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The relationship between the drainage function of inguinal lymph nodes and unilateral pelvic cancer-related lymphedema: A retrospective analysis

Medicine (Baltimore). 2021 Dec 3;100(48):e28051. doi: 10.1097/MD.0000000000028051.

ABSTRACT

The aim of this study was to investigate the relationship between iliolumbar lymph nodes (LNs), inguinal LNs, and unilateral pelvic cancer-related lymphedema by retrospective analysis of lymphoscintigraphy data.Ninety-six patients (3 men and 93 women; mean age, 53.3 ± 11.3 years) with pelvic cancer-related lymphedema were enrolled in this retrospective study. Lymphoscintigraphy was performed at 1 hour and 4 to 6 hours after injection. The visualization of inguinal LNs and iliolumbar LNs were recorded.According to statistical analysis, the display of inguinal LNs in lymphoscintigraphy has a significant negative correlation with ipsilateral lower limb lymphedema (P < .01, r = -0.561). However, there is no correlation between the show of iliolumbar LNs and ipsilateral lower extremity lymphedema (P = .056, r = -0.138). When lymphoscintigraphy was performed at 1 hour after injection, there were 13 out of 96 patients without inguinal LNs revealed on imaging, but at 4 to 6 hours after injection, inguinal LNs were seen in lymphoscintigraphy.The drainage function of inguinal LNs has a significant negative correlation with ipsilateral pelvic cancer-related lymphedema. Treatment dedicated to restoring the drainage function of LNs in the inguinal region may effectively relieve lymphedema. The image acquisition at 4 to 6 hours after injection is necessary for significant additional information.

PMID:35049221 | DOI:10.1097/MD.0000000000028051

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The effects of a pharmacist-led medication review in a nursing home: A randomized controlled trial

Medicine (Baltimore). 2021 Dec 3;100(48):e28023. doi: 10.1097/MD.0000000000028023.

ABSTRACT

BACKGROUND: In this study, an intensive review of pharmaceutical care for elderly patients was conducted in a Veterans Administration nursing home in Taiwan and its effects were evaluated.

METHODS: One hundred participants were enrolled in this randomized controlled study with even distribution. The inclusion criteria were age 65 years or older, prescriptions for at least 5 oral medicines daily, and ≥2 chronic diseases, for the period May 2013 to October 2014. Subjects were excluded if they had previously been included in an intensive medication review conducted by a pharmacist. The primary outcomes were numbers of drugs prescribed, potential inappropriate medications, and numbers of drug-related problems. The secondary outcomes were self-reported medical usages, measurements of quality of life, results of a satisfaction survey, and health status.

RESULTS: A total of 80 cases (42 in the intervention group with medication reconciliation and 38 in the control group without medication reconciliation) completed the study. Baseline characteristics were not statistically different between the 2 groups. The overall prevalence of potential inappropriate medication was 74.3%. There were no differences between the 2 groups, with the exception of “medical problems,” which showed a significantly higher prevalence in the intervention group (P < .05). The intervention group reported greater satisfaction regarding pharmacist visits and medication compliance (P < .01). The mean number of drug-related problems was significantly lower after the intervention (P < .01).

CONCLUSION: In this study, the intensive review of the elderly patients’ medications revealed that the only significant effect of pharmaceutical care was on “all outcomes.” A possible reason for this is the rather advanced ages of some patients who needed a considerable number of medications to treat several chronic diseases. Another reason may be the small sample size. However, participants who received the pharmacist intervention did have higher satisfaction with medication reconciliation and fewer drug-related problems.

PMID:35049214 | DOI:10.1097/MD.0000000000028023

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Acupuncture combine with Tuina for diabetic peripheral neuropathy: A protocol for a systematic review and meta-analysis

Medicine (Baltimore). 2021 Dec 3;100(48):e28042. doi: 10.1097/MD.0000000000028042.

ABSTRACT

BACKGROUND: Diabetic peripheral neuropathy (DPN) is one of the most common microvascular complications of diabetes mellitus, with an incidence ranging from 60% to 90%. With the change in modern dietary structure, the incidence of diabetes is increasing year by year, and DPN is also on the rise. Acupuncture and Tuina treatments are often combined to treat DPN; however, there has been no meta-analysis on their synergistic effect; therefore, we aimed to perform a systematic review and meta-analysis to estimate the effectiveness of acupuncture combined with Tuina in DPN treatment.

