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Purpose: Prostate cancer (PCa) is the second most common oncologic disease among men. Radical treatment with curative intent provides good oncological results for PCa survivors, although definitive therapy is associated with significant number of serious side-effects. In modern-era of medicine tissue-sparing techniques, such as focal HIFU, have been proposed for PCa patients in order to provide cancer control equivalent to the standard-of-care procedures while reducing morbidities and complications. The aim of this systematic review was to summarise the available evidence about focal HIFU therapy as a primary treatment for localized PCa. Material and methods: We conducted a comprehensive literature review of focal HIFU therapy in the MEDLINE database (PROSPERO: CRD42021235581). Articles published in the English language between 2010 and 2020 with more than 50 patients were included. Results: Clinically significant in-field recurrence and out-of-field progression were detected to 22% and 29% PCa patients, respectively. Higher ISUP grade group, more positive cores at biopsy and bilateral disease were identified as the main risk factors for disease recurrence. The most common strategy for recurrence management was definitive therapy. Six months after focal HIFU therapy 98% of patients were totally continent and 80% of patients retained sufficient erections for sexual intercourse. The majority of complications presented in the early postoperative period and were classified as low-grade. Conclusions: This review highlights that focal HIFU therapy appears to be a safe procedure, while short-term cancer control rate is encouraging. Though, second-line treatment or active surveillance seems to be necessary in a significant number of patients.

There is cumulative evidence supporting the negative effects of smoking on periodontal tissues. Smoking cessation can be successfully accomplished through specific programs, including behaviour modification and medications, and has been suggested as a suitable way to reduce the risk of several diseases, including periodontitis. The aim of this review is to provide a concise overview of the current knowledge about the impact of smoking cessation on periodontal tissues and therapy, with data from studies published in the last 15 years. Literature was searched using Medline database from 2005 up to and including September 2020 using medical subject heading (MeSH) terms and other search terms, restricted to the English language. Studies were evaluated and summarised in a narrative review format. Results demonstrated that there is convincing evidence to support the benefits of tobacco cessation in reducing the risk of periodontitis and tooth loss. In addition, the harmful effects of smoking on periodontal tissues seem to be assuaged as the number of years since quitting increases. The existing current evidence, even limited, also shows that smoking cessation may result in additional benefits to the outcome of nonsurgical periodontal treatment. Periodontal care providers should not only check their patient's smoking habit for estimating risk of disease progression and predictability of periodontal therapy, but they should also help smokers improve their oral and systemic health by providing efficient and personalised tobacco-cessation counselling and treatment.

In this review, we examined the top 10 nutraceutical products sold in Italian pharmacies and parapharmacies as well as hypermarkets and supermarkets; in the first, three product categories saw the greatest increase in sales (vitamins and minerals, immunostimulants, and sleep products) for the 12-month period between October 2019 and October 2020 (including first pandemic wave of SARS-CoV-2). We are investigating their respective formulas and isolating the botanicals that are used to make them. Many of these products have undergone preclinical and clinical studies. We performed a systematic literature search in the MEDLINE database using PubMed and Google Scholar from November 15, 2020 to December 15, 2020 (including studies carried out between 1980 and 2020). The search terms that were used included the complete name of the medicinal plant in English or Latin and the terms “cytochrome” or “drug interactions,” crossing, respectively, the Latin name and English common names with “cytochrome” and “drug interactions.” The search included in vitro and in vivo studies describing the effects of interaction between the plant (extract or botanical medicine) and human cytochromes. Despite their great complexity, there is decidedly limited clinical data on botanical medicine. In fact, of the 28 botanicals that were examined, only 2 (Citrus paradisi and Rhodiola rosea) show in vivo pharmacological interactions in human subjects. On the contrary, for the other botanicals, there is only weak evidence of dubious clinical significance or potential interactions shown in animal models or in vitro without clinical confirmation. This study provides a rational assessment of the most widely used products, including those used in self-medication, to simplify patient management during the COVID-19 health emergency.

The aim of this review is to describe reported techniques and to provide available scientific data on the success of penis length procedures for cosmetic purposes. Penis lengthening methods remain a controversial issue. Penis size is a matter of great interest among men who are affected by 'small penis anxiety'' or just believe themselves to have a small penis, even though the dimensions of the organ fall within the normal range. We performed a narrative review of the literature based on a comprehensive search in the MEDLINE database for original articles published until March 2021, referring to lengthening approaches exclusively for aesthetical reasons. Abstracts, opinion papers and case series ≤10 patients were not considered. We included the results of 14 papers in the review that gathered the experience obtained in a total of 1661 patients. Four of the studies referred to non-surgical procedures for penile length augmentation (PLA) and the remaining 10 analyzed the results of invasive (surgical) procedures. Both invasive and non-invasive techniques achieve similar improvements in penis length. These procedures vary in complexity and require specialized training and experience. However, the low scientific quality of the analyzed papers makes it difficult to establish recommendations to choose one technique over any other. However, it seems reasonable that, if possible, non-invasive techniques should be proposed as a first-line treatment. Before deciding the procedure, we must carry out a correct psychological evaluation of our patients, discuss with them the technique of choice, and adjust their expectations.

