scholarly journals Prognosis and Management of Communicating and Non-communicating Hydrocele

2021 ◽  
pp. 347-353
Author(s):  
Wedyan Salem Basaif ◽  
Abdullah Khalid Murshid ◽  
Yazeed Mohammed Alhadi ◽  
Sultan Dhafer Albarman ◽  
Mohammed Jamal Almunaikh ◽  
...  
Keyword(s):  
Case Reports ◽  
Case Series ◽  
Current Evidence ◽  
Surgical Approaches ◽  
Effective Management ◽  
Common Condition ◽  
Tunica Vaginalis ◽  
Current Management ◽  
Management Approaches ◽  
Left Hemi

Hydrocele can be found as a collection of fluid within the testicular tunica vaginalis. According to the etiology and pathophysiology of the disease, it can be classified into primary and secondary. Furthermore, primary hydrocele might include the closed or non-communicating, the communicating type, the congenital and or neonatal type. Many management approaches have been proposed for both the communicating and non-communicating hydrocele with different post-operative and prognostic outcomes. In this literature review, we have discussed the current management approaches and prognosis of communicating and non-community hydrocele. Adequate diagnosis of the condition is the first step to achieve favorable management outcomes. Although the reported management outcomes are reported to be effective in the literature, the surgical approaches seem to be superior. However, many side effects might be associated with these operations. Estimates show that following varicocelectomy procedures, ipselateral (left) hemi-scrotal varicocele is the most common condition to occur, which might even develop following the procedure by several months and years (in some cases). Further investigations are still needed because the current evidence is largely based on case reports and small case series investigations. Therefore, larger studies are needed to help draw effective management protocols and enhance the outcomes and prognosis.

scholarly journals Vitamin C in the Treatment of COVID-19

Nutrients ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 1172
Author(s):  
Gregorio Paolo Milani ◽  
Marina Macchi ◽  
Anat Guz-Mark
Keyword(s):  
Clinical Trials ◽  
Vitamin C ◽  
Respiratory Infections ◽  
Medical Condition ◽  
Case Reports ◽  
Case Series ◽  
Theoretical Background ◽  
Current Evidence ◽  
Vitamin C Supplementation ◽  
Essential Nutrient

Vitamin C is an essential nutrient that serves as antioxidant and plays a major role as co-factor and modulator of various pathways of the immune system. Its therapeutic effect during infections has been a matter of debate, with conflicting results in studies of respiratory infections and in critically ill patients. This comprehensive review aimed to summarize the current evidence regarding the use of vitamin C in the prevention or treatment of patients with SARS-CoV2 infection, based on available publications between January 2020 and February 2021. Overall, 21 publications were included in this review, consisting of case-reports and case-series, observational studies, and some clinical trials. In many of the publications, data were incomplete, and in most clinical trials the results are still pending. No studies regarding prevention of COVID-19 with vitamin C supplementation were found. Although some clinical observations reported improved medical condition of patients with COVID-19 treated with vitamin C, available data from controlled studies are scarce and inconclusive. Based on the theoretical background presented in this article, and some preliminary encouraging studies, the role of vitamin C in the treatment of patients with SARS-CoV-2 infection should be further investigated.

scholarly journals Is Non-Chlamydial Non-Gonococcal Urethritis Associated with Significant Clinical Complications in Men? A Systematic Review

2020 ◽  
Vol 14 (1) ◽  
pp. 1-13 ◽  
Author(s):  
Cassandra E.L. Fairhead ◽  
Alexander Hampson ◽  
Louis Dwyer-Hemmings ◽  
Nikhil Vasdev
Keyword(s):  
Systematic Review ◽  
Reactive Arthritis ◽  
Case Reports ◽  
Case Series ◽  
Current Evidence ◽  
Future Research ◽  
Qualitative Synthesis ◽  
Cross Sectional ◽  
Gonococcal Urethritis ◽  
Clinical Complications