METHODS: Nine electronic databases were retrieved for this study. The English databases mainly retrieved PubMed, Web of Science, Embase, AMED, and the Cochrane Library, while the CNKI, VIP, CBM, and Wanfang databases were used to retrieve the Chinese literature; there was no definite time limit for the retrieval literature, and the languages were limited to Chinese and English. We will consider articles published between database initiation and November 2021. We used Review Manager 5.4 software provided by the Cochrane Collaborative Network for statistical analysis. We then assessed the quality and risk of the included studies and observed the outcome measures.

RESULTS: This study provides a high-quality synthesis to assess the effectiveness and safety of acupuncture combined with Tuina for treating DPN.

CONCLUSION: This systematic review provided evidence to determine whether acupuncture combined with Tuina is an effective and safe intervention for patients with DPN.

ETHICS AND DISSEMINATION: The protocol for this systematic review does not require ethical approval because it does not involve humans. This article will be published in peer-reviewed journals and presented at relevant conferences.

SYSTEMATIC REVIEW REGISTRATION: INPLASY2021110017.

PMID:35049219 | DOI:10.1097/MD.0000000000028042

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Efficacy and safety of Yangxue Qingnao granules for the treatment of essential hypertension: A protocol for systematic review and meta-analysis

Medicine (Baltimore). 2021 Dec 3;100(48):e27911. doi: 10.1097/MD.0000000000027911.

ABSTRACT

BACKGROUND: Essential hypertension is a major risk factor for many fatal cardiovascular and cerebrovascular diseases and has become a heavy burden on families and society. At present, the prevention and treatment of essential hypertension is still unsatisfactory. Yangxue Qingnao granules is a kind of Chinese patent medicine that has been used to treat essential hypertension. The objective of this protocol is to systematically evaluate the efficacy and safety of Yangxue Qingnao granules in the treatment of essential hypertension.

METHODS: Randomized controlled trials on Yangxue Qingnao granules for essential hypertension will be searched from the following databases: PubMed, EMbase, Web of Science, Cochrane Library, China National Knowledge Infrastructure, Wanfang Data, China Science and Technology Journal Database, and China Biology Medicine disc from inception to August 27, 2021, regardless of language. Study screening and data extraction will be carried out by two independent reviewers. The quality of the included studies will be assessed using Cochrane risk-of-bias tool for randomized trials. Statistic analysis will be performed using RevMan 5.3 software. The quality of evidence will be assessed using GRADE approach.

RESULTS: This study will systematically evaluate the efficacy and safety of Yangxue Qingnao granules in the treatment of essential hypertension and provide high-quality evidence for clinical practice.

CONCLUSION: The findings of this systematic review will provide high-quality evidence to verify the efficacy and safety of Yangxue Qingnao granules in the treatment of essential hypertension.

INPLASY REGISTRATION NUMBER: INPLASY202190015.

PMID:35049194 | DOI:10.1097/MD.0000000000027911

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Prevalence and risk factors associated with repeat positive SARS-CoV-2 nucleic acid test results among discharged COVID-19 patients: A protocol for systematic review and meta-analysis

Medicine (Baltimore). 2021 Dec 3;100(48):e27933. doi: 10.1097/MD.0000000000027933.

ABSTRACT

BACKGROUND: The COVID-19 (coronavirus disease 2019) pandemic continues to have an immense impact on the world at large. COVID-19 patients who meet the discharge criteria, may subsequently exhibit positive viral RNA test results upon subsequent evaluation. This phenomenon has been a major source of research and public health interest, and poses a major challenge to COVID-19 prevention, treatment, and standardized patient management.

METHODS: We will search the PubMed, MEDLINE, Embase, Cochrane Clinical Trials Database, China National Knowledge Infrastructure, Wanfang Database, Chinese Science Journal Database, and China Biology Medicine databases for all studies published as of November 2021. Data will be extracted independently by two researchers according to the eligibility criteria. Finally, RevMan 5.3.0 will be implemented for statistical analyses.

RESULTS: The results of this study will show the prevalence and risk factors associated with repeat positive SARS-CoV-2 nucleic acid test results among discharged COVID-19 patients.

CONCLUSIONS: This study will provide a reliable evidence-based for the prevalence and risk factors associated with repeat positive SARS-CoV-2 nucleic acid test results among discharged COVID-19 patients.

TRIAL REGISTRATION NUMBER: CRD42021272447.

PMID:35049197 | DOI:10.1097/MD.0000000000027933

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Ranibizumab and conbercept for treating wet age-related macular degeneration in China: A systematic review and meta-analysis

Medicine (Baltimore). 2021 Dec 3;100(48):e27774. doi: 10.1097/MD.0000000000027774.

ABSTRACT

BACKGROUND: This study aimed to evaluate the therapeutic effects of ranibizumab and conbercept on wet age-related macular degeneration.