Familial Mediterranean fever (FMF) is an autoinflammatory, multisystem disease affecting the populations of the Mediterranean basin.The aim of this study was to assess the research input of Arab countries on FMF between 2004 and 2019.The Medline database (PubMed) was accessed for FMF-related publications. The number of publications was normalized to average: population size, GDP and number of physicians for every country. VOSViewer was used to create a co-occurrence bibliographic map.Between 2004 and 2019, 69 articles relating to FMF were published in the Arab world, accounting for 0.03% of the total number of publications originating in Arab countries, and 3.60% of all articles relating to FMF worldwide. After normalizing to average population size, GDP and number of physicians, Lebanon ranked first with 4.44, 0.64 and 1.99 publications per million persons respectively. Moderate positive correlations were found between number of publications and average population size (r = 0.385) and average number of physicians (r = 0.513). Half of the articles were published in journals ranked Q1 and Q2. An abundance of keywords relating to genetics hint at a main focus on the genetic aspect of the disease.The low number of publications could be a result of the absence of research funding and the political and military instability in the Arab world. Given that many articles were published in high quality journals, Arab countries should focus on providing a clinical aspect to their studies and working on regional and international collaborations.النشاط البحثي بشأن حُى البحر المتوسط العائلية في العالم العربي: الحاجة إلى التعاون الإقليمي والدولي.إليس السعود، سعيد الحاج، ستيفن سافي، أنطونيو الكاره، إيلي مقلد، باسكال سلامة.حُى البحر المتوسط العائلية هي مرض ذاتي التهابي متعدد الأجهزة يصيب سكان حوض البحر المتوسط.هدفت هذه الدراسة الى تقييم الإسهامات البحثية للبلدان العربية بشأن حُى البحر المتوسط العائلية بين عاميْ 2004 و2019.بحثنا في قاعدة بيانات مدلاين (PubMed) عن المنشورات المتعلقة بحُمى البحر المتوسط العائلية من أجل تقييمها. ونُظِّم عدد المنشورات في شكل متوسطات: حجم الفئة السكانية، والناتج المحلي الإجمالي، وعدد الأطباء لكل بلد. واستُخدمت برمجية VOSViewer لإنشاء خريطة ببليوجرافية للإصابات المشتركة.نُشرت 69 مقالة في العالم العربي تتعلق بحُمى البحر المتوسط العائلية في الفترة ما بين عاميْ 2004 و2019، ما يمثل 0.03٪ من إجمالي عدد المنشورات الصادرة في البلدان العربية، و3.60٪ من جميع المقالات المتعلقة بحُمى البحر المتوسط العائلية في مختلف أنحاء العالم. وبعد تنظيم عدد المنشورات في شكل متوسطات لحجم الفئة السكانية والناتج المحلي الإجمالي وعدد الأطباء، احتل لبنان المرتبة الأولى؛ إذ حقَّق معدلات تبلغ 4.44 و0.64 و1.99 من المنشورات لكل مليون شخص على التوالي. ووُجد ارتباط إيجابي متوسط بين عدد المنشورات ومتوسط حجم الفئة السكانية (r = 0.385) ومتوسط عدد الأطباء (r = 0.513). ونُشر نصف المقالات في مجلات مُصنَّفة ضمن الشريحة الربعية الأولى والثانية. وتشير كثرة الكلمات الرئيسية المتعلقة بعلم الوراثة إلى أن التركيز الرئيسي ينصب على الجانب الوراثي للمرض.قد يرجع انخفاض عدد المنشورات إلى عدم وجود تمويل للبحوث وعدم الاستقرار السياسي والعسكري في العالم العربي. ونظرًا إلى نشر العديد من المقالات في مجلات رفيعة المستوى، فإن على البلدان العربية أن تركِّز على تقديم جانب سريري لدراساتها وتعزيز التعاون الإقليمي والدولي في هذا الصدد.Activités de recherche sur la fièvre méditerranéenne familiale dans le monde arabe : la nécessité des collaborations régionales et internationales.La fièvre méditerranéenne familiale (FMF) est une maladie auto-inflammatoire multisystémique touchant les populations du bassin méditerranéen.L’objectif de la présente étude était d’évaluer la contribution des pays arabes à la recherche sur la FMF entre 2004 et 2019.La base de données Medline (PubMed) a été consultée pour accéder aux publications concernant la FMF. Le nombre de publications a été normalisé à la moyenne pour la taille de la population, du PIB et du nombre de médecins pour chaque pays. VOSViewer a été utilisé pour créer une carte bibliographique de co-occurrence.Entre 2004 et 2019, 69 articles concernant la FMF ont été publiés dans le monde arabe, ce qui représente 0,03 % du nombre total de publications en provenance des pays arabes, et 3,60 % de tous les articles relatifs à la FMF dans le monde. Après normalisation en fonction de la taille moyenne de la population, du PIB et du nombre de médecins, le Liban s'est classé premier avec respectivement 4,44, 0,64 et 1,99 publications pour un million de personnes. Des corrélations positives modérées ont été observées entre le nombre de publications et la taille moyenne de la population (r = 0,385) et le nombre moyen de médecins (r = 0,513). La moitié des articles ont été publiés dans des revues classées Q1 et Q2. Un grand nombre de mots-clés relatifs à la génétique indique que l'accent est mis sur l'aspect génétique de la maladie.Le faible nombre de publications pourrait être dû à l'absence de financement de la recherche et à l'instabilité politique et militaire dans le monde arabe. Étant donné que de nombreux articles ont été publiés dans des revues de grande qualité, les pays arabes devraient s'attacher à donner un aspect clinique à leurs études et à établir des collaborations régionales et internationales.

Background Despite promising early results, mid-term failures of the Nellix endovascular aneurysm sealing (EVAS) system (Endologix Inc, Irvine, Calif) have been reported at higher than expected rates. The management of proximal endoleaks and migration differs from those after conventional endovascular aortic aneurysm repair (EVAR) owing to the peculiar design of the Nellix device. In the present study, we report a monocentric experience in the management of EVAS complications using various techniques. We also performed a comprehensive review of the relevant literature on both open surgical and endovascular management of proximal failure of EVAS from the MEDLINE database. Methods We retrospectively analyzed the reinterventions for type Ia endoleak and migration after elective infrarenal EVAS at our institution. We collected preoperative, intraoperative, and follow-up data. Open and endovascular techniques are described. Overall survival, aortic-related mortality, and the technical success rate (rate of exclusion of endoleaks) with endovascular techniques were the primary outcomes. Results We performed 101 infrarenal elective EVAS procedures from 2013 to 2018. Of the 101 patients, 20 (19.8%) had required reintervention for proximal sealing failure. The indications were type Ia (Is2, Is3) endoleak, migration >5 mm, sac expansion >5 mm, and secondary rupture. Of the 20 patients, 6 (30%) were treated with endovascular techniques—2 with a chimney Nellix-in-Nellix application and 4 with proximal relining with a covered stent. The remaining 14 patients (70%) were treated with late open conversion (OC). The average time from EVAS to reintervention was 36.1 months (range, 3-65 months). Six patients (30%) had undergone OC in an emergent setting because of secondary rupture. The technical success rate for the patients treated with endovascular reinterventions was 100%. The 30-day mortality was 20% (4 of 20), all emergent cases (four of six emergent repairs; 67%). The overall survival for the 20 patients was 75% (n = 15) at a mean follow-up of 15.1 months (range, 2-47 months). One patient had died after 7 months of non–aortic-related causes. Conclusions The high reintervention rate of the Nellix graft mandates careful evaluation for its further use with the revised instructions for use, and it should not be used off-label. OC remains the strategy of choice when managing Nellix proximal sealing failures in fit patients. Chimney Nellix-in-Nellix application and transcatheter embolization are feasible alternative techniques. Proximal relining also appears to be an effective alternative to more complex interventions, although it requires further studies for validation.

Vitamin C (ascorbic acid) plays an important physiological role in numerous metabolic functions. It is also a cofactor in the synthesis of important substances, in particular catecholamines and vasopressin. A decrease in the level of ascorbic acid has been noted in various diseases, often accompanying the severity of the patient’s state. The aim of this article is to review the current knowledge on the physiological role of vitamin C and the experimental evidences of its use in critically ill surgical patients. Medline database on the PubMed platform was used to search for the literature sources with key words: vitamin C, sepsis, shock, trauma, burns.

Objetivo: Analizar y caracterizar, mediante técnica bibliométrica, la documentación científica existente en la base de datos bibliográfica MEDLINE sobre la Coronavirus Disease 2019 (COVID-19) relacionada con los cuidados domiciliarios. Método: Estudio descriptivo transversal. Los datos se obtuvieron de la base de datos MEDLINE, a través de PubMed, interrogando los términos a estudio en los campos de descriptores, título y resumen; fecha final de búsqueda 31 enero de 2021. Resultados: Evolución de la producción científica creciente (R2 = 0,8). El número de originales fue de 24 (20,5%), con Índice de Cooperación de 4,8 ± 0,3 autores/artículo. El idioma predominante fue el inglés con 103 (88,0%) referencias. El núcleo de Bradford lo constituyeron 9 (12,0%) revistas. La indización mayor sobre hospitalización a domicilio se constató en 28 (23,9%) de los documentos. Conclusiones: La producción analizada presentaba un crecimiento lineal directo, siendo el artículo original la principal tipología documental que principalmente estuvo redactada en inglés y presentó filiación estadounidense. Se probó un buen índice de colaboración, si bien el tema de hospitalización domiciliaria no estuvo mayoritariamente representado.

