Nevin Manimala

Medicine (Baltimore). 2022 Nov 18;101(46):e31473. doi: 10.1097/MD.0000000000031473.

ABSTRACT

BACKGROUND: Influenza is a common disease. If it is not treated in time, it may induce related chronic respiratory diseases and seriously endanger people’s health. Porridge, as a food of the East, has been recorded by doctors of all ages to treat influenza with porridge. However, due to insufficient research, there is a certain controversy about porridge in the treatment of influenza. We therefore plan to conduct a systematic review and meta-analysis to collect data from all published studies on this issue in order to obtain reliable evidence.

METHOD AND ANALYSIS: We will search for relevant trials in various databases published by December 2022. To study the efficacy and safety of a RCT of porridge in the treatment of influenza. Standardized data tables will be used to complete data search and extraction in duplicate. All differences will be resolved by consensus. The main result was to observe the symptom score of influenza patients, and the secondary results included body temperature, nasal secretions, nasal resistance and viral culture titers in the nasal secretions. Data synthesis and statistical analysis will be performed for each outcome with Stata V.14.0.

RESULTS: Our study will be a systematic review and meta-analysis to evaluate the efficacy and safety of porridge in the treatment of influenza.

CONCLUSION: The conclusion of this study has a certain reference value for the clinical use of porridge in the treatment of influenza.

PMID:36401469 | DOI:10.1097/MD.0000000000031473

Medicine (Baltimore). 2022 Nov 18;101(46):e31818. doi: 10.1097/MD.0000000000031818.

ABSTRACT

BACKGROUND: The effects of dexmedetomidine on the circulatory system are complex. It is difficult to predict its effects on intrapulmonary shunts and hypoxic pulmonary vasoconstriction in patients with one-lung ventilation. This study aimed to investigate the effect of dexmedetomidine on intrapulmonary shunt in patients with sevoflurane during one-lung ventilation.

METHODS: Forty patients requiring thoracoscopic lobectomy were randomly divided into the dexmedetomidine group (Group D, n = 20) and the normal saline group (Group N, n = 20). The arterial partial pressure of oxygen (PaO2), pulmonary shunt fraction (Qs/Qt), mean end-tidal sevoflurane concentration, mean arterial pressure, and heart rate were compared between the 2 groups at 3 time points: (i) after 5 minutes of two-lung ventilation (T0), (ii) after 30 minutes of one-lung ventilation (OLV) (T1), and (iii) after 45 minutes of OLV (T2). The dosage of sevoflurane from the beginning of OLV to T2 was calculated.

RESULTS: There were no significant differences in age, body mass index, and FEV1/FVC between Groups D and N (P > .05). At T0, T1, and T2, the PaO2 levels of Group D and Group N were similar (P > .05), and the PaO2 levels of Group D and Group N decreased after OLV. The Qs/Qt level of Groups D and N were similar at T0 (P > .05), and the level of Groups D and N at T1 and T2 was higher than that at T0. The Qs/Qt of Group D was statistically significantly lower than that of Group N at T1 and T2 (P < .05).

CONCLUSION: Compared with the control group, we found that dexmedetomidine can reduce the intrapulmonary shunt fraction and improve the body’s status during OLV.

PMID:36401465 | DOI:10.1097/MD.0000000000031818

Medicine (Baltimore). 2022 Nov 18;101(46):e28397. doi: 10.1097/MD.0000000000031519.

ABSTRACT

BACKGROUND: The use of lung ultrasound for the diagnosis of pulmonary atelectasis remains controversial. Therefore, we performed a protocol for systematic review and meta-analysis to evaluate the diagnostic accuracy of lung ultrasound for the diagnosis of pulmonary atelectasis both in adults and pediatrics.

METHODS: A comprehensive search of several databases from 1966 to October 2022 will be conducted. The databases include Ovid Medline In-Process & Other Non-Indexed Citations, Ovid MEDLINE, Ovid EMBASE, Ovid PsycINFO, Ovid Cochrane Central Register of Controlled Trials, Ovid Cochrane Database of Systematic Reviews, and PubMed. After screening and diluting out the articles that met inclusion criteria to be used for statistical analysis, the pooled evaluation indexes including sensitivity and specificity as well as hierarchical summary receiver operating characteristic curves with 95% confidence interval were calculated. All statistical analyses were calculated with STATA, version 12.0 (StataCorp, College Station, TX).

