MeSH Terms Research Articles

Effect of statins on arterial wall inflammation as assessed by 18F-FDG PET CT: an updated systematic review and meta-analysis

BackgroundPathogenesis of atherosclerosis is largely mediated by inflammatory process. Statins are lipid-lowering drugs which also have anti-inflammatory effects. 18 fluorine radiolabeled fluorodeoxyglucose (18 F-FDG) positron emission tomography-computed tomography (PET-CT) is considered to be a good indicator of arterial wall inflammation. Therefore, in this meta-analysis the role of statins on inflammatory process in the artery wall was evaluated using this method since its actual validity for this purpose is not yet well established.MethodsPubMed, Scopus, Web of Science, ClinicalTrials.gov, and Google Scholar databases were searched using MESH terms and keywords. Funnel plot, Begg’s rank correlation, and Egger’s weighted regression tests evaluated publication bias in the meta-analysis. In cases where funnel plot asymmetry was observed, the “trim and fill” method was used to check the input of potentially missing studies.ResultsFindings of 10 clinical trials involving 373 subjects showed a remarkable reduction of arterial wall 18 F-FDG uptake according to target-to-background ratio (TBR) index after treatment with statins. Subgroup analysis showed a significant decrease in TBR with high-intensity and non-significant reduction of TBR with low-to-moderate-intensity statin therapy.ConclusionTreatment with statins suppressed arterial wall inflammation as shown by using 18 F-FDG PET-CT.

A PubMed search filter for efficiently retrieving exercise training studies

BackgroundA barrier to evidence-informed exercise programming is locating studies of exercise training programs. The purpose of this study was to create a search filter for studies of exercise training programs for the PubMed electronic bibliographic database.MethodsCandidate search terms were identified from three sources: exercise-relevant MeSH terms and their corresponding Entry terms, word frequency analysis of articles in a gold-standard reference set curated from systematic reviews focused on exercise training, and retrospective searching of articles retrieved in the search filter development and testing steps. These terms were assembled into an exercise training search filter, and its performance was assessed against a basic search string applied to six case studies. Search string performance was measured as sensitivity (relative recall), precision, and number needed to read (NNR). We aimed to achieve relative recall ≥ 85%, and a NNR ≥ 2.ResultsThe reference set consisted of 71 articles drawn from six systematic reviews. Sixty-one candidate search terms were evaluated for inclusion, 21 of which were included in the finalized exercise-training search filter. The relative recall of the search filter was 96% for the reference set and the precision mean ± SD was 54 ± 16% across the case studies, with the corresponding NNR = ~ 2. The exercise training search filter consistently outperformed the basic search string.ConclusionThe exercise training search filter fosters more efficient searches for studies of exercise training programs in the PubMed electronic bibliographic database. This search string may therefore support evidence-informed practice in exercise programming.

3D-printed porous titanium versus polyetheretherketone cages in lateral lumbar interbody fusion: a systematic review and meta-analysis of subsidence