Background: It is estimated that between 50 and 89% of non-gonococcal urethritis is not caused by Chlamydia trachomatis. Associations between non-chlamydial non-gonococcal urethritis (NCNGU) with balanoposthitis, epididymo-orchitis and reactive arthritis have been suggested, but evidence to support these often-theoretical relationships is sparse and further investigation is called for. Concerns over increasing antimicrobial resistance has rendered the need for clarity over this question ever more pressing in recent years. A review of the current evidence on the complications of NCNGU in men is therefore urgently warranted. Objective: This systematic review summarizes and evaluates the available evidence that NCNGU, whether symptomatic or asymptomatic, causes the significant complications that are already well-recognized to be associated with non-gonococcal urethritis. These significant complications are epididymo-orchitis, balanoposthitis, and sexually-acquired reactive arthritis (Reiter's syndrome) including arthritis or conjunctivitis. Summary: We conducted a systematic review and qualitative synthesis using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis framework. Five databases (PubMed, EMBASE, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, and British Nursing Index) were searched. We included studies that measured clinical outcome after diagnosis of NCNGU in men. Bias was assessed using variations of the Newcastle-Ottawa scale. Data were extracted and entered into a pre-written data abstraction proforma. Seven peer-review studies were included. This included 2 retrospective cohort studies, 1 case series, 2 case reports and 2 cross-sectional studies. The studies described and analyzed 3 types of complication: balanitis, posthitis and/or meatitis; reactive arthritis and/or conjunctivitis; and epididymitis. All studies reported one or more complications. Key Messages: This review identifies an important avenue for future research: while the available evidence suggests that NCNGU has the potential to cause significant complications in men, with the strongest evidence existing for balanitis, posthitis and/or meatitis, the nature and significance of these relationships is far from clear. The findings of this review suggest that prospective, adequately powered research into whether there is a causal link between NCNGU and significant clinical complications in men would be highly worthwhile. The findings of this review raise important questions about the utility of the term NCNGU in research and clinical practice.

scholarly journals Applications of Office-Based 445 nm Blue Laser Transnasal Flexible Laser Surgery: A Case Series and Review of Practice

2020 ◽  
Vol 100 (1_suppl) ◽  
pp. 105S-112S
Author(s):  
Benjamin John Miller ◽  
Amr Abdelhamid ◽  
Yakubu Karagama
Keyword(s):  
Laser Surgery ◽  
Case Reports ◽  
Case Series ◽  
Primary Outcome Measure ◽  
Blue Laser ◽  
Current Evidence ◽  
Future Research ◽  
Retrospective Case ◽  
Laryngeal Lesions ◽  
Benign Laryngeal Lesions

Background: The recent introduction of 445 nm blue laser to office-based laryngology presents potential advantages. These include a desirable combination of cutting and photoangiolytic qualities and a lightweight, shock-resistant design. Despite its increasing use, current evidence is limited to experimental data and case reports. Objectives: The authors present a case series and overview of office blue laser transnasal flexible laser surgery (TNFLS), considering indications, patient selection, safety, technique, and surgical outcomes. We also review the safety and relevance of TNFLS to the ongoing coronavirus pandemic. Methods: Retrospective case series and narrative review. Our primary outcome measure was preoperative and postoperative Voice Handicap Index (VHI-10) score. Complications were documented by nature and severity. Results: Thirty-six cases of office blue laser TNFLS were performed. A statistically significant improvement in VHI-10 score was demonstrated in cases of recurrent respiratory papillomatosis (RRP) and benign laryngeal lesions causing dysphonia ( P < 0.01 and 0.045). Blue laser also proved effective in assisting office biopsy procedures. A minor and self-limiting complication was reported. Conclusions: Office blue laser TNFLS is safe and effective in the treatment of RRP and a range of benign laryngeal lesions. Future research should compare the efficacy and safety of blue laser with potassium titanyl phosphate laser in office-based treatment of these conditions. Further assessment of the cutting qualities of blue laser, initially in the theater environment, is necessary to refine our understanding of future applications.

Is SARS-CoV-2 transmitted by asymptomatic and pre-symptomatic infected individuals?

2021 ◽  
Vol 54 ◽  
Author(s):  
Abigail F. Melicor ◽  
Katrina Loren R. Rey ◽  
Leonila F. Dans
Keyword(s):  
Case Reports ◽  
Case Series ◽  
The Philippines ◽  
World Health ◽  
Current Evidence ◽  
Wide Confidence Interval ◽  
Cross Sectional ◽  
Viral Shedding ◽  
Asymptomatic Patients ◽  
Health Organization