Purpose To explore the anatomy, etiopathogenesis, diagnosis and classification, current evidence on intervention and the surgical management of orbital roof fractures and defects (ORFD) for oculoplastic surgeons presented with such cases. Methods A review of the current literature through the MEDLINE database using the following search terms: "orbital roof fracture (+treatment/management)," "orbital roof defect (+treatment/management)," "orbital roof erosion (+treatment/management)," "orbital roof repair," "orbital roof," "orbital fracture," "pediatric orbital roof (defect/fracture/erosion)," "orbital anatomy," and "orbital roof anatomy" was conducted. As relatively little has been published on this topic, inclusion criteria were broad and peer-reviewed articles judged to be of clinical importance, relevant to the aims of this review, were included. Non-English abstracts were also included if relevant. Year of publication was not a strict exclusion criterion, and older articles were judged for their suitability based on clinical importance and relevance to current practice. Additional references were obtained from citations in key articles and recommendations from the coauthors based on their areas of expertise. Results The etiopathogenesis of ORFD varies. Classification systems have been formulated to guide management decisions and can range from conservative management to complex neurosurgery. Eyelid approaches have also been described. This review provides a summary of the evidence for each and a management framework oculoplastic surgeons can use when presented with ORFD. Conclusion Oculoplastic surgeons can be involved, either alone or as part of a multidisciplinary team, in the management of ORFD, and for some, conduct orbital approach reconstructive surgery.

The present study aimed to describe and critically discuss the current evidence regarding the penile girth enhancement procedures for aesthetic purposes. We designed a narrative review of the literature. A comprehensive search in the MEDLINE database was performed. Original articles in English-language, published until March 2021, were selected. A total of 29 studies were included (3 reporting non-invasive approaches, 11 injection therapies, and 15 surgical procedures). The vast majority of articles (26, 89.7%) were not randomized controlled trials, with overall low quality and limited level of evidence. Only 1 (33.3%) paper regarding non-invasive approaches reported a minimal (+0.03 cm) but a significant increase of penile girth (p = 0.034). A low rate (11.2-14.4%) of mild, temporary adverse events and poor-to-moderate patient satisfaction were found. Eight (72.7%) articles concerning injection therapies showed a significant increase in penile girth (p < 0.05). A low rate of mild complications, generally at the injection site, and a high patient satisfaction rate (75-100%) were highlighted. Nine (60%) papers on surgical treatments found a significant increase in penile girth (p < 0.05), while the other 6 (40%) studies reported a generic improvement in penile circumference. Skin necrosis or ulcers, wound infections, or need for reoperation were reported in 8 (53.3%) studies. A high patient satisfaction rate (60-100%) was reported. Our review highlighted the overall positive results of injection procedures, the poor outcomes associated with non-invasive techniques, and the good efficacy and satisfaction with a non-negligible risk of complications in patients undergoing surgical treatments. However, the adverse events are probably largely under-reported and these procedures should still be considered under investigation due to the limited evidence available and the lack of guidelines.

Objetivo: Investigar estudos sobre educação/capacitação permanente relacionados a triagem neonatal (TN) e/ou teste do pezinho, identificando estratégias que favoreçam futuras ações relativas ao tema. Métodos: Trata-se de um estudo descritivo por meio de revisão integrativa, realizado em agosto de 2019, nas bases de dados "LILACS", "MEDLINE", "IBECS" e "SciELO", através dos termos: "Triagem Neonatal", "Teste do Pezinho", "Capacitação" e "Educação em Saúde". Resultados: A amostra final foi composta por 12 estudos, a maioria da base de dados Medline (n=11). Dentre os artigos analisados, três foram publicados em periódicos nacionais e nove em periódicos internacionais. Considerando as modalidades de TN, sete estudos abordaram a TN biológica, enquanto as triagens auditiva e de cardiopatias foram referidas por quatro e um artigos, respectivamente. A população mais estudada foi de enfermeiros e pais. Conclusão: Ratifica-se a importância de implantar programas de educação permanente e capacitação, abordando estratégias eficazes para melhorar a Triagem Neonatal Universal.

Background Anterior retroperitoneal spine exposure has become increasingly performed for the surgical treatment of various spinal disorders. Despite its advantages, the procedure is not riskless and can expose to potentially life-threatening vascular lesions. The aim of this review is to report the vascular lesions that can happen during anterior lumbar spinal surgery using mini-open retroperitoneal approach and to describe their management. Methods A systematic literature search was performed according to PRISMA to identify studies published in English between January 1980 and December 2019 reporting vascular complications during anterior lumbar spinal surgery with mini-open retroperitoneal approach. Three authors independently conducted the literature search on PubMed/Medline database using a combination of the following terms: “spinal surgery”, “anterior lumbar surgery (ALS)”, “anterior lumbar interbody fusion (ALIF)”, “lumbar total disc replacement”, “artificial disc replacement”, “vascular complications”, “vascular injuries”. Vascular complications were defined as any peri-operative or post-operative lesions related to an arterial or venous vessel. The management of the vascular injury was extracted. Results Fifteen studies fulfilled the inclusion criteria. Venous injuries were observed in 13 studies. Lacerations and deep venous thrombosis ranged from 0.8% to 4.3% of cases. Arterial lesions were observed in 4 studies and ranged from 0.4% to 4.3% of cases. It included arterial thrombosis, lacerations or vasospasms. The estimated blood loss was reported in 10 studies and ranged from 50 mL up to 3000 mL. Vascular complications were identified as a cause of abortion of the procedure in 2 studies, representing respectively 0.3% of patients who underwent ALS and 0.5% of patients who underwent ALIF. Conclusion Imaging pre-operative planning is of utmost importance to evaluate risk factors and the presence of anatomic variations in order to prevent and limit vascular complications. Cautions should be taken during the intervention when manipulating major vessels and routine monitoring of the limb oxygen saturation should be systematically performed for an early detection of arterial thrombosis. The training of the surgeon access remains a key-point to prevent and manage vascular complications during anterior lumbar spinal surgery with mini-open retroperitoneal.

Background: Malignant melanomas of the oral cavity are rare tumours. The diagnosis of mucosal melanoma can be difficult especially when it presents itself in its amelanotic form. Methodology: An electronic search was carried out on Pubmed and Medline database to find studies addressing this question published between Jan 2001 and April 2020. Multiple studies are done to determine the staining and positivity of the above mentioned three markers were found. A total of 4 studies were finally selected for this review which tried to determine the efficiency of these three markers in the diagnosis of oral mucosal melanomas. Results: The patient’s data that stained positive S100, HMB45 and Melan A from 4 studies were selected. Conclusion: S100 continues to remain the most sensitive marker for melanoma with its promising ability in diagnosing the desmoplastic variant. The lack of specificity is still a drawback of S100.

The MEDLINE database and PubMed.com web-platform are the world’s best-known and most used sources for search scientific information in biology and medicine. Indexing in MEDLINE and making a journal searchable through PubMed.com is a most powerful tool to promote it worldwide. No other databases, even Scopus and Web of Science, can be compared with MEDLINE in terms of its effect on the readability and availability in web-search results. At the same time, medical and biological journals from Russia have serious problems with the MEDLINE indexation results in an extremely low presence of publications from Russian journals in this database. Over the past decade, the number of Russian journals indexed in MEDLINE has significantly decreased. Present article discusses the main characteristics of the MEDLINE database and PubMed.com, their journal selection process and the reasons for their high importance in scientific journals promotion, as well as the experience of submitting journals for peer review to be indexed in this database. Both positive and negative experience of preparing a journal for indexing in MEDLINE is considered, this can help the editors and publishers of all biology and medicine journals in Russia in solving this task.