BackgroundCage subsidence frequently complicates lumbar fusion procedures, including lateral lumbar interbody fusion (LLIF), potentially leading to recurrent pain, impaired fusion, and accelerated degeneration of adjacent segments. A critical factor influencing cage subsidence is the selection of material. Polyetheretherketone (PEEK) and three-dimensional printed titanium (3D-Ti) cages are commonly used in LLIF procedures, each offering distinct advantages. However, these materials possess inherent property differences that may translate into divergent settling rates. To contribute to this discourse and offer insights, this systematic review and meta-analysis aims to compare the rates of cage subsidence between 3D-Ti and PEEK cages in LLIF.MethodsA meticulous systematic search that employs distinct MeSH terms was conducted in major electronic databases (MEDLINE, PubMed, Embase, Scopus, Web of Science, and Cochrane) up to December 20, 2023. The quality of inclusion was measured using the Newcastle-Ottawa Scale (NOS) for non-randomized trials. The primary outcome measure was cage subsidence, while the secondary outcome involved evaluating subsidence within each treatment segment using the Marchi classification.ResultsThe review included 265 patients (441 segments) from three studies. All with NOS ratings exceeding 5 stars. In the analysis, 189 segments (42.9%) underwent LLIF with 3D-Ti cages, while 252 segments (57.1%) participated in LLIF with PEEK cages. Overall, the cage subsidence rate was significantly lower with 3D-Ti compared to PEEK (p < 0.00001, OR = 0.25; 95% CI 0.14 to 0.44). Specifically, the 3D-Ti group exhibited a markedly lower subsidence rate, categorized by grade I, II, and III, compared to the PEEK group (p < 0.05). Furthermore, the incidence of severe subsidence was significantly reduced in the 3D-Ti group compared to the PEEK group (p = 0.0004, OR = 0.17; 95% CI 0.07 to 0.46).ConclusionThe study concludes that the subsidence rate associated with 3D-Ti cages in LLIF is notably lower than that observed with PEEK cages, underscoring the potential advantages of 3D-Ti cages in mitigating cage subsidence.

Recent Progress in Nanoparticle-Driven Drug Delivery Strategies for Cancer Therapy: Focus on Colorectal Cancer

Context: Nanotechnology, specifically nanoparticles, has revolutionized cancer therapy through enhanced drug delivery, precise imaging, and accurate diagnosis. Their ability to target cancer cells directly with minimal side effects makes them especially promising for treating colorectal cancer (CRC), allowing for more effective treatments. Methods: A systematic literature review was conducted across multiple databases (PubMed, Scopus, Embase, Cochrane, Web of Science, Google Scholar) using MeSH terms such as nanoparticles, cancer, drug delivery, and target cells. The objectives of this review were to examine the effectiveness of nanoparticle-based drug delivery systems, evaluate their targeting mechanisms, and assess their impact on treatment outcomes for CRC. Study eligibility, participant inclusion criteria, and specific intervention types were critically analyzed to ensure a comprehensive understanding. Results: Nanoparticle-based systems have demonstrated significant promise in shrinking tumors, improving drug accumulation at the tumor site, and facilitating easier surgical removal. These systems enhance drug efficacy, reduce toxicity, and overcome biological barriers in CRC, particularly through the use of pH-responsive and thermoresponsive nanoparticles. Conclusions: The application of nanoparticles for drug delivery represents a safe and effective treatment option, demonstrating improved targeting, reduced side effects, and enhanced therapeutic outcomes. However, further research is necessary to evaluate the long-term safety, efficacy, and scalability of these systems, alongside their optimization for clinical use in personalized treatments.

Metabolic Syndrome and Its Impact on Bone and Joint Health: A Comprehensive Review

Objective: To explore the complex relationship between metabolic syndrome (MetS) and musculoskeletal (MSK) disorders, highlighting the impact of MetS on bone and joint health, and to propose effective management strategies for improving patient outcomes. Methods: This comprehensive review involved an extensive literature search conducted on 17 September 2024, utilising scientific databases such as PubMed, Google Scholar, and Scopus. The search, focused on articles published in English and pertaining to humans, employed Boolean operators and MeSH terms ‘MSK’, ‘metabolic diseases’, ‘diabetes’ and ‘osteoporosis’. Results: MetS, characterised by obesity, inflammation, insulin resistance (IR), and hypertension, is closely associated with a variety of MSK disorders including osteoarthritis, osteoporosis, and tendinopathy, among others. These conditions exacerbate MetS symptoms, creating a feedback loop that complicates patient management. The review identifies both common and rare metabolic and genetic disorders contributing to MSK issues, emphasising the intricate interplay between metabolic dysfunctions and MSK health. Special attention is given to the MSK manifestations of prevalent metabolic diseases such as diabetes mellitus, gout, and osteoporosis, underscoring their significant impact on quality of life. Conclusion: Understanding the relationship between MetS and MSK disorders is crucial for the development of holistic management strategies. The review suggests that addressing the root metabolic issues alongside direct treatment of MSK symptoms can significantly improve patient outcomes. Future research should focus on integrated care approaches that offer hope and optimism for individuals facing these interconnected challenges.