RESULT: We will synthesize the current studies to evaluate the diagnostic accuracy of lung ultrasound for the diagnosis of pulmonary atelectasis.

CONCLUSION: The result of this review will provide more reliable references to help clinicians make decisions for the diagnosis of pulmonary atelectasis.

PMID:36401459 | DOI:10.1097/MD.0000000000031519

Medicine (Baltimore). 2022 Nov 18;101(46):e31516. doi: 10.1097/MD.0000000000031516.

ABSTRACT

BACKGROUND: Knee osteoarthritis (KOA) often causes joint pain, weakness and mobility disorders, which seriously affects people’s daily life and makes them unable to work and study normally. Traditional Chinese medicine (TCM) prescription Danggui Sini Decoction (DGSND) has been widely used in clinical practice and achieved good results. But there is no high-level evidence to support this result. The aim of this study is to evaluate DGSND’s efficacy and safety in the management of KOA.

METHODS: We will search 7 electronic databases including Chinese National Knowledge Infrastructure (CNKI), Wanfang Data (WF), Chinese Scientific Journals Database (VIP), Chinese databases SinoMed (CBM), PubMed, Embase, and Cochrane Library databases. All the publications, with no time restrictions, will be searched without any restriction of language and status, the time from the establishment of the database to September 2022. Two reviewers will independently assess the quality of the selected studies, NoteExpress and Excel software will be used to extract data, and the content will be stored in an electronic chart. Different researchers will separately screen the titles and abstracts of records acquired potential eligibility which comes from the electronic databases. Full-text screening and data extraction will be conducted afterward independently. Statistical analysis will be conducted using RevMan 5.4 software.

RESULTS: This study will compare the effects of DGSND and any other different methods on patients with KOA to provide high-quality, evidence-based clinical recommendations.

CONCLUSION: The study provides a trustable clinical foundation for DGSND in the treatment of KOA.

PMID:36401458 | DOI:10.1097/MD.0000000000031516

Medicine (Baltimore). 2022 Nov 18;101(46):e31945. doi: 10.1097/MD.0000000000031945.

ABSTRACT

BACKGROUND: Colonoscopy can detect colorectal adenomas and reduce the incidence of colorectal cancer, but there are still many missing diagnoses. Artificial intelligence-assisted colonoscopy (AIAC) can effectively reduce the rate of missed diagnosis and improve the detection rate of adenoma, but its clinical application is still unclear. This systematic review and meta-analysis assessed the adenoma missed detection rate (AMR) and the adenoma detection rate (ADR) by artificial colonoscopy.

METHODS: Conduct a comprehensive literature search using the PubMed, Medline database, Embase, and the Cochrane Library. This meta-analysis followed the direction of the preferred reporting items for systematic reviews and meta-analyses, the preferred reporting item for systematic review and meta-analysis. The random effect model was used for meta-analysis.

RESULTS: A total of 12 articles were eventually included in the study. Computer aided detection (CADe) significantly decreased AMR compared with the control group (137/1039, 13.2% vs 304/1054, 28.8%; OR,0.39; 95% CI, 0.26-0.59; P < .05). Similarly, there was statistically significant difference in ADR between the CADe group and control group, respectively (1835/5041, 36.4% vs 1309/4553, 28.7%; OR, 1.54; 95% CI, 1.39-1.71; P < .05). The advanced adenomas missed rate and detection rate in CADe group was not statistically significant when compared with the control group.

CONCLUSIONS: AIAC can effectively reduce AMR and improve ADR, especially small adenomas. Therefore, this method is worthy of clinical application. However, due to the limitations of the number and quality of the included studies, more in-depth studies are needed in the field of AIAC in the future.

PMID:36401456 | DOI:10.1097/MD.0000000000031945

Medicine (Baltimore). 2022 Nov 18;101(46):e31910. doi: 10.1097/MD.0000000000031910.

