Year
Publisher
Journal
1
Institution
Institution Country
Publication Type
Field Of Study
Topics
Open Access
Language
Filter 1
Year
Publisher
Journal
1
Institution
Institution Country
Publication Type
Field Of Study
Topics
Open Access
Language
Filter 1
Export
Sort by: Relevance
Efficacy and safety of acupuncture treatment for stiff neck: A systematic review and meta-analysis.

Stiff neck is a common acute musculoskeletal condition that significantly affects the quality of life of patients. Acupuncture is recommended as an effective method for alleviating pain and restoring neck mobility in patients with stiff neck, but there is currently a lack of scientific evidence supporting its efficacy and safety. The purpose of this study was to investigate the efficacy and safety of acupuncture in the treatment of stiff neck. This study searched 8 Chinese and English electronic medical databases, including China Biology Medicine disc, VIP database, Wanfang Data, China National Knowledge Infrastructure, Web of Science, PubMed, Embase, and the Cochrane Library, with a search period up to May 13, 2024. The focus was on clinical randomized controlled trials evaluating acupuncture treatment for stiff neck. The primary outcome measures were the total effective rate and visual analog scale scores. The quality of evidence and methodology of the included studies were assessed according to the GRADEpro guidelines. Meta-analysis was conducted to assess the results, with heterogeneity analysis, sensitivity analysis, subgroup analysis, trial sequential analysis, and publication bias analysis performed to verify the robustness of the combined results and explore potential sources of heterogeneity. This study evaluated 10 clinical randomized controlled trials comparing acupuncture therapy with conventional treatment, involving 754 patients. The treatment group received acupuncture alone or in combination with conventional treatment, whereas the control group received only conventional treatment. The analysis results showed that the treatment group was significantly superior to the control group in improving the total effective rate (risk ratio = 1.12, 95% confidence interval [CI] [1.04, 1.21], P = .002), reducing visual analog scale scores (mean difference [MD] = -0.93, 95% CI [-1.29, -0.57], P < .001), reducing neck disability index scores (MD = -6.39, 95% CI [-6.79, -6.00], P < .001), and restoring cervical range of motion (cervical lateral flexion: MD = 4.29, 95% CI [3.15, 5.43], P < .001; cervical rotation: MD = 6.08, 95% CI [4.46, 7.70], P < .001). Acupuncture is an effective and safe method for treating stiff neck. However, to validate this conclusion, more rigorously designed and higher-quality studies are needed in the future.

Read full abstract
Open Access Just Published
Small prostate associated with higher incidence of detrusor underactivity and tendency of combination with bladder stone in patients with bladder outlet obstruction.

Benign prostate hyperplasia is the leading cause of lower urinary tract symptoms due to bladder outlet obstruction (BOO) in elderly male patients. The impact of prostate volume (PV) on clinical and urodynamic characteristics was evaluated in those patients with BOO requiring prostate de-obstruction maneuvers in this study. We retrospectively reviewed the clinical data of 301 patients underwent transurethral resection of prostate due to combination with urinary retention (UR) alone and bladder stone (BS) alone. The present study investigated the differences of subjective symptoms, sonographic parameters, and urodynamic characters and assessed the proportion of UR to BS as well as the incidence of detrusor underactivity (DU) in those patients according to PV. There was not a difference of age, international prostate symptoms scores, post-voiding residual, and peak flow rate (Qmax) among 3 groups (all P > .05), whereas increasing of intravesical prostate protrusion (IPP), bladder wall thick (BWT), detrusor pressure at Qmax, bladder contractility index, bladder outlet obstruction index (BOOI), and quality of life scores with enlargement of PV was found (all P < .05). Correlations between PV and IPP (R = 0.251), Qmax (R = -0.188), post-voiding residual (R = 0.215), BWT (R = 0.170), and quality of life scores (R = 0.165) at large prostate and relationships between BWT and BOOI (R = 0.246) and bladder contractility index (R = 0.239) in moderate prostate as well as IPP and BOOI (R = 0.204) in large prostate were significantly found (all P < .05). Significant higher proportion of UR was found in patients with moderate (18%) and large prostate (47.6%) when compared to that of small prostate (3.7%), whereas higher proportion of BS was found in patients with small prostate (96.7%) compared to that of moderate (82%) and large (52.4%) prostate. Lower incidence of DU was discovered in large prostate (31.9%) compared with small (55.6%) and moderate (47.2%) prostate. BOO patients with small prostate were associated with less severity of BOO but higher incidence of DU and had a tendency of occurrence of BS, which gave a support for the theory that multifactor involved in the formation of BS rather than BOO only.

Read full abstract
Open Access Just Published
Comparison of two formulas for calculating intraocular lens in patients with angle-closure glaucoma.