Introduction: Venetoclax has emerged as a breakthrough treatment which has revolutionized the therapeutic paradigm of chronic lymphocytic leukemia (CLL). This is primarily attributed to the efficacy of venetoclax as a time-limited, chemo-free, therapy in a field dominated by targeted agents given on a continuous schedule. Furthermore, compelling clinical data support the use of venetoclax in combination with other targeted agents in the hope of preventing drug resistance due to the emergence of acquired mutations.Areas covered: This paper provides an overview of clinical results of newly approved or investigational venetoclax-based therapies for CLL. In view of current and potential roles in CLL care, the strengths and disadvantages of venetoclax-combinations are discussed. The MEDLINE database, ClinicalTrials.gov and conference proceedings were all reviewed to select the relevant literature.Expert opinion: While the advent of venetoclax-based combinations has significantly expanded the therapeutic options for patients with CLL, further research with longer follow-up is required to address remaining open questions such as (I) the role of venetoclax as fixed duration therapy(II) timing and threshold of minimal residual disease (MRD) assessment for therapy discontinuation, (III) the efficacy of novel triplet combinations with venetoclax as backbone therapy, (IV) indications for the re-initiation of therapy with venetoclax.

Background: Publication in a scientific journal is the desired outcome of the research cycle. However, previous anesthesiology research has not thoroughly examined factors predictive of subsequent publication after a meeting presentation. We aimed to assess the rate of peer-reviewed publication of abstracts presented at the Japanese Society of Anesthesiologists (JSA) annual meetings and identify factors associated with successful publication. Methods: This study included all abstracts presented at JSA meetings from 2015 to 2017. The outcome of interest was subsequent publication of abstracts in journals included in the MEDLINE database within 36 months after presentation. Differences between published and non-published abstracts were evaluated. Results: Among the 2,418 eligible abstracts, 487 were published within 3 years (publication rate, 20.1%). Multivariable logistic regression analysis showed that factors independently associated with subsequent publication were: presentation style (poster discussions: adjusted odds ratios (AOR) 1.70, 95% confidence interval [CI] 1.31-2.20; excellent abstracts: AOR 2.82, 95% CI 1.98-4.01); basic research (AOR 4.39, 95%CI 3.23-5.96), male first author (AOR 1.41, 95% CI 1.09-1.81); region (Kansai: AOR 2.16, 95% CI 1.57-2.99; abroad: AOR 4.57, 95% CI 2.58-8.09); facility characteristics (private university: AOR 3.97, 95% CI 2.60-6.08; public university: AOR 3.53, 95%CI 2.35-5.30; medical company: AOR 16.70, 95% CI 3.75-74.46); and number of collaborating facilities (two: AOR 1.50, 95% CI 1.15-1.97; three: AOR 1.83, 95% CI 1.23-2.73; four: AOR 2.40, 95% CI 1.27-4.54). Conclusions: Approximately one-fifth of abstracts presented at JSA meetings are published in peer-reviewed journals within 3 years. Factors independently associated with subsequent full publication are presentation style, basic research, male gender, specific region, affiliation characteristics, and number of collaborating facilities. Our data should stimulate further studies that elucidate ways to assist the full publication process of meeting abstracts.

Hospitalized patients who have established kidney disease and those who have acute kidney injury in the hospital, along with patients with electrolyte disturbances tend to be some of the most complex to care for. Through working closely in nephrology consultation in the hospital with patients and providers, in both private and academic settings, we have come to encounter certain common presentations and recurrent themes that are worthy of emphasis, and of which a good understanding can translate into improved patient care. For the provider who works closely with such patients, many of these aspects are important to recognize and understand. In this review, we present 10 questions that address some of the highly relevant aspects of nephrology for the provider in the hospital. Through a MEDLINE database search, we reviewed the most pertinent studies as we then go through the explanation of management decisions in an evidence-based methodology with an up-to-date approach based on the current literature on the subject.

Background Perioperative blood transfusion is often necessary during spine surgery because of blood loss from the surgical field during and after surgery. However, blood transfusions are associated with a small but significant risk of causing several adverse events including hemolytic transfusion reactions and transfusion-associated circulatory overload. Moreover, many prior publications have noted increased rates of perioperative morbidity and worsened outcomes in spine surgery patients who received blood transfusions. We performed a systematic review of the literature to better characterize the effects of blood transfusion on spine surgery outcomes. Methods The PubMed/MEDLINE database was queried using the composite key word “transfus∗ AND ‘spine surgery.’” A title and abstract review were performed to identify articles for final inclusion. Results A title and abstract review of the resulting 372 English-language articles yielded 13 relevant publications, which were subsequently incorporated into this systematic review. All included studies were retrospective, nonrandomized analyses. Conclusions Overall, prior literature indicates a relationship between perioperative blood transfusion and worsened outcomes after spine surgery. However, the available data represent level IV evidence at best. In the future, prospective, randomized, controlled studies may help define the effects of perioperative blood transfusion on spine surgery outcomes.

Purpose To perform a review of the literature focusing on rehabilitation protocols in patients with acromioclavicular (AC) joint injuries treated operatively and nonoperatively and to provide an updated rehabilitation treatment algorithm. Methods Studies were identified by searching the MEDLINE database from 01/1995 to 09/2020. Included studies contained detailed rehabilitation protocols with physiologic rationale for AC joint injuries. Biomechanical studies, technique articles, radiographic studies, systematic reviews, case studies, editorials, and studies that compared nonoperative versus operative treatment without focus on rehabilitation were excluded. Following identification of the literature, an updated treatment algorithm was created. Results The search strategy yielded 1742 studies, of which 1654 studies were excluded based on title, 60 on the abstract, and 25 on the full manuscript. One study was manually identified using article reference lists, yielding four publications presenting detailed rehabilitation protocols based on physiologic rationale. No randomized controlled trials or comparative studies were identified or cited as a basis for these rehabilitation protocols. Conclusion Few detailed rehabilitation protocols in patients with AC joint injuries have been published. These protocols are limited by their standardization, arbitrary timelines, and provide minimal assessment of individual patient characteristics. The quality of patient care can be improved with more practical guidelines that are goal-oriented and allow for critical thinking among clinicians to address individual patient needs. Three common barriers preventing successful rehabilitation were identified and addressed: Pain, Apprehension, and (anterior chest wall) Stiffness to regain Scapular control, effectively termed "PASS" for AC joint rehabilitation. Clinical relevance Rehabilitation protocols for AC joint injuries should be less formulaic and instead allow for critical thinking and effective communication among clinicians and therapists to address individual patient needs.

The aim of this review was to determine the most important risk factors (RF) in the development of malnutrition in people over 65 years living in the community. A rapid review has been conducted by applying the PRISMA methodology (Preferred Reporting Items of Systematic Reviews and Meta-Analyses) and using the Medline database (PubMed). A search strategy was drawn up, up to 13 January 2020. A total of 24 articles published in the last 5years were included in this review. Assuming the methodological limitations of the present review, it is possible to conclude that undernutrition is a multifactorial problem whose most significant RF are: age, economic status, alterations in the digestive system, comorbidity, polymedication, dependence on the performance of daily life activities, physical inactivity, food insecurity, depression, social isolation, and the field of self-perceptions. Early identification of geriatric patients exposed to these RF can allow a preventive approach in the development of malnutrition from primary care.