The role of executive functioning in smoking cessation: A scoping review.

Creating and implementing a plan to successfully quit smoking likely requires executive function (EF) skills such as inhibition, cognitive flexibility, attention and working memory. This scoping review consolidates the research evidence evaluating the role of EF in smoking cessation. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR), researchers and a medical librarian searched PubMed, EMBASE, ERIC, CINAHL and PSYCINFO in June 2022, hand-search in September 2022 using relevant MeSH terms, and an updated search was completed in August 2024. Fifteen articles were included. Self-regulation was the most frequently evaluated EF across all studies. Performance on measures of impulsivity was most frequently related to successful smoking cessation. Across studies, performance on measures in areas of attention, working memory, cognitive flexibility and higher-level EF was variable as it relates to smoking cessation success. There was considerable variability in the measures used to evaluate EF and definitions of cessation success. Across studies, very little research evaluates higher-level EF. Differences in EF and cessation measures make comparisons across studies difficult. Future work is needed utilising common assessment and outcome measures that will improve our understanding of the complex cognitive skills needed for successful cessation. Particular consideration should be given to higher-level EFs including reasoning, planning, problem-solving and decision-making.

Systematic review of the feasibility of sparing the rectoprostatic fascia in male patients undergoing total mesorectal excision for rectal cancer.

The main purpose of this study was to determine the feasibility of sparing the rectoprostatic fascia (RPF) in adult male cadavers and in adult male patients who underwent total mesorectal excision (TME) for rectal cancer. A secondary objective was to evaluate urogenital function following rectal cancer surgery, pathologic, and oncologic outcomes. In accordance with PRISMA guidelines, we performed a systematic review with an a priori design to identify relevant studies via MESH terms and keywords. Research was conducted from March 1stto July31st 2023andwas updated betweenSeptember 30thtoOctober 10th 2024 in MEDLINE, SCOPUS, the Web of Science, Google Scholar, and reference lists. Disagreements between individual judgments were resolved by referral to a third researcher. In total, 3693 studies were identified, 22 of which were relevant to the main research question. Overall, 785 living individuals and 25 cadavers were included in whom RPF was identified and spared (498/785 patients or 63.44%). The quality of the surgical specimen was considered good in all cases. Urogenital integrity at 6months after RPF-TME and the classic TME were compromised in 27.9% and 41% of patients, respectively. One study revealed that at 3years, local/systemic recurrence was similar between the two groups. Despite the fact that the current practice of rectal cancer surgery requires the TME to extend anteriorly to the RPF, RPF-sparing TME is not only a feasible and safe option but also important for preserving fair male urogenital function, especially for young patients whose erectile function is a priority. CRD42020171188.

Efficacy of reminiscence therapy in improving cognitive decline: a systematic review and meta-analysis.

‌ Reminiscence therapy(RT) is used in the care of people with dementia to help improve their quality of life, but the efficacy of RT in various cognitive decline populations is unclear, and long-term effects are not sufficiently evidenced.This systematic review and meta-analysis aims to determine the efficacy of RT in improving cognitive decline and provide evidence for its implementation in care. A comprehensive search strategy utilizing MeSH terms and free-text keywords was employed to systematically search the Embase, PubMed, and Cochrane databases up to January 24, 2024. Randomized controlled trials(RCTs) investigating RT monotherapy for improving cognitive decline were included. The primary outcomes of interest were the standard Mini-Mental State Examination (MMSE) scores. Additionally, all data analyses will be performed using RevMan5.4 software. ‌ We identified 612 studies, and 24 studies met the inclusion criteria, involving 2650 participants. This meta-analysis shows that RT significantly improves immediate and long-term cognitive decline with Standardized Mean Difference(SMD) and 95% CI of 0.55 [0.37, 0.73] and 0.50 [0.11, 0.88], respectively. However, there is no significant difference in efficacy between subgroups (P > 0.05). ‌ Our findings suggestS that RT significantly improves cognitive decline, with no significant differences between subgroups. This suggests that RT is universal in improving cognition and that the way RT is implemented has no significant effect on outcomes. These findings supportS the use of RT as a reliable non-pharmacological treatment option to enhance cognitive function.