This study compares the accuracy of SRK/T and Barrett Universal II intraocular lens (IOL) measurement formulas for cataract phacoemulsification combined with intraocular lens implantation in angle-closure glaucoma (ACG) patients. Prospective serial case studies were conducted. A total of 146 patients (146 eyes) with ACG complicated with cataract who underwent cataract surgery with atrial angle closure ≤180° were observed. All the patients were divided into 2 groups according to different intraocular lens calculation formula, with 73 cases in each group (73 eyes). SRK/T intraocular lens calculation formula was used in group A, and Barrett intraocular lens calculation formula was used in group B. The visual acuity, the best corrected visual acuity, intraocular pressure and central anterior chamber depth were significantly improved in 146 eyes 3 months after operation, and the differences were statistically significant. There was statistically significant difference in postoperative spherical equivalent (SE) between the 2 groups (t = 2.147, P = .033), and there was statistically significant difference in preoperative expected refraction between group A and postoperative SE (t = 4.221, P < .001). There was no significant difference between preoperative expected diopter and postoperative SE in group B (t = 1.857, P = .065). The difference in absolute predicted error between the 2 groups was statistically significant (t = 4.929, P < .001). Axis length was negatively correlated with SRK/T formula and Barrett Universal II formula absolute refractive error value (ME) (group A: r = -0.740, P < .001; group B: r = -0.532, P < .001), there was A significant negative correlation between absolute refractive error value and anterior chamber depth in both groups (group A: r = -0.382, P = .001; group B: r = -0.358, P = .002). The cataract phacoemulsification combined with intraocular lens implantation is safe and effective for ACG patients with cataract. For such patients, the Barrett Universal II intraocular lens measurement formula may be more accurate after surgery.

Read full abstract
Open Access Just Published
Association between hemoglobin-to-red blood cell distribution width ratio and chronic kidney disease: A cross sectional study.

The hemoglobin-to-red blood cell distribution width ratio (HRR) is recognized as a novel prognostic biomarker; however, studies exploring its relationship with chronic kidney disease (CKD) are scarce. This study used data from the National Health and National Health and Nutrition Examination Survey database from 2005 to 2018. The analysis included individuals aged ≥ 20 years who had complete HRR and CKD data. Weighted univariate and multivariate logistic regression analyses were used to assess the association between the HRR and CKD prevalence. Additionally, restricted cubic spline and subgroup analyses were conducted for further validation. Ultimately, 19,426 participants were included in this study. After adjusting for confounders, multivariate logistic regression analysis revealed a negative association between HRR and CKD (OR = 0.35, 95% CI = 0.22-0.56). In addition, restricted cubic spline regression analysis revealed a negative linear association between HRR and CKD, with higher levels of HRR associated with a lower prevalence of CKD. The subgroup analysis revealed that the negative association between HRR and CKD was stronger in the male population. HRR is negatively associated with the prevalence of CKD in the adult population of the US. HRR is a potential indicator for assessing the prevalence of CKD and provides a rationale for personalized management.

Read full abstract
Open Access Just Published
Simpler and safer anastomosis by pancreaticogastrostomy using a linear stapler after pancreaticoduodenectomy.

Postoperative pancreatic fistula (POPF) remains a major and serious problem after pancreaticoduodenectomy (PD). In its presence, pancreatic juice may leak from the main duct or branches of the pancreatic stump. To prevent this, we have applied a newly modified anastomosis of pancreaticogastrostomy (PG) using a linear stapler (stapled PG). Clinical records of 30 consecutive patients who underwent PD were reviewed between 2013 and 2023 at our community hospital. Regarding procedures, 12 stapled PGs and eighteen pancreaticojejunostomies (PJs) were performed after PD, from 2018 to 2023 and from 2013 to 2017, respectively. The pancreas was transected for long compression by a linear stapler, involving: pre-compression for 5 min, stapling for 5 min, and dissection for 5 min. After removal of the staples at the main duct opening of the pancreatic stump, PG anastomosis was performed. The outer layer was anastomosed by a straight single row pancreas-transfixing suture with the posterior gastric wall, and inner layer duct-to-mucosa anastomosis was also performed in a radial axis manner. Anastomosis of PJ was conducted without using a linear stapler. POPF was defined as a clinical manifestation of POPF (grade B/C) based on the ISGPF (International Study Group of Pancreatic Fistula) criteria. None of the 12 patients who had undergone stapled PG developed clinically relevant POPF, whereas 5 (27%) patients who had received PJ developed POPF. Three patients showed POPF grade B and 2 patients exhibited POPF grade C. Stapled PG after PD may reduce clinically relevant POPF. Because our sample size was small, the further accumulation of cases is required to validate this method.