Background The need for preservation(P) or removal(R) of articular cartilage during disarticulations remains unanswered. Methods Medline database was used to conduct a systematic review regarding all types of minor disarticulations and some types of major disarticulations in patients with diabetes mellitus, peripheral arterial disease or trauma related disarticulations. Fisher-exact statistical test was used to perform calculations for the entire group as for subgroups. Results A total of 444 disarticulations at the Chopart joint, ankle and knee were included (P = 255 vs. R = 189). There was no difference in wound healing, functionality and mortality. Reamputation rate was lower in the P-group (9.4% vs. 16.9%). Infection rate was not significantly different. Differences in reamputations (R = 10.6% vs. P = 1.0%) and infections (R = 4.4% vs. P = 22.6%) were only present for the ankle subgroup. Conclusions There is no difference in wound healing, functionality and mortality between the preservation and removal of articular cartilage in the lower limb.

As lesões endo-periodontais são lesões destrutivas que acometem o tecido periodontal e pulpar de um determinado dente. O diagnóstico e o tratamento dessas lesões representam um grande desafio na prática clínica. Logo, o objetivo desta revisão foi responder a seguinte pergunta foco: “Quais são os protocolos de tratamento para as lesões endo-periodontais?” Uma revisão de escopo foi realizada de acordo com as normas PRISMA-ScR. A base de dados MEDLINE (pubmed) foi pesquisada até agosto de 2020. Foram procurados estudos com qualquer desenho que relataram o tratamento endodôntico e periodontal de pelo menos um dente com lesão endo-periodontal. A busca eletrônica gerou 238 títulos/resumos e 44 artigos foram incluídos nesta revisão. No total, 545 voluntários foram incluídos e 651 dentes foram diagnosticados/tratados como lesões endo-periodontais. A terapia de maior prevalência foi o tratamento endodôntico convencional antes da terapia periodontal cirúrgica, seguido pelo tratamento endodôntico cirúrgico sendo realizado ao mesmo tempo que o tratamento periodontal cirúrgico, e em menor proporção a terapia periodontal não cirúrgica antes da terapia endodôntica. Não existiram relatos de casos onde o tratamento periodontal cirúrgico ocorreu antes da endodontia convencional. Em conclusão, o tratamento das lesões endo-periodontais deve envolver tanto a terapia endodôntica quanto a periodontal. A maioria dos casos relatados iniciou o tratamento pela endodontia convencional e seguido pelo tratamento periodontal (não-cirúrgico e/ou cirúrgico). Porém, ainda existe controvérsia se deve ser aguardado um tempo de reparo entre os dois tratamentos. A maioria dos dentes diagnosticados com algum tipo de lesão endo-periodontal e tratados tem resultados positivos.

Background With doctors in short supply and a strong demand for surgeon services in all areas of the United States, urban and rural, there are pressures to remain in active practice for longer. Even with an older workforce, there are currently no requirements for when a surgeon must retire in the United States. Objectives The aim of this article was to highlight the importance of the aging surgeon to the medical community and to provide an evidence-based overview of age-related cognitive and physical issues that develop during the later stages of a surgeon’s career. Methods A search of the PubMed/MEDLINE database was performed for the phrase “aging surgeon.” Inclusion criteria were applied to include only those articles related to surgeon age or retirement. Additional reports were handpicked from citations to substantiate claims with statistical evidence. Results The aging surgeon contributes extensive experience to patient care, but is also prone to age-related changes in cognition, vision, movement, and stress as it relates to new techniques, surgical performance, and safety measures. Studies show that although surgeons are capable of operating well into their senior years, there is the potential of decline. Nevertheless, there are proven recommendations on how to prepare an older surgeon for retirement. Conclusions Age-related trends in cognitive and physical decline must be counterbalanced with wisdom gained through decades of surgical experience.

Introduction. Bariatric surgery is the most effective method of weight reduction among patients suffering from morbid obesity. Reduction of body weight before surgery is an important element. The aim of the study was to present the current knowledge on preoperative weight reduction and diet for this purpose. Material and methods. To achieve the aims of the paper, articles available in the PubMed / MEDLINE database published in 2005-2020 were used, as well as the guidelines of societies such as Metabolic and Bariatric Surgery Chapter of the Association of Polish Surgeons, American Association of Clinical Endocrinologists, The Obesity Society and American Society for Metabolic & Bariatric Surgery, International Federation for Surgery of Obesity and Metabolic Disorders-European Chapter and European Association for the Study of Obesity. Results. Studies show that even a modest reduction in weight in the early preoperative period facilitates surgery and reduces the number of complications. The available data do not support the effect of preoperative weight loss on increased postoperative weight loss. The use of balanced, energy-restricted diet in the preoperative period prepares the patient for changes in the way of nutrition, which improves the nutritional status of patient. Low calorie (LCD) or very low calorie (VLCD) diet can be an effective method of weight loss before surgery, however, this approach does not allow to modify eating habits. The use of a very low calorie ketogenic diet (VLCKD) remains under discussion. Conclusions. There is a need for large randomized trials to assess short and long term benefits of preoperative weight loss and methods of weight loss among patients qualified for bariatric surgery, also the standardization of nutritional management in the preoperative period.

Background: Atrial fibrillation (AF) is in an increasing pattern worldwide, especially in the Arab world. Objective: The aim of this article is to assess AF research activity in the Arab countries over the past 16 years, taking into consideration the population size, gross domestic product (GDP) and disability-adjusted life years (DALY). Methods: Atrial fibrillation related research articles published from Arab countries between 2004 and 2019 were collected from the MEDLINE database and are cited online on PubMed. Medical Subject Heading (MeSH) terms related to the subject, the origin and the date of publication were used to search for the published articles. Results: The number of AF related publications in the Arab world over the past 16 years was only 283 (0.73%) out of a total of 38,983 publications worldwide. Saudi Arabia ranked first in terms of number of AF related publications, followed by Egypt. Lebanon is the country with the highest number of publications per USD billion GDP, while Egypt and Saudi Arabia have the highest number of publications per 1% DALYs. According to the population size, Qatar and Bahrain produced the highest number of publications per million persons (PPMP). A strong and positive correlation was found between the number of publications and the GDP. The population size and the percentage of DALY showed positive yet weak correlation. Conclusion: A slight increase in AF related publications is observed. Nonetheless, AF research activity in the Arab world is still insufficient.

Key summary points Aim This narrative review aims to find and summarize recent publications on definitions, epidemiology and clinical consequences of polypharmacy. Findings Numerous definitions of polypharmacy and associated terms were found. The prevalence of polypharmacy greatly varies, and numerous adverse clinical outcomes were associated with polypharmacy. Message The clinically oriented definitions of polypharmacy are more useful and relevant. Regardless of the definition, polypharmacy is highly prevalent in older adults. Approaches to increase the appropriateness of polypharmacy can improve clinical outcomes in older adults., Background The number of older adults has been constantly growing around the globe. Consequently, multimorbidity and related polypharmacy have become an increasing problem. In the absence of an accepted agreement on the definition of polypharmacy, data on its prevalence in various studies are not easily comparable. Besides, the evidence on the potential adverse clinical outcomes related to polypharmacy is limited though polypharmacy has been linked to numerous adverse clinical outcomes. This narrative review aims to find and summarize recent publications on definitions, epidemiology and clinical consequences of polypharmacy. Methods The MEDLINE database was used to identify recent publications on the definition, prevalence and clinical consequences of polypharmacy using their respective common terms and their variations. Systematic reviews and original studies published between 2015 and 2020 were included. Results One hundred and forty-three definitions of polypharmacy and associated terms were found. Most of them are numerical definitions. Its prevalence ranges from 4% among community-dwelling older people to over 96.5% in hospitalized patients. In addition, numerous adverse clinical outcomes were associated with polypharmacy. Conclusion The term polypharmacy is imprecise, and its definition is yet subject to an ongoing debate. The clinically oriented definitions of polypharmacy found in this review such as appropriate or necessary polypharmacy are more useful and relevant. Regardless of the definition, polypharmacy is highly prevalent in older adults, particularly in nursing home residents and hospitalized patients. Approaches to increase the appropriateness of polypharmacy can improve clinical outcomes in older adults.