Illuminating the Path to Thyroid Disorder Management Using Artificial Intelligence: A Narrative Review

Background: Dysregulation of thyroid function, manifesting as hyperthyroidism or hypothyroidism, can profoundly impact an individual's overall health. In this context, artificial intelligence (AI) applications have the potential to revolutionize diagnostic approaches, treatment strategies, and patient monitoring. Objectives: This study comprehensively reviews the latest literature on AI applications in thyroid functional and autoimmune disorders. Methods: An online search was conducted on databases using search queries crafted with MeSH terms related to AI and thyroid disorders. After screening, studies aligned with our research focus were selected for this narrative review. Results: Multiple studies have explored the use of AI technologies, including machine learning (ML) and deep learning (DL), to enhance laboratory workflows for thyroid function tests (TFT) and improve the accuracy of TFT interpretation by incorporating clinical data. In imaging, DL-based models have demonstrated the potential to assist less experienced radiologists in interpreting scintigraphy and ultrasound images. Artificial intelligence has also provided valuable insights into identifying diagnostic genes for thyroid-related autoimmune disorders and understanding the effects of environmental factors, such as chemicals, on thyroid gland function. Some ML models have been developed to predict the risk of hypothyroidism following radioiodine therapy (RAI). Furthermore, AI has shown promise in personalized levothyroxine dose adjustments, predicting treatment responses, and accurately diagnosing complications such as thyroid-associated ophthalmopathy (TAO). Finally, ML-based models forecasting the risk of suicide attempts in patients with major depressive disorder (MDD) and predicting pregnancy outcomes, such as gestational diabetes mellitus (GDM) and preterm delivery, based on TFT results, appear beneficial in addressing these significant health issues. Conclusions: The current state of AI in diagnosing and treating thyroid function disorders is promising, with applications primarily focused on improving diagnostic accuracy, consistency, and personalized treatment approaches. However, challenges remain that prevent these models from fully substituting professionals. Addressing these challenges is crucial to ensure AI effectively contributes to the management of patients with thyroid diseases.

Early case series with placement of NeuroOne Evo stereoelectroencephalography depth electrodes and review of other Food and Drug Administration-approved products

Background: Stereoelectroencephalography (SEEG) is a common diagnostic surgical procedure for patients with medically refractory epilepsy. We aimed to describe our initial experience with the recently released NeuroOne Evo SEEG electrode product (Zimmer Biomet, Warsaw, IN) and review technical specifications for other currently approved depth SEEG electrodes. Methods: We performed a record review on the first five patients implanted with NeuroOne Evo SEEG electrode product using the robotic stereotactic assistance robot platform and described our surgical technique in detail. We recorded technical specifications of all currently Food and Drug Administration-approved SEEG electrodes for comparison. Results: Our initial 5 surgical patients were reviewed. The average total time of operation was 92 min, with an average of 16.8 electrodes. The estimated time per electrode insertion was <2 min. There were no intracranial hemorrhages or hardware complications noted during monitoring. Monitoring provided diagnostic information in all patients, and removal and incision healing proceeded without issues. Conclusion: NeuroOne SEEG electrodes can be implanted with efficiency and provide a valuable additional tool for the epilepsy surgeon. A tapered drill bit prevents the bolt from being placed beyond the inner cortex and may reduce the risk of brain contusion or inadvertent advancement of anchor bolts, and the electrode internal stylet also affords the potential to reduce the number of trajectory passes. MeSH Terms: Epilepsy, EEG, Drug-resistant Epilepsy, Intracranial EEG

Assault rifle injuries in civilians: ballistics of wound patterns, assessment and initial management.