ABSTRACT

Malignant transformation of oral potentially malignant disorders (OPMDs) is a potential cause of oral cancer. Currently, there is no research investigating the rate of malignant transformation of OPMDs into oral cancer in indigenous Taiwanese peoples. This study aimed to retrospectively investigate whether ethnicity (indigenous vs non-indigenous people) plays a role in increasing the malignant transformation rate of OPMDs into oral cancer. This study used data from the oral mucosal screening database and the Cancer Registry File, both of which originated from the National Health Insurance Research Database. We matched the baseline characteristics to control for confounding factors between indigenous peoples and non-indigenous peoples (17,768 indigenous subjects vs 71,072 non-indigenous subjects; 1:4 match) and compared the 2 cohorts. After matching for confounding factors such as age, sex, habits, and OPMD subtype, the malignant transformation rate was not statistically higher for indigenous people than for non-indigenous people. We also discovered that indigenous people with oral verrucous hyperplasia might have a higher chance of malignant transformation into oral cancer than the non-indigenous cohort. We conclude that ethnicity is not a risk factor for the malignant transformation of OPMDs into oral cancer; however, indigenous people with oral verrucous hyperplasia need to pay special attention and are suggested to undergo regular follow-ups for the occurrence of oral cancer.

PMID:36401444 | DOI:10.1097/MD.0000000000031910

Medicine (Baltimore). 2022 Nov 18;101(46):e31840. doi: 10.1097/MD.0000000000031840.

ABSTRACT

Auditory processing in children diagnosed with speech and language impairment (SLI) is atypical and characterized by reduced brain activation compared to typically developing (TD) children. In typical speech and language development processes, frontal, temporal, and posterior regions are engaged during single-word listening, while for non-word listening, it is highly unlikely that perceiving or speaking them is not followed by frequent neurones’ activation enough to form stable network connections. This study aimed to investigate the electrophysiological cortical activity of alpha rhythm while listening words and non-words in children with SLI compared to TD children. The participants were 50 children with SLI, aged 4 to 6, and 50 age-related TD children. Groups were divided into 2 subgroups: first subgroup – children aged 4.0 to 5.0 years old (E = 25, C = 25) and second subgroup – children aged 5.0 to 6.0 years old (E = 25, C = 25). The younger children’s group did not show statistically significant differences in alpha spectral power in word or non-word listening. In contrast, in the older age group for word and non-word listening, differences were present in the prefrontal, temporal, and parieto-occipital regions bilaterally. Children with SLI showed a certain lack of alpha desynchronization in word and non-word listening compared with TD children. Non-word perception arouses more brain regions because of the unknown presence of the word stimuli. The lack of adequate alpha desynchronization is consistent with established difficulties in lexical and phonological processing at the behavioral level in children with SLI.

PMID:36401430 | DOI:10.1097/MD.0000000000031840

Medicine (Baltimore). 2022 Nov 18;101(46):e31786. doi: 10.1097/MD.0000000000031786.

ABSTRACT

Hematopoietic stem cell transplantation (HSCT) recipients may be at an elevated risk of developing active tuberculosis infection due to suppression in the cellular immune system. Herein, we aimed to evaluate the prevalence of latent tuberculosis and active tuberculosis in patients with allogeneic and autologous HSCT. In this cohort, data were obtained retrospectively from patients’ records. The patients who were followed up in the bone marrow transplantation unit of the University of Health Sciences Dr Abdurrahman Yurtaslan Ankara Oncology Education and Research Hospital between January 2016 and December 2019 were screened for the study. And the HSCT recipients who had tuberculin skin test and/or QuantiFERON-TB gold (QFT-GIT) test results were included in the study. A total of 361 patients were included in the study, 227 patients had autologous HSCT, and 134 patients had allogeneic HSCT. QFT-GIT was performed in 10 patients with allogeneic HSCT, and it was found positive in only 1 patient. Tuberculin skin test ≥5 mm was accepted as positive and was accepted to have latent tuberculosis, and it was positive in 18.2% (41) of the patients with autologous HSCT and was positive in 21.6% (29) of the patients with allogeneic HSCT. There was no significant difference between the 2 groups (P = .429). Isoniazid (INH) prophylaxis was started in 16.7% of patients with autologous HSCT and 22.4% of patients with allogeneic HSCT. During follow-up, active tuberculosis did not develop in any patients in both groups. There was no statistically significant difference found between allogeneic and autologous HSCT recipients regarding the prevalence of latent tuberculosis. Active tuberculosis infection did not develop in any of the patients who started INH prophylaxis. INH prophylaxis seems to be very efficient in preventing the reactivation of latent tuberculosis in patients going through allogeneic HSCT and/or autologous HSCT.