KEY FINDINGSAsymptomatic and pre-symptomatic transmission of SARS-CoV-2 may occur.• Manifestations of COVID-19 are highly varied and may include asymptomatic cases, who do not manifest with anysigns and symptoms despite testing positive for COVID-19 by viral nucleic acid tests. Pre-symptomatic cases areinfected individuals who are still in their incubation period, hence do not exhibit any symptoms yet but eventuallydevelop symptoms.• As of June 2020, only 586 (2.8%) of the 20,990 active cases in the Philippines were classified as asymptomatic,but it is unclear whether cases are pre-symptomatic or carriers (true asymptomatic).• Based on 36 observational studies (case reports, case series, cross-sectional and cohort studies) and 9 statisticalmodeling analysis, asymptomatic and pre-symptomatic transmission of SARS-CoV-2 may occur. However, 3studies reported no transmission from pre-symptomatic and asymptomatic cases.• Studies on viral load comparing symptomatic cases with pre-symptomatic and asymptomatic cases reportedcontradicting results. The duration of viral shedding was significantly longer for symptomatic patients comparedto asymptomatic patients but similar for asymptomatic and pre-symptomatic patients.• Therewas no difference in the transmission rates of symptomatic and asymptomatic cases. However,the estimatedinfectivity and probability of transmission was higherfor symptomatic cases compared to asymptomatic cases, butresults were imprecise due to a wide confidence interval.• The World Health Organization (WHO) and Centers for Disease Control and Prevention (CDC) recognize thepossibility of pre-symptomatic and asymptomatic transmission. According to WHO, current evidence suggestsasymptomatic cases are less likely to transmit the virus than symptomatic cases.

scholarly journals Environmental Issues and Neurological Manifestations Associated with COVID-19 Pandemic: New Aspects of the Disease?

2020 ◽  
Vol 17 (21) ◽  
pp. 8049
Author(s):  
Luigi Bellocchio ◽  
Ioana Roxana Bordea ◽  
Andrea Ballini ◽  
Felice Lorusso ◽  
Denisa Hazballa ◽  
...  
Keyword(s):  
Case Reports ◽  
Case Series ◽  
Transverse Myelitis ◽  
Neurological Complications ◽  
Neurological Symptoms ◽  
Current Evidence ◽  
Pubmed Central ◽  
Global Pandemic ◽  
Neurological Features ◽  
Specific Symptoms

Coronavirus (SARS-CoV-2) emerged in China in December 2019 and rapidly caused a global health pandemic. Current evidence seems to suggest a possible link with ecosystem disequilibrium and even air pollution. The primary manifestations affect respiratory and circulatory systems, but neurological features are also being reported through case reports and case series. We summarize neurological symptoms and complications associated with COVID-19. We have searched for original articles published in PubMed/Medline, PubMed Central and Google Scholar using the following keywords: “COVID-19”, “Coronavirus”, “pandemic”, “SARS-COV-2”, “neurology”, “neurological”, “complications” and “manifestations”. We found around 1000 publications addressing the issue of neurological conditions associated with COVID-19 infection. Amongst those, headache and dizziness are the most common reported symptoms followed by encephalopathy and delirium, while the most frequent complications are cerebrovascular accidents, Guillain–Barré syndrome, acute transverse myelitis, and acute encephalitis. Specific symptoms affecting the peripheral nervous system such as hyposmia and dysgeusia are the most common manifestations recorded in the selected studies. Interestingly, it was noted that these kinds of neurological symptoms might precede the typical features, such as fever and cough, in COVID patients. Neurological symptoms and complications associated with COVID-19 should be considered as a part of the clinical features of this novel global pandemic.

Current Evidence Based Guidelines for Factor VIIa Use in Trauma: The Good, the Bad, and the Ugly

2008 ◽  
Vol 74 (12) ◽  
pp. 1159-1165 ◽  
Author(s):  
Juan C. Duchesne ◽  
Kavitha A. Mathew ◽  
Alan B. Marr ◽  
Michael R. Pinsky ◽  
James M. Barbeau ◽  
...  
Keyword(s):  
Case Reports ◽  
Case Series ◽  
Penetrating Trauma ◽  
Cost Benefit ◽  
Assessment Instrument ◽  
Class I ◽  
Factor Vii ◽  
Current Evidence ◽  
Trauma Patients ◽  
Thromboembolic Events