Wounds from assault rifles and their commercial offspring have been encountered with increasing frequency in civilian practice. Our aim is to summarize wound ballistics related to the main injury patterns that can also affect management strategies. An online search of the PubMed was conducted for research and review articles published after 2000 in English, using the MeSH terms "gunshot wounds", "mass casualty incidents", "war-related injuries", "soft tissue injuries", "vascular system injuries", "colon injuries", "wound infection", "antibiotic prophylaxis", "debridement", "hemorrhage", "penetrating head injuries", "pneumothorax" and additional free-text terms. Other academic databases were also searched for relevant articles and book chapters. Consensus regarding recognition of high energy wounds from assault rifle projectiles is largely based on war experience. Studies of such wounds inflicted by expanding projectiles suggest that their wounding effects significantly increase tissue damage and adverse outcomes following injury, as a result of the temporary cavity and bullet fragmentation. The use of assault rifles in mass shootings has prompted utilization of tourniquet for control of life-threatening hemorrhage, also derived from military experience, while limited evidence indicates that tension pneumothorax rather than extremity wounds is the leading cause of potentially preventable death in these incidents. Wound ballistics provides a system for evaluation of injuries from assault rifles and risk analysis of shooting incidents. Lessons learned from armed conflicts can improve the management of victims, with due consideration given to characteristics of civilian injuries. Further research is required to define the impact on survival by key life-saving procedures in the prehospital setting, in order to prioritize these interventions.

From Ancient Rituals to Modern Rhinoplasty: A Historical Evolution of Nasal Reconstruction

Background and aims: As surgical practices continue to evolve, the origins of these techniques and their respective indications are often lost over time, while in other cases they remain fundamental to modern utility. Rhinoplasty is a prime example of an operative intervention that has been heavily influenced by cultural beauty standards throughout different eras and civilizations to improve both aesthetics and functionality. By recognizing the historical context and evolution of this procedure, its modern-day application that integrates both form and function is better understood. This study aims to delineate the development of rhinoplasty from its genesis onward and demonstrate how the influences of different civilizations, eras, and cultural beliefs have shaped what the rhinoplasty is today. Methods: We performed a narrative review of various articles pertaining to ancient and modern contributions to the rhinoplasty. Articles were selected based on relevance and significance to the evolution of the procedure in a given era, highlighting pioneers and revolutionaries in the field. MESH terms, including but not limited to, “ancient rhinoplasty,” “evolution of the rhinoplasty”, and “modern-day rhinoplasty” were searched on PubMed, Google Scholar, and other major literature databases. Key sources included medical journals, historical texts, and surgical reports, supplemented by systematic reviews of existing literature. Results: Twenty-three sources were taken into consideration and categorized based on time periods. Their notable contributions, surgical innovations, and clinical impacts were expanded upon. Our analysis also explores the cultural implications of rhinoplasty and influential beauty standards across history, and how these have carried over to the present day. In a similar fashion, technical procedures were critiqued on whether they have withstood the test of time and their responsiveness to the aesthetic status quo. Finally, our analysis shows how the varied historical indications for rhinoplasty, whether functional or cosmetic, have persisted into modern practice. Conclusions: The historical evolution of rhinoplasty reveals more than mere advancements in surgical technique, as it reflects broader cultural values that influence its utilization. By examining its history, we gain valuable insight into how ancient practices have progressed through the middle ages, renaissance, and early modern period, continuing to shape the field of plastic surgery in the present day.