Read full abstract
Open Access Just Published
Comparative evaluation of pain rating scales for dental pain among the Saudi population: A cross-sectional study.

Pain, being a subjective phenomenon, is perceived in different manner by individuals based on various factors including age and gender. Various scales are available in literature to assess and record the pain perceived by an individual. Comparison of commonly used pain perception scales among Saudi Arabian population is scarce. A cross-sectional observational study was conducted among 180 subjects who were belonging to 2 age groups namely 7 to 16 years (group 1; n = 90) and 51 to 60 years (group II; n = 90). Subjects with dental pain of pulpal origin were included by employing consecutive sampling. The included participants were asked to record the severity of pain using visual analogue scale (VAS) and Wong Baker facial pain rating scale (WBS) in a computer-generated random order. The data obtained was subjected to statistical analysis. t test was used to compare the pain score recorded using VAS and WBS among males and females. The correlation between VAS and WBS was also assessed. P value < 0.05 was considered statistically significant. All subjects who participated responded to both the pain perception scales. No difference was found between males and females in the pain perception recorded using VAS and WBS in both the groups. A strong positive correlation was found between VAS and WBS score which was found to be statistically significant in both the groups. Both VAS and WBS are reliable tool to record pain perception in both age groups. WBS is found to be easier and more convenient one.

Read full abstract
Open Access Just Published
Herbal medicine for the treatment of non-erosive reflux disease: A systematic review and meta-analysis.

Non-erosive reflux disease (NERD) is the most prevalent gastroesophageal reflux disease. Currently, proton pump inhibitors are the most commonly used treatment for NERD. Recently, the demand for herbal medicines with relatively few side effects is increasing and trials confirming the effectiveness and safety of herbal medicines for the treatment of NERD have been conducted. This study aimed to investigate the effectiveness and safety of herbal medicine in the treatment of NERD through published randomized-controlled trials. Ten electronic databases were searched from inception until May 2023. Disease, intervention-related terms, and publication type keywords were combined as search terms. Studies designed as randomized controlled trials, including participants diagnosed with NERD with any type of herbal medicine as a treatment intervention were included. Data extraction and analysis were conducted by 2 independent reviewers. The total clinical efficacy rate was assessed as a primary outcome, while the secondary outcomes were recurrence rate, reflux diagnostic questionnaire score, short-form 36 health survey score, and serum motilin level. The risk of bias in each study and quality of evidence were assessed. Thirty-four randomized controlled trials involving 3759 patients were analyzed. Herbal medicine was significantly more effective in improving total clinical efficacy, recurrence rate, reflux diagnostic questionnaire score, some domains of short-form 36 health survey, and serum motilin levels in patients with NERD than conventional medical therapy. No severe intervention-related adverse effects were observed. Regarding the quality of evidence, most outcomes were revealed to have moderate to low levels of evidence. This systematic review and meta-analysis suggests that herbal medicine can be an effective and safe therapy for NERD; however, there are several limitations regarding the methodological quality of the included studies. Further research with high methodological quality is necessary to improve the quality of evidence.

Read full abstract
Open Access Just Published
Application of ultrasound-guided inferior vena cava collapsibility measurement in volume assessment for patients undergoing single-shot spinal anesthesia in total hip arthroplasty.

To explore the value of ultrasound in volume assessment during the perioperative period of single-shot spinal anesthesia for total hip arthroplasty. A total of 100 patients undergoing elective surgery under spinal anesthesia at our hospital from January 2022 to January 2024 were selected. Transthoracic echocardiography was used to measure the diameter of the abdominal aorta (Ao) before anesthesia (T1), 10 minutes after anesthesia (T2), and 30 minutes after anesthesia (T3). The inferior vena cava collapsibility index (IVC-CI) and the ratio of IVCe to Ao (IVCe/Ao) were calculated. A volume load test was performed 10 minutes after anesthesia. Based on the increase in stroke volume (ΔSV) after the volume load test, patients were divided into a volume-responsive group (ΔSV ≥ 15%) and a volume-nonresponsive group (ΔSV < 15%). The reliability of inferior vena cava parameters in predicting hypotension after spinal anesthesia and the value in predicting volume responsiveness postanesthesia were evaluated using ROC curves. A total of 100 patients were enrolled, 18 were withdrawn, and a total of 82 patients were included. After the volume load test, the parameters of the volume response group and the volume nonresponse group were basically consistent, and the difference was not statistically significant (P > .05). The SV of volume reaction group was significantly higher than that of volume no reaction group (P < .05). The incidence of hypotension in the volume response group was higher than that in the non-volume response group (51.28% vs 11.63%, χ2 = 15.174, P < .01). The AUC for volume reactivity prediction using IVCe, IVCi, IVC-CI, and IVCe/Ao were 0.62, 0.71, 0.70, and 0.72, respectively. IVCi, IVC-CI, and IVCe/Ao were significant predictors of volume reactivity (P < .05). The AUC predicting persistent hypotension after spinal anesthesia using IVCe, IVCi, IVC-CI, and IVCe/Ao were 0.78, 0.79, 0.70, and 0.84, respectively. IVCe, IVCi, IVC-CI, and IVCe/Ao can predict volume reactivity before anesthesia. IVCi, IVC-CI, and IVCe/Ao predicted persistent hypotension in patients with spinal anesthesia after anesthesia, and IVCe/Ao showed the best predictive effect. Thus, IVCe/Ao is a reliable parameter for predicting persistent hypotension and assessing volumetric reactivity.

