Systematic Review Of Clinical Applications Research Articles

Understanding the potential role of whole genome sequencing (WGS) in managing patients with gonorrhoea: A systematic review of WGS use on human pathogens in individual patient care

The utility of whole genome sequencing (WGS) to inform sexually transmitted infection (STI) patient management is unclear. Timely WGS data might support clinical management of STIs by characterising epidemiological links and antimicrobial resistance profiles. We conducted a systematic review of clinical application of WGS to any human pathogen that may be transposable to gonorrhoea. We searched six databases for articles published between 01/01/2010-06/02/2023 that reported on real/near real-time human pathogen WGS to inform clinical intervention. All article types from all settings were included. Findings were analysed using narrative synthesis. We identified 12,179 articles, of which eight reported applications to inform tuberculosis (n=7) and gonorrhoea (n=1) clinical patient management. WGS data were successfully used as an adjunct to clinical and epidemiological data to enhance contact-tracing (n=2), inform antimicrobial therapy (n=5) and identify cross-contamination (n=1). WGS identified gonorrhoea transmission chains that were not established via partner notification. Future applications could include insights into pathogen exposure detected within sexual networks for targeted patient management. While there was some evidence of WGS use to provide individualised tuberculosis and gonorrhoea treatment, the eight identified studies contained few participants. Future research should focus on testing WGS intervention effectiveness and examining ethical considerations of STI WGS use.

Systematic Review of Clinical Applications of CAD/CAM Technology for Craniofacial Implants Placement and Manufacturing of Orbital Prostheses.

This systematic review was aimed at gathering technical and clinical applications of CAD/CAM technology for the preoperative planning of craniofacial implants placement, designing of molds and substructures and fabrication of orbital prostheses. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, an electronic search was executed. Human studies that utilized digital planning systems for the prosthetic rehabilitation of orbital defects were included. A total of 16 studies of 30 clinical cases, which were virtually planned through various digital planning and designing software, were included. The most common preoperative data required for digital planning were CT scans in 15 cases, the 3DSS-STD-II scanning system in 5 cases, an Artec Color 3D scanner in 3 cases and a NextEngine Desktop 3D laser scanner in 2 cases. Meanwhile, the digital designing software were Ease Orbital Implant Planning EOIPlan software in eight cases, Geomagic software in eight cases, Simplant software in four cases and Artec Studio 12 Professional in three cases. Surgical templates were fabricated for 12 cases to place 41 craniofacial implants in the orbital defect area. An image-guided surgical navigation system was utilized for the placement of five orbital implants in two cases. Digital designing and printing systems were reported for the preoperative planning of craniofacial implants placement, designing of molds and substructures and fabrication of orbital prostheses. The studies concluded that the digital planning, designing and fabrication of orbital prostheses reduce the clinical and laboratory times, reduces patient visits and provide a satisfactory outcome; however, technical skills and equipment costs are posing limitations on the use of these digital systems.

Systematic Review of Clinical Applications of CAD/CAM Technology for Craniofacial Implants Placement and Manufacturing of Nasal Prostheses

The aim of this systematic review was to gather the clinical and laboratory applications of CAD/CAM technology for preoperative planning, designing of an attachment system, and manufacturing of nasal prostheses. According to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, an electronic search was carried out. Only human clinical studies involving digital planning for the rehabilitation of facial defects were included. A total of 21 studies were included with 23 patients, which were virtually planned through different planning software. The most common preoperative data for digital planning were CT scans in nine cases, CBCT in six cases, and laser scans in six cases. The reported planning softwares were Mimics in six cases, Geomagic Studio software in six cases, ZBrush in four cases, and Freeform plus software in four cases. Ten surgical templates were designed and printed to place 36 implants after digital planning, while post-operative assessment was done in two cases to check the accuracy of planned implants. Digital 3D planning software was reported for presurgical planning and craniofacial implants placement, fabrication of molds, designing of implants, designing of retentive attachments, and printing of silicone prostheses. Digital technology has been claimed to reduce the clinical and laboratory time; however, the equipment cost is still one of the limitations.

Machine Learning Quantitation of Cardiovascular and Cerebrovascular Disease: A Systematic Review of Clinical Applications.

Research into machine learning (ML) for clinical vascular analysis, such as those useful for stroke and coronary artery disease, varies greatly between imaging modalities and vascular regions. Limited accessibility to large diverse patient imaging datasets, as well as a lack of transparency in specific methods, are obstacles to further development. This paper reviews the current status of quantitative vascular ML, identifying advantages and disadvantages common to all imaging modalities. Literature from the past 8 years was systematically collected from MEDLINE® and Scopus database searches in January 2021. Papers satisfying all search criteria, including a minimum of 50 patients, were further analysed and extracted of relevant data, for a total of 47 publications. Current ML image segmentation, disease risk prediction, and pathology quantitation methods have shown sensitivities and specificities over 70%, compared to expert manual analysis or invasive quantitation. Despite this, inconsistencies in methodology and the reporting of results have prevented inter-model comparison, impeding the identification of approaches with the greatest potential. The clinical potential of this technology has been well demonstrated in Computed Tomography of coronary artery disease, but remains practically limited in other modalities and body regions, particularly due to a lack of routine invasive reference measurements and patient datasets.

