 32.4% (2/38; 95% CI − 37.3 to 102.1%). In Stool sample positivity was 54.9% (396/779; 95% CI 41.0–68.8%), 45.2% (180/430; 95% CI 28.1–62.3%) and 34.7% (4/38; 95% CI − 29.5 to 98.9%) for SARS CoV-2, MERS CoV, and SARS CoV, respectively. In blood sample the positivity was 33.3% (7/21; 95% CI 13.2–53.5%), 23.7% (42/277; 95% CI 10.5–36.9%) and 2.5% (2/81; 95% CI 0.00–5.8%) for MERS CoV, SARS CoV-2 and SARS CoV respectively. SARS‐CoV‐2 along with previous two pandemic causing viruses from this family, were highly detected stool and saliva. A low positive rate was recorded in blood samples. Viruses were also detected in fluids along with unusual samples like semen and vaginal secretions thus highlighting unique pathogenic potential of SARS‐CoV‐2.

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Systematic review with meta‐analysis: neoplasia detection rate and post‐endoscopy Barrett's neoplasia in Barrett's oesophagus

Alimentary Pharmacology & Therapeutics ◽

10.1111/apt.16531 ◽

2021 ◽

Author(s):

Nour Hamade ◽

Amrit K. Kamboj ◽

Rajesh Krishnamoorthi ◽

Siddharth Singh ◽

Leslie C. Hassett ◽

...

Keyword(s):

Systematic Review ◽

Detection Rate ◽

Meta Analysis ◽

Barrett’S Oesophagus ◽

Barrett's Oesophagus

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A commentary on “The prognosis of radiofrequency ablation versus hepatic resection for patients with colorectal liver metastases: A systematic review and meta-analysis based on 22 studies”

International Journal of Surgery ◽

10.1016/j.ijsu.2021.105924 ◽

2021 ◽

Vol 88 ◽

pp. 105924

Author(s):

Menghu Han ◽

Jiye Li

Keyword(s):

Systematic Review ◽

Radiofrequency Ablation ◽

Liver Metastases ◽

Hepatic Resection ◽

Colorectal Liver Metastases ◽

Meta Analysis

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Effect of dynamic position changes on adenoma detection rate during colonoscope withdrawal: systematic review and meta-analysis

Endoscopy International Open ◽

10.1055/a-1265-6634 ◽

2020 ◽

Vol 08 (12) ◽

pp. E1842-E1849

Author(s):

Venkat Nutalapati ◽

Madhav Desai ◽

Vivek Sandeep Thoguluva-Chandrasekar ◽

Mojtaba Olyaee ◽

Amit Rastogi

Keyword(s):

Systematic Review ◽

Detection Rate ◽

Meta Analysis ◽

Lateral Position ◽

Adenoma Detection Rate ◽

Position Change ◽

Withdrawal Time ◽

Left Lateral Position ◽

Adenoma Detection ◽

Withdrawal Phase

Abstract Background and study aims The adenoma detection rate (ADR) is an important quality metric of colonoscopy. Higher ADR correlates with lower incidence of interval colorectal cancer. ADR is variable between endoscopists and depends upon the withdrawal technique amongst other factors. Dynamic position change (lateral rotation of patients with a view to keep the portion of the colon being inspected at a higher level) helps with luminal distension during the withdrawal phase. However, impact of this on ADR is not known in a pooled sample. We performed a systematic review and meta-analysis to study the impact of dynamic position changes during withdrawal phase of colonoscopy on ADR Methods A comprehensive search of MEDLINE, EMBASE, Google Scholar, and the Cochrane Database was conducted from each database’s inception to search for studies comparing dynamic position changes during colonoscope withdrawal with static left lateral position (control). The primary outcome of interest was ADR. Other studied outcomes were polyp detection rate (PDR) and withdrawal time. Outcomes were reported as pooled odds ratio (OR) with 95 % confidence intervals (CI) with statistical significance (P < 0.05). RevMan 5.3 software was used for statistical analysis. Results Six studies were included in our analysis with 2860 patients. Of these, dynamic position change was implemented in 1177 patients while 1183 patients served as the controls. ADR was significantly higher in the dynamic position change group with pooled OR 1.36 (95 % CI, 1.15–1.61; P < 0.01). There was low heterogeneity in inclusion studies (I2 = 0 %). PDR was numerically higher in position change group (53.4 % vs 49.6 %) but not statistically significant (P = 0.16). Mean withdrawal time did not significantly change with dynamic position change (12.43 min vs 11.46 min, P = 0.27). Conclusion Position change during the withdrawal phase of colonoscopy can increase the ADR compared to static left lateral position. This is an easy and practical technique that can be implemented to improve ADR.

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