Chemopreventive and Chemotherapeutic Potential of Betulin and Betulinic Acid: Mechanistic Insights From In Vitro, In Vivo and Clinical Studies

ABSTRACTBetulin is a bioactive compound found in large quantities in birch bark and has a triterpene pentacyclic structure. Through the oxidation of betulin, betulinic acid is obtained, which is found in large quantities in nature. Betulin and betulinic acid have multiple pharmacological properties such as antiviral, anti‐inflammatory, and anticancer properties. This comprehensive review aims to deepen the knowledge of the chemopreventive and chemotherapeutic effects of betulin and betulinic acid by presenting in vitro, in vivo, and clinical studies evaluating the anticancer mechanisms of betulin, betulinic acid, and their derivatives. The databases searched using specific MESh terms to conduct this review were PubMed/MEDLINE, Web of Science, TRIP database, Wiley, and Scopus. The anticancer properties of betulin and betulinic acid have been reported in a variety of experimental pharmacological studies using different types of cancer cell lines. It has been indicated that induction of apoptosis is the primary anticancer activity of these compounds by selectively affecting cancer cells. As shown by various research, the apoptotic cell death by these compounds is mainly related to factors such as type of cancer and cancer cell line, tumor size, source of betulin/betulinic acid, dose, treatment time, and the type of the drug delivery system employed. Numerous preclinical pharmacological studies and clinical trials on the chemopreventive and antitumour effects of betulin, betulinic acid, and their derivatives have been published. Future translational pharmacological studies establishing the exact anticancer dose effective in humans are needed.

Impact of haptic simulator in prosthodontics training during preclinic dental education: a systematic review protocol

Background Prosthodontics significantly impacts oral health-related quality of life, especially oral comfort, functions, aesthetics, and overall well-being. This discipline is grounded in a solid academic and evidence-based understanding of fundamental principles for managing dental diseases and aims to restore the health of teeth and supporting tissues and compensate missing ones. Dental education is evolving quickly with the rise of digital dentistry, especially in prosthodontics. Integrating augmented reality simulations and haptic feedback has significantly advanced this transformation. This systematic review protocol intends to determine the effectiveness of haptic simulators in prosthodontics training during preclinical dental education. Methods An exhaustive search strategy will be employed, exploring PubMed, Scopus, EBSCO, Web of Science and Cochrane Central to select relevant studies, thereby enhancing the robustness of the review findings. Boolean operators (AND,OR) were utilized to assemble MeSH terms and relevant keywords. Titles and abstracts screening to identify studies that satisfy the eligibility criteria was followed by the quality and risk of bias assessment for the selected studies, via the Cochrane Collaboration’s tool and the Newcastle-Ottawa Scale (NOS). Data will be collected via standard form. Reviewers disagreement will be solved throughout debate, or by referring to a third opinion. This protocol will adhere the recommendations appointed by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Discussion The outcomes of this systematic review are highly significant for dental education exploring the importance of enhancing haptic simulation during preclinic prosthetic training. Recognizing the strengths and weaknesses of virtual reality (VR) in relation to traditional preclinical training methods is crucial for developing effective educational strategies. This understanding can lead to enhanced training outcomes and increased student satisfaction, which in turn contributes to improved quality of clinical prosthetic services. Systematic review registration PROSPERO: CRD42024603681 (Registered on 30/10/2024).

The Current Pathogenicity and Potential Risk Assessment of Nipah Virus as Potential Cause of "Disease X": A Narrative Review.

The World Health Organization (WHO) recognized the potential for a severe international epidemic and introduced the term "Disease X" to classify pathogens that not yet identified. The Nipah virus (NiV) is highly dangerous due to its zoonotic nature, high mortality rate, and ability to cause severe clinical symptoms in humans. In this review, we gather the latest information on the NiV and its potential to become a significant candidate for Disease X. We performed a thorough review of articles published in PubMed, Scopus, and Google Scholar using appropriate MeSH terms and keywords. Studies reported NiV infection were considered for this review. The NiV exhibits different epidemiological patterns in different countries that calls for customized prevention and control strategies. Genetic analysis highlights NiV's ability to mutate that alters possible treatment options. Transmission typically involves bats as the primary reservoir, with humans becoming infected either through intermediate hosts or food. This shows NiV's complex nature, including its ability to reach the central nervous system through the olfactory nerve. Promising treatment options, such as monoclonal antibodies, antivirals, and ongoing vaccine research, provide hope. However, the virus's adaptability, human-to-human transmission, and the lack of specific antiviral therapy raise concerns about its potential to cause a global pandemic. The interconnection between animals, humans, and the environment stresses the need for a One Health approach to tackle emerging infectious disease by NiV. Global collaboration, surveillance, and research investments are imperative for the preparation of future pandemics. The ongoing COVID-19 challenges underscoring the critical need for sustained scientific endeavors, global leadership, and recognition of the prominence of NiV as a candidate for the potential Disease X.