Read full abstract
Open Access Just Published
Predictive value of systemic immune-inflammatory biomarkers for drug-induced liver injury in hepatitis B virus surface antigen positive tuberculosis patients: A retrospective observational study.

Drug-induced liver injury (DILI) is a major concern in tuberculosis (TB) treatment. For early detection of DILI, immune-inflammatory biomarkers are needed for better management. To explore the predictive effect of systemic immune-inflammation index (SII) combined with neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), eosinophil (EOS%), and CD4/CD8 on DILI occurrence in TB patients with HBsAg positive. This is a retrospective study enrolling patients who were treated with anti-tuberculosis drugs and infected with hepatitis B virus (HBV) in the Guangzhou Chest Hospital from 2018 to 2023. Population demographics and clinical data of 2643 patients were collected by reviewing electronic medical records. Using a propensity score matching model, the study ultimately included 516 patients (258 patients with DILI and 258 patients without DILI). Logistic regression analysis was conducted to investigate the predictive role of systemic immune-inflammatory biomarkers (SII, NLR, MLR, EOS%, and CD4/CD8) in DILI in hepatitis B virus surface antigen-positive TB patients (HBV-TB-DILI). As compared to patients without DILI, patients with DILI have elevated levels of systemic immune-inflammatory biomarkers (SII, NLR, MLR, EOS%, and CD4/CD8), (all P < .05). The SII, NLR, MLR, PLR, EOS%, and CD4/CD8 are risk factors of HBV-TB-DILI. The NLR, MLR, SII, and EOS% were positively correlated with liver function (P < .001). The combination of SII, NLR, MLR, EOS%, and CD4/CD8 demonstrated good predictive performance for DILI occurrence in HBV-TB patients. The combination of SII, NLR, MLR, EOS%, and CD4/CD8 demonstrated good predictive performance for DILI occurrence in HBV-TB patients.

Read full abstract
Open Access Just Published
Diagnostic accuracy and image quality evaluation of ultrashort echo time MRI in the lungs.

This study evaluates the diagnostic accuracy of ultrashort echo time (UTE)-MRI for detecting pulmonary nodules and image quality. A total of 46 patients at our hospital underwent unenhanced computed tomography (CT) and UTE-MRI. The image quality and number of nodules detected using CT were used as the gold standards. Three diagnostic radiologists independently recorded the image quality (visibility and sharpness of normal anatomical structures) of the CT and UTE images and the number of pulmonary nodules detected. The diagnostic accuracy, subjective image quality, and consistency between observations were statistically analyzed. Among 46 patients, 36 (78.2%) had pulmonary nodules on CT images, whereas 10 patients (21.7%) had no pulmonary nodules. A total of 48 lung nodules were detected, 3 of which were ground-glass opacities. UTE-MRI revealed 46 lung nodules. Compared with CT, the sensitivity of all MRI readers for detecting lung lesions was 95.8%, and the 3-observer agreement was nearly perfect (P < .001, Kendall Wa [Kender Harmonious Coefficient] = 0.913). The overall image quality score of the observers was high, ranging from good to excellent, and the consistency of the subjective UTE-MRI image quality was good (Kendall Wa = 0.877, P < .001). For tracheal display, the subsegment of the bronchus was displayed, and the wall of the tube was clearly displayed. The difference in the Wa values between the observers was 0.804 (P < .001), indicating strong consistency. For blood vessels, subsegment blood vessels could also be displayed with clear walls and uniform signals (Kendal Wa = 0.823, P < .001), indicating strong consistency. Compared to CT, UTE-MRI can detect pulmonary nodules with a high detection rate, relatively good image quality, and strong consistency between observers. The development of UTE-MRI can provide a novel imaging method for the detection and follow-up of pulmonary nodules and diagnosis of pneumonia by reducing ionizing radiation.

Read full abstract
Open Access Just Published