PMID:36401428 | DOI:10.1097/MD.0000000000031786

Medicine (Baltimore). 2022 Nov 18;101(46):e31395. doi: 10.1097/MD.0000000000031395.

ABSTRACT

Primary biliary cholangitis (PBC) is an autoimmune cholestatic liver disease. The clinical effectiveness of ursodeoxycholic acid (UDCA) plus glucocorticoids and/or immunosuppressants remains controversial in PBC patients. The study aimed to compare the efficacy of monotherapy and combination therapy in patients with PBC and to assess the factors affecting the efficacy. In this retrospective study, 266 patients diagnosed with PBC were divided into monotherapy group (UDCA), double therapy group (UDCA plus glucocorticoids or immunosuppressants), and triple therapy group (UDCA plus glucocorticoids and immunosuppressants) according to different treatments. Demographic characteristics, immune parameters, biochemistry profiles, and other indicators were evaluated at baseline, 6 months, and 1 year following treatment. The prognosis was evaluated using the Paris II standard. The liver transplant-free survival at 3, 5, 10, and 15 years was predicted by GLOBE score. All statistical analyses were conducted using SPSS (version 24) software (SPSS Inc, Chicago, IL). The long-term survival rate of the triple therapy group was significantly improved compared with the monotherapy group (P = .005). In addition, multivariate analysis showed that abnormal platelet count, alkaline phosphatase, and albumin levels were risk factors for poor response. When IgG levels were elevated but below twice the upper limit of normal, the clinical benefit was not significant compared with monotherapy (P > .05). Compared with monotherapy and double therapy, triple therapy may improve the long-term survival rate of PBC patients. Abnormal platelet count, alkaline phosphatase, and albumin levels were associated with a poor prognosis.

PMID:36401422 | DOI:10.1097/MD.0000000000031395

Medicine (Baltimore). 2022 Nov 18;101(46):e31297. doi: 10.1097/MD.0000000000031297.

ABSTRACT

Sepsis and septic shock are the most common causes of death in non-cardiac surgical intensive care units (ICU). Adequate analgesia is essential to achieve positive outcomes. There were differences in pain management between patients with and without sepsis or septic shock. The release of inflammatory mediators, especially cytokines, in sepsis or septic shock decreases the pain threshold. Septic intensive care patients probably require higher doses of opioids than do non-septic patients. A retrospective observational study was carried out in an anesthesiologic intensive care unit from January 1, 2014 to June 30, 2016. Patients were divided into 4 groups according to the following criteria: sepsis (“yes/no” and communication ability “yes/no”). After adjusting for the number of cases using the pairing method, a total of 356 patients were recruited. The endpoint of our study was defined as the “total opioid dose”. Statistical evaluations were performed using t tests and 2-factor analysis of variance. There was a significant difference in opioid doses between communicative and non-communicative ICU patients F(1, 352) = 55.102, P < .001). This effect was observed in the ICU patients with and without sepsis. The mean sufentanil dose was significantly higher in non-communicative patients than in communicative patients group (E(1, 352) = 51.435, P < .001, partial ƞ2 = 0.144). The effect of higher opioid- (F(1, 352) = 1.941, P = .161) and sufentanil (F(1, 352) = 1.798, P = .342) requirement was not statistically significant due to sepsis. The hypothesis that sepsis decreases the pain threshold could not be proven in this study. The effect of a higher opioid requirement is not directly caused by sepsis but by communication ability. Furthermore, we were able to show through our investigations and especially through the data of the pain recording instruments that the septic and non-septic intensive care patients receive sufficient pain therapy treatment in our ICU. Regular pain evaluations should be performed on patients in the ICUs who are able to communicate and those who are not.

PMID:36401417 | DOI:10.1097/MD.0000000000031297