METHODS: Randomized controlled trials comparing ranibizumab and conbercept in the treatment of wet age-related macular degeneration were searched in the PubMed, Medline, EMbase, Cochrane Library, China National Knowledge Infrastructure, Wanfang databases, and Weipu Journal. Two reviewers independently extracted the data and assessed the methodological quality. Data analysis was performed using Rev Man 5.3 software for statistical analysis.

RESULTS: A total of 16 randomized controlled trials, including 1018 patients, were included, and the results showed that the effect of ranibizumab on uncorrected visual acuity was not significantly different from that of conbercept (Mean difference [MD] = -.03, 95% Confidence interval [CI] [-.10-.05], P = .47), and there was no significant difference between the two drugs in the effect on best-corrected visual acuity (MD = .00, 95% CI [-.02-.03], P = .73). The effect of conbercept on intraocular pressure was better than that of ranibizumab (MD = 1.61, 95% CI [1.05-2.17], P < .001). The effect of ranibizumab on central macular thickness was not significantly different from that of conbercept (MD = 1.31, 95% CI [-3.81-6.43], P = .62). Conbercept had a better inhibitory effect on choroidal neovascularization than ranibizumab (MD = .49, 95% CI [.32-.76], P = .001).

CONCLUSION: The effects of ranibizumab on uncorrected visual acuity, best corrected visual acuity, and central macular thickness were not significantly different from those of conbercept. Conbercept is associated with a lower risk of increased intraocular pressure and regression of choroidal neovascularization compared with ranibizumab.

PMID:35049171 | DOI:10.1097/MD.0000000000027774

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Trends and projections in cutaneous melanoma death in the Netherlands from 1950 to 2045

Medicine (Baltimore). 2021 Dec 3;100(48):e27784. doi: 10.1097/MD.0000000000027784.

ABSTRACT

Child sun protection has recently been linked to the future disappearance of fatal melanoma in adults in successive generations. In the Netherlands, however, mortality rates from melanoma have increased gradually from the 1950s, with some indication of stabilisation since 2010, which may be compatible with a birth cohort effect by sun-protective measures and screening. To study the trajectories ahead a trend analysis was applied. Numbers of people with cutaneous melanoma as underlying cause of death from 1950 to 2018 and population data were derived from Statistics Netherlands. A graphical approach was used to explore trends in mortality by age, calendar period, and cohorts born in the successive periods of 1889 to 1979. Age-period-cohort modelling outcomes and population forecasts provided projections of mortality until 2045. Based on 24,151 cases of melanoma death (13,256 men, 10,895 women), age-standardised mortality rates were similar from 1950 to 1989 for both genders, and increased thereafter more in men. The age-curve patterns changed gradually towards higher death rates at older age, implying the existence of a birth cohort effect. The age-period-cohort models showed an increase in melanoma mortality rates in successive generations. For women, the birth cohort effect plateaued for generations born since the mid-1980s. The projected total mortality number was predicted to rise in the next 3 decades.It is concluded that a small future decline of mortality in younger generations can be expected in the Netherlands, but mortality is still rising for the total population.

PMID:35049174 | DOI:10.1097/MD.0000000000027784

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Mapping of global research output in congenital cataracts from 1903 to 2021

Medicine (Baltimore). 2021 Dec 3;100(48):e27756. doi: 10.1097/MD.0000000000027756.

ABSTRACT

BACKGROUND AND AIM: Globally, congenital cataract remains one of the main causes of visual loss in children. This study was designed to plot the overall research output and evaluate some key bibliometric indicators in congenital cataracts research.

METHODS: Publications on congenital cataracts were retrieved from the Web of Science Core Collection database. The published literature was searched using the keywords “congenital cataract” OR “congenital cataracts” in the title filed with document types and language restrictions. The data were exported into HistCite to analyze; publication year, top authors, countries, institutions, journals, keywords, and most cited studies. VOSviewer software was used to construct network visualization mapping.

RESULTS: A total of 1427 publications (1903-2021) published in English language were included in this study. Over the past few decades, the total number of publications in congenital cataracts was found to be increased. The most productive year was 2016 (n = 72), while the most cited year was 1941 (1268 citations). The Investigative Ophthalmology & Visual Science (Impact Factor: 4.799) was the most attractive journal with 161 publications, and the Molecular Vision (Impact Factor : 2.367) was the most cited journal with 1915 citations and 161.723 citations per year. The most productive country was the United States of America (USA) (n = 325), while the most active institute was Sun Yat-sen University, China (n = 36). The most prolific author was Yao K (n = 27). The most studied Web of Science category was ophthalmology (n = 852). The most widely used keyword was congenital (n = 1427). The most cited paper in congenital cataracts was “Congenital cataract following German measles in the mother, cited 1268 times. The USA and author keyword congenital cataract had the highest total link strength.