Split notochord syndrome (SNS) is a rare congenital defect of the central nervous system and has been associated with several anomalies affecting multiple organ systems. One association has been communication with the gastrointestinal tract and the spine, previously identified as a neuroenteric fistula (NEF). Here, the authors describe the unique case of a female infant with SNS and NEF treated with a multistage surgical repair. The three-stage operative plan included a two-stage repair of the defect and temporary subgaleal shunting followed by delayed ventriculoperitoneal shunt placement. The infant recovered well postsurgery and over a 5-year follow-up. A case description, surgical techniques, and rationale are reported. Additionally, a systematic review of the literature utilizing the MEDLINE database was performed.Treatment of SNS with NEF using a multidisciplinary multistaged approach to repair the intestinal defect, close the neural elements, and divert cerebrospinal fluid to the peritoneum is shown to be a safe and viable option for future cases.

The emergence and spread of new technologies have allowed for the introduction of new forms of gambling. Problem online gambling has specific characteristics, and its prevalence may differ from traditional forms of gambling. This paper systematically reviews studies that include data relevant to problem online gambling and to the sociodemographic and comorbidity variables related to it. A systematic literature search was conducted from Medline database. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement, preliminary search resulted in 427 articles, from which 20 were included in this systematic review based on pre-determined criteria. The reported prevalence of problem online gambling varied widely across the different studies. This heterogeneity is due to large variations in settings, instruments, and definitions of problem online gambling, which rules out a meta-analytic approach to the results. The sources of variability in the prevalence, the sociodemographic and comorbidity factors, and the implications for future research are discussed.

Introduction Spigelian hernia is a rare lateral ventral hernia traditionally repaired through open incision with extensive dissection. Three laparoscopic techniques have been reported in the literature: intraperitoneal onlay mesh (IPOM), transabdominal preperitoneal (TAPP), and total extraperitoneal (TEP). TEP is less popular than the other approaches. We evaluated TEP's safety and effectiveness and compared different laparoscopic techniques. Methods All patients with Spigelian hernia who had undergone extended TEP (eTEP) repair with mesh in our center from January 2007 to February 2020 were studied. A three-port technique with a preperitoneal space created by telescope at the midline was adopted. A systematic review on laparoscopic mesh repair was performed by searching for "Spigelian hernia" and "laparoscopic" from 1999 to 2019 in the MEDLINE database. Results Seven patients underwent eTEP repair for Spigelian hernia. Five presented with abdominal mass and underwent preoperative imaging. Two were diagnosed incidentally during TEP for inguinal hernia. The mean operative duration was 65 minutes (range, 40-93 minutes). There were no open conversions or intraoperative complications. The mean length of hospital stay was 1.4 days (range, 1-3 days). The mean follow-up period was 44.3 months. One patient developed seroma. There was no recurrence or chronic pain. We identified 197 laparoscopic mesh repairs reported in 41 articles. IPOM (n = 91) was the most popular approach, followed by TAPP (n = 70) and TEP (n = 36). Laparoscopic mesh repair of Spigelian hernia is safe and offers excellent outcomes. Conclusion We found the eTEP approach safe and effective for Spigelian hernia repair. IPOM, TAPP, and TEP are comparable.

In this scientific review, in order to form ideas about the possibilities of fixing reactions to erotic stimuli in pedophilia using modern technologies, the electronic resources of the scientific electronic library elibrary.ru and the MEDLINE database of the US National Library of Medicine were studied. The search was carried out using combinations of the keywords MRI, PET, EEG, event related potential with the words pedophilia, paedophilia . The theoretical concepts of the neurophysiological mechanisms of abnormal sexual preference are described, the results of the most significant psychophysiological, neuroimaging and electrophysiological studies are presented.

Objective The aim: This review was aimed to understand the role of different types of autoantibodies like antiphospholipid, antithyroid, antisperm, antinuclear, anti-ovarian autoantibodiesand heat shock protein HSP 60 in the process of implantation in the normal way of conceiving and IVF and also to estimate that how the presence of these autoantibodies affect the normal pregnancy outcome. Patients and methods Materials and methods: This review process performed in the obstetrics and gynaecology postgraduate department, Bogomolets national medical university, Kyiv, Ukraine. It was a review of already published papers not to need the ethical board committee's approval. By following the literature review guidelines, this paper was written and searched for relevant studies regarding autoantibodies and implantation, published in medical literature till 2020 were included in this review process. The search is done for studies published till 2020 in the English language from the Medline database, including Google Scholar, PubMed, Web of Science and Cochrane library database. Conclusion Conclusions: Our recent work found that the involvement of APA, ANA and/or ATA in recipients of oocyte donations did not affect their pregnancy outcomes. Some researchers did not give any clear conclusion about these risks, and some stated that the use of some immunodepressant agents could be useful to reduce the harmful effects of these autoantibodies associated with implantation failure. Each autoantibody has a different mechanism of action to create the pathological state, some have direct effect, and some indirectly impact implantation. In future, further high-quality studies need to be performed for better understanding.

Background: Oral administration of medications and current oral modified-release systems are the most preferred drug delivery routes, but they provide efficacy up to 12-24 hours per administration and are not useful when the patient has short transit time. The once-daily administered formulations are the endpoint of many types of drug development, and some innovations in capsule endoscopy (CE) can solve this problem. Objective: This review aims to reveal recent advances in drug delivery systems (DDS) for CE as an essential field of research for more precise drug targeting at the gastrointestinal (GI) tract. Methods: We performed a narrative overview of the MEDLINE database from 1991-2020 using the keywords of DDS and CE with synthesizing the findings, hand searches, and authoritative articles. Results: There are microelectromechanical systems and non-mechanical patent technologies for DDS for CE, and the implementation of wireless-capsule medical devices into the human body will provide new diagnostic and therapeutic options. Integrating biomedical CE with DDS and the cloud technology will bring remote real-time feedbackbased automated treatment or responsive medication. Conclusion: Swallowable drug delivery systems for capsule endoscopy brings an entirely new approach for diagnostic and therapeutic methods in digestive diseases.