A comparison between transoral endoscopic thyroidectomy vestibular approach and transareolar thyroidectomy regarding postoperative pain and cosmetic outcomes: A systematic review and meta-analysis.

Remote scarless surgeries have been developed for cosmetic reasons; literature showed that remote endoscopic surgeries were superior to conventional thyroidectomy. However, no researchers have compared the transoral thyroidectomy vestibular approach and transareolar approach regarding cosmetic outcomes and postoperative pain score. This meta-analysis assessed the same among patients with papillary microcarcinoma, thyroid disease, and small-size papillary carcinoma. We searched PubMed MEDLINE, Web of Science, SCOPUS, and Cochrane Library from the date of the first inception up to January 2024. The general keywords used are trans-areolar thyroidectomy, trans-oral thyroidectomy vestibular approach, scar-less thyroidectomy, remote thyroidectomy, pain score, and cosmetic effects. The MeSH terms "mouth", "areola", "nipples", "vestibular", "oral", "endoscopes", "endoscopic", and "thyroid" were used. Out of the 389 studies and 114 remained after the removal of duplication, from them, 22 full texts were screened, and only 10 studies were included in the final meta-analysis. The tansoral thyroidectomy vestibular approach showed better cosmetic outcomes compared to the trans-areolar approach, odd ratio, 1.26, 95% CI, 0.53-1.99. However, no significant statistical difference was found regarding postoperative pain score, odd ratio, -0.11, 95% CI, -0.26-0.04, and central lymph node dissection, odd ration, 1.52, 95% CI, -0.14-3.17. The transoral endoscopic thyroidectomy vestibular approach was better compared to the trans-areolar approach in terms of cosmetic outcomes, no differences were evident regarding pain score and central lymph node dissection. Further larger well-controlled studies assessing operative and postoperative outcomes are needed.

Virtual Reality Versus Simulation in the Management of Trauma Based Scenarios-A Systematic Review.

Simulation allows trainees to practice skills safely. It is the current gold standard method of teaching. More recently, novel methods such as virtual reality and augmented reality are being explored as possible alternative methods. To evaluate the current evidence pertaining to simulation and virtual reality as methods of teaching in teaching trauma management. Medline and Embase (via Ovid interface) were used to search for articles up to April 2023. A combination of the following MeSH terms were employed in the primary search string - "virtual reality," "simulation," "surgery," "trauma," and "medical education." 3815 studies were initially identified. After de-duplication, 2648 articles were screened using Covidence. Forty articles underwent full text review. Thirteen studies were included in the final review with a pooled total of 489 participants. Significant heterogeneity exists in the range of participants, scenarios and parameters assessed. The overall self-reported perception of VR as a teaching modality is positive and is well accepted however objective assessment and validation is needed. VR can be useful for training and evaluation of trauma-based scenarios. It is a useful adjunct but is unlikely to replace simulation at present. More robust and replicable studies with larger sample sizes are needed to evaluate the long-term integration of virtual reality and augmented reality into the medical and surgical teaching curriculum.

Assessing the role of Osteopontin in prognosis of Oral Squamous Cell Carcinoma- A Systematic Review.