CONCLUSION: These findings provide useful insights, current status, and trends in clinical research in congenital cataracts. This study can be used to identify future research areas and standard bibliography references for better diagnosis and disease control.

PMID:35049169 | DOI:10.1097/MD.0000000000027756

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A multiple linear regression approach to extimate lifted load from features extracted from inertial data

G Ital Med Lav Ergon. 2021 Dec;43(4):373-378.

ABSTRACT

Work-related musculoskeletal disorders are among the main occupational health problems. Substantial evidence has shown that work-related physical risk factors are the main source of low back complaints, particularly affecting heavy and repetitive manual lifting activities. The aim of the study is, during load lifting tasks, to explore the correlation between the time domain features extracted from the acceleration and angular velocity signals of the performing subject and the load lifted, and to explore the feasibility of a multiple linear regression model to predict the lifted load. The acceleration and angular velocity signals were acquired along the three directions of space by means of an inertial sensor placed on the subject’s chest, during lifting activities with load gradually increased by 1 kg from 0 kg to 18 kg. Successively three time-domain features (Root Mean Square, Standard Deviation and MinMax value) were extracted from the acquired signals. First a correlation analysis was carried out between each individual feature and the load lifted (calculating r); then the time-domain features that proved most representative (strong correlation) were used to create a multiple linear regression model (calculating R-square). The statistical analysis was carried out by means of the Pearson correlation and multiple linear regression model was fed with the most informative time-domain features according to the correlation analysis. The correlation analysis showed a strong correlation (r > 0,7) between six features (three extracted from z-axes acceleration and three extracted from y-axes angular velocity) and the lifted load. The predictive multiple linear regression model, fed with these six features achieved a Rsquare greater than 0,9.The study demonstrated that the proposed combination of kinematic features and a multiple regression model represents a valid approach to automatically calculate the load lifted based on raw signals obtained by means of an inertial sensor placed on the chest. The results confirm the potential application of this methodology to indirectly monitor the load lifted by workers during their activity.

PMID:35049162

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Management of stable coronary artery disease and atrial fibrillation with anti-thrombotic therapy: A systematic review and meta-analysis

Medicine (Baltimore). 2021 Dec 3;100(48):e27498. doi: 10.1097/MD.0000000000027498.

ABSTRACT

INTRODUCTION: Long term management of patients with stable coronary artery disease of >1 year after myocardial infarction (MI) or percutaneous coronary intervention and atrial fibrillation is unclear. Current guidelines recommend using oral anti-coagulation (OAC) alone although the recommendation is weak and there is low quality evidence. Two new randomized control trials (RCTs) were published recently. We conducted an updated meta-analysis to evaluate the effect of these studies on patient outcomes.

OBJECTIVE: To conduct a systematic review and meta-analysis of published RCTs and observational studies to compare OAC alone versus OAC plus single anti-platelet therapy.

METHODS: Electronic searches were conducted using appropriate terms from 3 databases. Relevant studies included. Data extracted and analysis were performed using STATA.

MEASUREMENTS: Summary statistics were pooled and measured for primary and secondary outcomes of both treatment arms.

MAIN RESULTS: Eight studies involving 10,120 patients were included for the analysis. Five thousand two hundred thirty-seven patients were on combination therapy while 4883 were on OAC alone. There was no statistically significant difference in the primary outcome of major adverse cardiac events (hazard ratio [HR] 1.067; 95% confidence interval [CI] 0.912-1.249; P value .417). There was no statistically significant difference even in the measured secondary outcomes namely all cause mortality (HR 1.048; 95% CI 0.830-1.323; P value .695), cardiovascular mortality (HR 0.863; 95% CI 0.593-1.254; P value .439). However, we found statistically significant difference between the 2 groups in the incidence of MI with higher incidence in mono therapy group (HR 1.229; 95% CI 1.011-1.495; P value .039) and higher incidence of major bleeding in the combination therapy group in the subgroup analysis (HR 0.649; 95% CI 0.464-0.907; P value .011).

CONCLUSION: We found no reduction of major adverse cardiac event between combination therapy and mono therapy. Although mono therapy showed increased risk of major bleeding overall, subgroup analysis of the RCTs showed increased risk of major bleeding in the combination therapy group. MI was higher in the mono therapy group compared to the combination therapy group, however this outcome was not reproducible in the subgroup analysis of the RCTs.

PMID:35049165 | DOI:10.1097/MD.0000000000027498