Recombinant factor VII (rFVIIa) has arisen as an option for the control of life-threatening traumatic bleeding unresponsive to other means. The timing of administration, dosage, mortality, units of blood transfusion saved, risk of thrombotic events, and risk/benefits ratio are presently poorly defined. A Medline search from 1995 through March 2008 was conducted. All English language articles containing the terms “trauma” and “factor VII” or its variants were retrieved. Letters to the editor, animal studies, and general reviews were excluded. A total of 19 articles met inclusion criteria. These articles were then reviewed and stratified into three classes of evidence according to the quality assessment instrument developed by the Brain and Trauma Foundation. Levels of recommendation were developed. A total of 118 articles were identified. Only one Class I study was identified. This study demonstrated that three doses of rFVIIa given in blunt traumatic hemorrhage yielded a significant reduction of 2.6 of red blood cells used. These findings were not statistically significant for penetrating trauma patients. There was no reduction in mortality and no increase in thromboembolic events. Four Class II studies were identified; three showed a significant decrease of blood product usage and one demonstrated significant reductions in 24-hour and 30 day death from hemorrhage in patients receiving rFVIIa. The remaining 14 studies were Class III reviews of databases, registries, case series, and case reports. No identified study specifically addressed the cost/benefit analysis of rFVIIa usage in trauma hemorrhage. Utility of rFVIIa in trauma-associated hemorrhage remains controversial. There is Level I supporting the use of rFVIIa for blunt trauma patients only. There is no Class I evidence supporting decreased mortality or differences in thromboembolic events. Minimal effective dosing regimens and cost/benefit analyses have not yet been examined.

scholarly journals Is the Simplicity of the Evidence Pyramid Actually Detrimental for Understanding Evidence?

2017 ◽  
Vol 2 (1) ◽  
Author(s):  
Annette O'Connor
Keyword(s):  
Cohort Studies ◽  
Real World ◽  
Disease Risk ◽  
Case Reports ◽  
Meta Analysis ◽  
Information Source ◽  
Case Series ◽  
Case Control ◽  
Current Evidence ◽  
Case Control Studies

The evidence pyramid for assessing the efficacy of interventions under real world conditions has been used in various forms for many years, and to a lesser extent the pyramid has been used for assessing evidence for disease risk factors. While acknowledging minor differences, many pyramids list the following information sources for interventions in decreasing order of “validity”: systematic review and meta-analysis of randomised control trials, randomised controlled trials, cohort studies, case control studies, case series and case reports. The evidence pyramid is often used as a teaching aid to help clinicians and students visualise the concept that all studies might not have equal evidentiary value when evaluating real world efficacy.The rationale for the hierarchy of the pyramid is partially based on the potential for bias in some designs and partially based on the external validity of the information source. Designs with greater potential for bias “on average” are placed lower on the pyramid. The greater risk of bias means a greater risk that effect size estimates from studies lower on the pyramid may be systematically incorrect (overestimated or underestimated). As such, the evidence pyramid makes very broad statements about the design “on average”. Of course, for any particular study or topic, the pyramid may not be correct. Regardless, the generalisations described in the evidence pyramid have over the years been considered useful and use of the tool continues likely because of its simplicity. However, the validity of most pyramids that we have seen (and used ourselves, and published ourselves) is predicated on two potentially false concepts. The first potentially false concept conveyed by most evidence pyramids, is that there is only one case-control design and it is of lesser evidentiary value than cohort studies. The second potentially false concept conveyed by evidence pyramids is that the terms cohort, case control, and case series can be used to “filter” out studies of lower evidentiary value.In this presentation Annette discusses the validity of the evidence pyramid on the interpretation of evidence from primary research. She proposes a new way to think about evidence from primary studies using the framework for classifying epidemiologic studies proposed by Pearce (2012) based on incident and prevalent cases. This would also result in a rethinking of the current evidence pyramid.

scholarly journals Breastfeeding of Infants Born to Mothers with COVID-19: A Rapid Review

2020 ◽  
Author(s):  
Nan Yang ◽  
Siyi Che ◽  
Jingyi Zhang ◽  
Xia Wang ◽  
Yuyi Tang ◽  
...  
Keyword(s):  
Nucleic Acid ◽  
Breast Milk ◽  
Close Contact ◽  
Case Reports ◽  
Case Series ◽  
Rapid Review ◽  
Current Evidence ◽  
Cochrane Library ◽  
China National Knowledge Infrastructure ◽  
Viral Nucleic Acid