Oral cancer is always a global burden. It is the sixteenth most common cancer. It leads to metastasis since it is often diagnosed at late stages. To monitor the progress of this condition, various biomarkers are being utilized. Osteopontin is one such biomarker and its level in bodily fluids can be used as a reliable biomarker. The current study aims to review and evaluate the prognostic role of osteopontin in oral squamous cell carcinoma. A literature search was conducted across various databases such as Scopus, PubMed and Google Scholar. It yielded 18 articles totally using MeSH terms. The inclusion criteria were original research articles written only in English language involving both tissue and plasma osteopontin on oral cancer patients. Of these, only two articles which met the inclusion criteria were added into this systematic review. The search had no time restriction. The studies showed that osteopontin play a vital role in the prognosis of the OSCC patients. One study from Taiwan and other from India proved the osteopontin expression in plasma and tissue can help to predict the prognosis of patients with oral cancer. Also, the level of plasma osteopontin was correlated with aggressiveness of OSCC. Tissue osteopontin expression was significantly lower in stage I OSCC patients when compared with stage II and III. Since there were only two studies, there is limited evidence of results. From these findings, osteopontin can also be used as a reliable biomarker to predict the prognosis of oral cancer. Since there were only two studies to substantiate the finding, there is limited evidence and more studies are warranted to confirm the results.

Endoscopic Combined Intrarenal Surgery: best practices and future perspectives.

Endoscopic Combined Intrarenal Surgery (ECIRS) has emerged as a promising technique for the management of large and complex kidney stones, potentially offering advantages over traditional Percutaneous Nephrolithotomy (PCNL). This study aims to evaluate best practices, outcomes, and future perspectives associated with ECIRS. A comprehensive PubMed search was conducted from 2008 to 2024, using MESH terms and the following key words: "ECIRS" and "Endoscopic Combined Intrarenal Surgery" The search yielded 157 articles, including retrospective cohort studies, two randomized controlled trials (RCTs), and four meta-analyses comparing ECIRS with PCNL. Most important findings were summarized regarding indications, patient positioning, kidney access, tract size, surgical outcomes, and complications. ECIRS demonstrated higher stone-free rate, lower complication rate, and a reduced need for multiple procedures compared to traditional PCNL. Additionally, ECIRS has the potential to integrate new technologies to further enhance outcomes. ECIRS demonstrates significant advantages in the management of large kidney stones. Future research should focus on well-designed RCTs to provide robust evidence of its efficacy, safety, and cost-effectiveness, potentially establishing ECIRS as the first option treatment for complex kidney stones.

Hypertrophic nonunion management with distraction osteogenesis: a scoping review of the literature

Abstract Introduction: Traditionally, stiff hypertrophic nonunions have been managed with open preparation of the nonunion site, which is then secured with internal fixation. Alternative surgical options are available including distraction osteogenesis with an external fixator. There is currently a limited amount of literature pertaining to the use of distraction osteogenesis in the management of hypertrophic nonunion. The aim of this systematic review was to collate and assess the effectiveness of distraction osteogenesis (DO) in the management of hypertrophic nonunions and to evaluate the complications that are commonly reported in the literature. Methods: We searched for articles pertaining to the treatment of hypertrophic nonunion using distraction osteogenesis. Several electronic bibliographic databases and clinical trial registries were searched using the MeSH terms “hypertrophic non-union,” “distraction osteogenesis,” “stiff non-union,” and “External Fixation” in various combinations to return the maximal number of studies for review. We performed a systematic review and identified a total of 11 studies eligible for review. Results: The review of the literature demonstrated that this technique is highly effective in achieving bony union with minimal complications. The most common complication is mild superficial pin site infections, usually managed with oral antibiotics and effective wound hygiene. Other complications reported were deep pin tract infections, broken hardware, and deformity recurrence due to collapse of regenerate bone. Conclusion: The use of distraction osteogenesis with external fixator devices is an effective and safe method for producing bony union in hypertrophic nonunions. There were minimal associated complications.