Impact of radiomics on prostate cancer detection: a systematic review of clinical applications.

To systematically review the current literature to assess the role of radiomics in the detection and evaluation of prostate cancer (PCa). Radiomics involves the high-throughput extraction of radiologic features from clinical imaging, using a panel of sophisticated data-characterization algorithms to make an objective and quantitative determination of diagnoses and clinical characteristics. Radiomics evaluation of existing clinical images would increase their clinical value in many cancer management pathways, including PCa. However, a consensus on the implementation of radiomics has not been established across different sites, delaying its implementation in clinical practice. There are many potential advantages to radiomics. The ability to extract features from existing clinical imaging is one such advantage. A second is the empiric nature of the analysis. The third lies in the application of new technologies, such as machine learning, to be able to evaluate large quantities of data to make clinical conclusions. In this systematic review, we identify publications regarding the role of radiomics in PCa detection and evaluation. Many of these studies noted that radiomics, when incorporated into predictive models, had an advantageous impact on detection of PCa, clinically significant PCa, and extracapsular extension. This may assist in individualized decision making not only for diagnosis of PCa, but also for surveillance and surgical planning. With additional validation in large sample sizes, and randomized, multicenter studies using a consensus driven methodology, radiomics has the potential to alter the landscape of PCa detection and management, necessitating further prospective randomized investigation. Radiomics is a promising new field, allowing for high-throughput analysis of imaging features for PCa detection and evaluation. These features can be extracted from existing data; therefore, the potential for future study is immense.

Le cellule staminali: impiego clinico

A systematic review of clinical applications of MSCs in the treatment of knee osteoarthritis (OA). Twenty-three papers were included in the final analysis (10 on BMAC and 13 on SVF). Of these, only 4 were randomised controlled trials (RCTs). The Coleman Score, used for bias risk evaluation, revealed an overall poor quality of the studies. In terms of clinical application, despite the apparent safety and the short-term positive clinical outcomes, clinicians reported different preparation and administration methods. The available literature is not sufficient to make any recommendation on the use of either product in clinical practice, even though they have both shown to be safe and have some short-term beneficial effects.

A systematic review of clinical applications of polymer gel dosimeters in radiotherapy

Radiotherapy has rapidly improved because of the use of new equipment and techniques. Hence, the appeal for a feasible and accurate three-dimensional (3D) dosimetry system has increased. In this regard, gel dosimetry systems are accurate 3D dosimeters with high resolution. This systematic review evaluates the clinical applications of polymer gel dosimeters in radiotherapy. To find the clinical applications of polymer gel dosimeters in radiotherapy, a full systematic literature search was performed on the basis of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines in electronic databases up to January 31, 2017, with use of search-related terms in the titles and abstracts of articles. A total of 765 articles were screened in accordance with our inclusion and exclusion criteria. Eventually, 53 articles were included in the study. The findings show that most clinical applications of polymer gel dosimeters relate to external radiotherapy. Most of the gel dosimeters studied have acceptable dose accuracy as a 3D dosimeter with high resolution. It is difficult to judge which is the best polymer gel dosimeter to use in a clinical setting, because each gel dosimeter has advantages and limitations. For example, methacrylic acid–based gel dosimeters have high dose sensitivity and low toxicity, while their dose response is beam energy dependent; in contrast, N-isopropylacrylamide gel dosimeters have low dose resolution, but their sensitivity is lower and they are relatively toxic.

A systematic review of clinical application of Percu Twist tracheostomy in intensive care unit

To evaluate the effectiveness of Percu Twist (PT) tracheostomy comparing with that of operative tracheostomy (OT) in intensive care unit (ICU). Related data were retrieved from CBM, CNKI, Wanfang Data, VIP, PubMed, EMBASE, CENTRAL, and Web of Science from the time of their establishment to May 15th 2014, and the data of randomized controlled trials (RCTs) concerning PT and OT were selected. The risk of bias assessment and data extraction were performed by two independent reviewers. Meta analysis was conducted using RevMan 5.2 software. A total of 12 RCTs were identified, and 893 patients in ICU were involved. The results of Meta-analysis showed that PT could significantly shorten the operation time [mean difference (MD)=-15.11, 95% confidence interval (95% CI)=-17.14 to -13.07, P<0.000 01], reduce the volume of blood loss (MD=-17.59, 95% CI=-21.90 to -13.28, P<0.000 01), reduce the size of incision (MD=-2.20, 95% CI=-2.57 to -1.82, P<0.000 01), shor ten the time of healing (MD=-3.60, 95% CI=-4.15 to -3.05, P<0.000 01), and reduce complications such as infection of the wound [odds ratio (OR)=0.20, 95%CI=0.10-0.44, P<0.000 1] and cutaneous emphysema/mediastinal emphysema (OR=0.22, 95% CI=0.10-0.47, P<0.000 1) compared with OT group. The funnel plot suggested that publication bias might be found among 12 researches. PT was shown to be more effective than OT in ICU with lower incidence of complications. As number of RCT cases is still small with unsatis factory quality, further clinical use is warranted for a better assessment.