Background: Chronic wounds are commonly associated with polymicrobial biofilm infections. In the last years, the extensive use of antibiotics has generated several antibiotic-resistant variants. To overcome this issue, alternative natural treatments have been proposed, including the use of microorganisms like probiotics. The aim of this manuscript was to review current literature concerning the application of probiotics for the treatment of infected chronic wounds. Methods: Relevant articles were searched in the Medline database using PubMed and Scholar, using the keywords “probiotics” and “wound” and “injuries”, “probiotics” and “wound” and “ulcer”, “biofilm” and “probiotics” and “wound”, “biofilm” and “ulcer” and “probiotics”, “biofilm” and “ulcer” and “probiotics”, “probiotics” and “wound”. Results: The research initially included 253 articles. After removal of duplicate studies, and selection according to specific inclusion and exclusion criteria, 19 research articles were included and reviewed, accounting for 12 in vitro, 8 in vivo studies and 2 human studies (three articles dealing with animal experiments included also in vitro testing). Most of the published studies about the effects of probiotics for the treatment of infected chronic wounds reported a partial inhibition of microbial growth, biofilm formation and quorum sensing. Discussion: The application of probiotics represents an intriguing option in the treatment of infected chronic wounds with multidrug-resistant bacteria; however, current results are difficult to compare due to the heterogeneity in methodology, laboratory techniques, and applied clinical protocols. Lactobacillus plantarum currently represents the most studied strain, showing a positive application in burns compared to guideline treatments, and an additional mean in chronic wound infections. Conclusions: Although preliminary evidence supports the use of specific strains of probiotics in certain clinical settings such as infected chronic wounds, large, long-term clinical trials are still lacking, and further research is needed.

Purpose To perform a bibliometric analysis of lased-based BPH treatment publications and to obtain an understanding of the publication trends over time. Materials and methods The Medline database was searched for articles in English language regarding laser-based BPH therapy up to 2018. Matching articles were assigned to at least one of the following categories: Ho:YAG, Tm:YAG, green light, diode, Nd:YAG laser and review articles. The laser categories were analysed using bibliometric procedures regarding citation rate, authors, country of origin and journal of publication. Moreover, the articles on laser BPH therapy included in the EAU, AUA and JUA guidelines were analysed to evaluate the most influential articles. Results In total, 982 articles were included: 317 articles were assigned to green light, 283 to Ho:YAG, 101 to Tm:YAG, 74 to Nd:YAG and 39 to diode lasers. The publication rate for Nd:YAG laser has declined, but continues to grow for Ho:YAG and Tm:YAG lasers. We found a positive correlation between number of authors and year of publication (R = 0.3, p Conclusion Laser-based approaches for BPH treatment are increasing but have not been implemented worldwide. Asia’s contribution should be acknowledged. An inflationary trend regarding the number of authors per article is confirmed.

OBJECTIVE Immediate postoperative urinary retention (UR) and voiding dysfunction (VD) are some factors limiting outpatient procedure for mid-urethral sling (MUS) surgery in women presenting with stress urinary incontinence. The objective of the current review was to report the main predictive factors associated with immediate postoperative UR/VD following MUS surgery in women. METHODS A systematic review was performed using Medline database, according to PRISMA methodology, using following keywords midurethral sling; tension-free vaginal tape; TVT; transobturator tape; TOT; predicting factor; voiding dysfunction; urinary retention; postvoid residual; postoperative residue of urine. RESULTS Thirteen studies were included. Main clinical predictive factors associated with immediate postoperative urinary retention (UR) and voiding dysfunction (VD) were: previous pelvic surgery (hysterectomy, incontinence or pelvic organ prolapse surgery) [OR: from 3.7 ((CI95%: 1.14-12.33); P=0.029)] to 8.93 [(CI95%:1.17-61.1); P=0.035)], previous UR [OR: 415 (CI95%: 20-8619); P

Objective: To analyze the scientific production on the instruments for pain assessment in children and adolescents with cognitive impairment. Methods: An integrative literature review. Publications on the topic were searched in the Virtual Health Library, in the Scielo electronic library and in the Medline database (via Pubmed), from 2014 to 2019, in English, Portuguese and Spanish. The final sample included five studies, which answered the guiding question: Which are the instruments for pain assessment in children and adolescents with [...]

The trapeziometacarpal prosthesis is mostly used in Europe to treat osteoarthritis of the basal joint of the thumb. Its supposed benefits are that it restores the length of the thumb, improves strength, function and mobility while reducing recovery time compared to other surgical treatments. However, previous reviews of the literature could not confirm these assumptions. This article provides an updated systematic review to help answer to these questions through a methodical statistical analysis and to quantify the two main complications, namely failure and deep infection. To achieve these aims, a selection of articles including implant case series was done in the Medline database based on specific criteria. Data about pain, function, strength, infection, and failure were compiled and a statistical analysis was performed. Results show a fast recovery in terms of pain and function but the positive effect on strength seems limited. The failure rate represented by the revision rate is high and the deep infection rate is fairly low. Randomized controlled studies are needed to obtain reliable data to compare the prosthesis to other surgical treatments. [La prothèse trapézo-métacarpienne: revue de la littérature mise à jour] La prothèse trapézo-métacarpienne est principalement implantée en Europe pour traiter la rhizarthrose. Ses avantages supposés sont la restauration de la longueur du pouce, la diminution de la douleur, l'amélioration de la force, de la fonction et de la mobilité avec un temps de récupération postopératoire restreint par rapport aux autres traitements chirurgicaux. Les précédentes revues de la littérature n'ont cependant pas permis de confirmer ces suppositions. Le présent article est une revue de la littérature mise à jour afin d'apporter une partie des réponses à ces questions à travers une analyse statistique méthodique et de quantifier deux complications majeures à savoir l'échec et l'infection profonde. Pour atteindre ces objectifs, une sélection d'articles rapportant des séries de prothèses a été réalisée suivant des critères spécifiques dans la base de données Medline. L'ensemble des données concernant la douleur, la fonction, la force, l'échec et l'infection ont été répertoriées et une analyse statistique a été effectuée. Les résultats ont montré une amélioration postopératoire rapide en termes de douleur et de fonction, mais l'effet positif sur la force semble limité. Le taux d'échec, représenté par le taux de révision, est élevé et le taux d'infection profonde est particulièrement bas. Des études randomisées contrôlées seraient intéressantes afin d'obtenir des données fiables permettant la comparaison avec les autres traitements chirurgicaux de la rhizarthrose.

Background Microneedling (MN) is used for the treatment of scars, amongst other indications. Although used in Asia and the Middle East for decades, related to the supposed lack of post-procedure pigmentary alterations even in darker skin types, MN only recently gained attention in the United States as an effective, well-tolerated aesthetic treatment. Materials and methods A systematic review of the Medline database was completed using search terms "microneedle" or "microneedling" or "micro needle" or "micro needling" and "scar". Included articles were written in English and discussed the use of MN for the treatment of scars in human subjects. Results Fifty-eight studies were included for review, with a total of 1845 patients treated for acne scarring, hypertrophic or keloid scars, and those resulting from surgery, trauma, varicella or smallpox. MN and its counterpart fractional radiofrequency MN (FRF-MN) were used as monotherapy or in combination with topical, surgical or systemic modalities. MN and FRF-MN treatment resulted in clinical improvement of scar appearance from baseline. No serious adverse events occurred. Conclusion MN is a well-tolerated, minimally invasive procedure that can be used for the treatment of scars with a high level of patient satisfaction. Further clinical studies are needed to develop standardized treatment protocols.