AbstractBackgroundExisting recommendations on whether mothers with COVID-19 should continue breastfeeding are still conflicting. We aimed to conduct a rapid review of mother-to-child transmission of COVID-19 during breastfeeding.MethodsWe systematically searched Medline, Embase, Web of Science, Cochrane library, China Biology Medicine disc, China National Knowledge Infrastructure, Wanfang, and preprint articles up to March 2020. We included studies relevant to transmission through milk and respiratory droplets during breastfeeding of mothers with COVID-19, SARS, MERS and influenza. Two reviewers independently screened studies for eligibility, extracted data, assessed risk of bias and used GRADE to assess certainty of evidence.ResultsA total of 4481 records were identified in our literature search. Six studies (five case reports and one case series) involving 58 mothers (16 mothers with COVID-19, 42 mothers with influenza) and their infants proved eligible. Five case reports showed that the viral nucleic acid tests for all thirteen collected samples of breast milk from mothers with COVID-19 were negative. A case series of 42 influenza infected postpartum mothers taking precautions (hand hygiene and wearing masks) before breastfeeding showed that no neonates were infected with influenza during one-month of follow-up.ConclusionsThe current evidence indicates that SARS-CoV-2 viral nucleic acid has not been detected in breast milk. The benefits of breastfeeding may outweigh the risk of SARS-CoV-2 infection in infants. Mothers with COVID-19 should take appropriate precautions to reduce the risk of transmission via droplets and close contact during breastfeeding.

scholarly journals Current evidence of SARS-CoV-2 vertical transmission: an integrative review

2020 ◽  
Vol 66 (suppl 2) ◽  
pp. 130-135 ◽  
Author(s):  
Lisiane Vital de Oliveira ◽  
Camila Radelley Azevedo Costa da Silva ◽  
Lorenna Peixoto Lopes ◽  
Isabela Karine Rodrigues Agra
Keyword(s):  
Vertical Transmission ◽  
Case Reports ◽  
Scientific Evidence ◽  
Case Series ◽  
Integrative Review ◽  
Current Evidence ◽  
Viral Pathogens ◽  
Potential Risks ◽  
Clinical Conditions ◽  
Positive Results

SUMMARY OBJECTIVE To review the current scientific evidence of vertical transmission related to coronavirus disease 2019 (COVID-19). METHODS An integrative review was performed by two independent researchers, based on the literature available in the MEDLINE (via PubMed) and LILACS databases, using the descriptors “pregnancy” AND “COVID-19” AND “vertical transmission”. This search included case reports or case series published up until 17th June 2020 in English or Portuguese. After reading the articles available in their entirety, those related specifically to the potential risks of vertical transmission of COVID-19 during pregnancy were selected. We initially found a total of 57 articles; 26 were carefully screened and 15 were finally selected. RESULTS Pregnancy can make women more susceptible to infections, especially by viral pathogens, given the various physiological and immunological changes that occur to maintain maternal-fetal balance. It is speculated that the fetus may be a possible target for COVID-19. Few studies (3 out of 15) in our analysis have found positive results for SARS-CoV-2 in fetal membranes, placenta, and in newborns right after birth. Additionally, no difference was noticed when comparing different modes of delivery, and seems reasonable to assume that pregnant women with stable clinical conditions can be encouraged for vaginal delivery. CONCLUSION Further studies with a great number of cases are warranted to elucidate whether the virus may be vertically transmitted to the fetus and if any maternal conditions can influence that. Our findings seem to demonstrate that vertical transmission is possible but quite unusual.

scholarly journals Updates on Robotic CME for Right Colon Cancer: A Qualitative Systematic Review

2021 ◽  
Vol 11 (6) ◽  
pp. 550
Author(s):  
Wanda Petz ◽  
Simona Borin ◽  
Uberto Fumagalli Romario
Keyword(s):  
Case Reports ◽  
Case Series ◽  
Complete Mesocolic Excision ◽  
Clinical Results ◽  
Right Colectomy ◽  
Current Evidence ◽  
Right Colon Cancer ◽  
Histopathologic Evaluation ◽  
Oncologic Results ◽  
Robotic Right Colectomy

Background. Complete mesocolic excision (CME) is a surgical technique introduced with the aim of ameliorating the oncologic results of colectomy. Various experiences have demonstrated favorable oncologic results of CME in comparison with standard colectomy, in which the principles of CME are not respected. The majority of the literature refers to open or laparoscopic CME. This review analyses current evidence regarding robotic CME for right colectomy. Methods. An extensive Medline (Pub Med) search for relevant case series, restricted to papers published in English, was performed, censoring video vignettes and case reports. Results. Fourteen studies (ten retrospective, four comparative series of robotic versus laparoscopic CME) were included, with patient numbers ranging from 20 to 202. Four different approaches to CME are described, which also depend on the robotic platform utilized. Intraoperative and early clinical results were good, with a low conversion and anastomotic leak rate and a majority of Clavien–Dindo complications being Grades I and II. Oncologic adequacy of the surgical specimens was found to be good, although a homogeneous histopathologic evaluation was not provided. Conclusions. Further large studies are warranted to define long-term oncologic results of robotic right colectomy with CME and its eventual benefits in comparison to laparoscopy.

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