Objective The aim of this meta-analysis was to summarize the current available evidence regarding the surgical outcomes of laparoscopic redo fundoplication (LRF). Summary background data Although antireflux surgery is highly effective, a minority of patients will require a LRF due to recurrent symptoms, mechanical failure, or intolerable side-effects of the primary repair. Methods A systematic electronic search on LRF was conducted in the Medline database and Cochrane Central Register of Controlled Trials. Conversion and postoperative morbidity were used as primary endpoints to determine feasibility and safety. Symptom improvement, quality of life (QoL) improvement, and recurrence rates were used as secondary endpoints to assess efficacy. Heterogeneity across studies was tested with the chi-square and the proportion of total variation attributable to heterogeneity was estimated by the inconsistency (I) statistic. A random-effect model was used to generate a pooled proportion with 95% confidence interval (CI) across all studies. Results A total of 30 studies and 2,095 LRF were included. The mean age at reoperation was 53.3 years. The weighted pooled proportion of conversion was 6.02% (95% CI, 4.16%-8.91%) and the meta-analytic prevalence of major morbidity was 4.98% (95% CI, 3.31%-6.95%). The mean follow-up period was 25 (6-58) months. The weighted pooled proportion of symptom and QoL improvement was 78.50% (95% CI, 74.71%-82.03%) and 80.65% (95% CI, 75.80%-85.08%), respectively. The meta-analytic prevalence estimate of recurrence across the studies was 10.71% (95% CI, 7.74%-14.10%). Conclusions LRF is a feasible and safe procedure that provides symptom relief and improved quality of life to the vast majority of patients. Although heterogeneously assessed, recurrence rates appear to be low. LRF should be considered a valuable treatment modality for patients with failed antireflux surgery.

Abstract Background In December 2019, SARS-CoV-2 was identified as the causative agent of pneumonia cases in China. This virus is spread by coughing or sneezing and can infect other persons by on contacting mucous membranes. SARS-Cov-2 most frequent serious manifestation is pneumonia. Chest computed tomography in COVID-19 patients usually shows ground-glass opacities that may be accompanied by consolidation lesions. Early diagnosis of the disease and rapid isolation of the patient is of great importance. So far, confirmation of COVID-19 infection is made by RT-PCR of nasopharyngeal or respiratory specimens. Recent research reported that the sensitivity of computed tomography in diagnosing COVID-19 is 98% while RT-PCR sensitivity is 71%. Herein, we compare the sensitivity of both chest CT and RT-PCR in diagnosing COVID-19 at initial patient presentation through a meta-analysis study. Main body Using MEDLINE database a systematic literature search was conducted to identify relevant published studies within from November 2019 to April 2020. Only articles with full text were examined to determine eligibility and extract data by two reviewers. It was decided to include studies mentioning sensitivity of chest CT scan and sensitivity of RT-PCR and both done at the same time. Results Potentially relevant 15,300 studies were identified in our search in MEDLINE whose titles were quickly reviewed. Potentially eligible studies missing any of the forementioned inclusion criteria were excluded. This process left 7 eligible articles that fulfilled the inclusion criteria and were thus included in the meta-analysis and used for further analyses. Conclusion The meta-analysis study showed that chest CT may be beneficial in early detection of cases of COVID-19. Imaging, in adjunct to clinical and laboratory findings, should be used for monitoring of disease course, until further evidence is available.

Eye disease is the third-highest contributor toward health inequality for Aboriginal Australians. Understanding how the Central Australian ophthalmology service addresses complexities of remote eye care is crucial in understanding how expansion can meet current and future needs. The present study analyses findings from the MEDLINE database and Governmental reports, and descriptive information from stakeholders in Central Australia and the Australian Department of Health. We describe the current Central Australian ophthalmology model at three levels; (i) the healthcare service level (specialized primary care, local/outreach optometry and ophthalmology services, and intensive extended surgical weeks), (ii) the community level (local community staff, clinics and initiatives, and eye "champions" and mutual support), and (iii) the healthcare system level (federal and state Government, and private funding). We conclude that building full-time specialist availability, and system-wide approaches to increase patient utilisation, will facilitate overcoming barriers of remoteness, and create enduring improvements in Central Australian eye care and health-inequality.

Varicocele is the most common and treatable cause of male infertility. Therefore, surgical treatment of varicocele should be recommended for motivated patients and infertile couples who do not have other identified causes of infertility. Varicocelectomy has been proved to improve sperm parameters and improve chances of successful conception in most patients. However, surgical treatment is associated with certain risks, and therefore, the choice of the optimal treatment is under discussion. A total of 78 articles using a search in MEDLINE database (PubMed) were found and included in the review, dedicated to current concepts of functional anatomy of testicular arteries and veins. The current recommendations of professional communities regarding the selection of patients for varicocelectomy are described. The efficiency and safety of various surgical procedures for varicocele is analyzed. This review suggests high inconsistences in the literature. The available information on the indications for surgical treatment, as well as comparative data on the efficiency and safety of the inguinal, laparoscopic and microsurgical sub-inguinal approaches are presented. When urologist faces with a diagnosis of varicocele, individual approach should be applied, with a discussion of both benefits and possible complications of surgical treatment. Of the many existing techniques, microsurgical ligation of dilated veins is the most preferred.

New technology has facilitated survey research of anesthesia professional society members. We evaluated prevailing metrics of quality and impact of published research studies based on surveys of anesthesiologists. We hypothesized that adherence to recommended practices (such as use of reminders) would be associated with increased survey response rates, and that higher response rates would be associated with higher article impact. Using the MEDLINE database, we identified 45 English-language research articles published in 2010-2017 reporting original data from surveys of anesthesiologists. The median response rate was 37% (IQR: 25-46%). Recommended survey practices, including the use of reminders (p = 0.861) and validated questionnaires (p = 0.719), were not correlated with response rates. In turn, survey response rates were not associated with measures of article impact (p = 0.528). The impact of published research based on surveys of anesthesiologists, as measured by citation scores (p = 0.493) and Altmetrics (p = 0.826), may be driven primarily by the novel data or questions raised using survey methodology, but does not appear to be associated with response rates. Improving reporting of survey methodology and understanding possible sources of non-response bias are important for future studies in this area.

La Etnofarmacología es un campo interdisciplinario de la antropología cultural, la biología y la medicina; abarca las observaciones en campo, descripción del uso y preparación de los remedios, la determinación botánica del material obtenido, estudios fitoquímicos para aislar los compuestos presentes en las plantas, así como los estudios farmacológicos; por lo que es una ciencia que ha cobrado gran importancia. En este estudio se realizó un análisis documental en torno al concepto de Etnofarmacología en México en MEDLINE a partir de 1960, así como documentos sobre las comunidades indígenas de México y las características de atención a la salud en nuestro país. Los resultados muestran que las investigaciones sobre plantas medicinales y Etnofarmacología tienen una larga y fecunda historia en México y un sorprendente aumento en publicaciones sobre Etnofarmacología. La mayoría de los trabajos analizados son estudios interdisciplinarios en los que participaron diversas universidades y grupos de trabajo, muchos son reportes de estudios de campo lo que indica que la Etnofarmacología es una ciencia joven con gran capacidad de desarrollo y una potencial generadora de propuestas terapéuticas

Background Correcting pseudoparalysis of the shoulder due to massive rotator cuff tear is challenging. The most reliable treatment for restoring active shoulder elevation is debatable. Therefore, the purpose of this systematic review was to evaluate the success of various treatment options for reversing pseudoparalysis due to massive rotator cuff tear. Methods A search was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines of the MEDLINE database, Cochrane database, Sportdiscus, and Google Scholar database for articles evaluating shoulder pseudoparalysis due to massive rotator cuff tears. Results Nine articles evaluating reverse total shoulder arthroplasty (RTSA), superior capsular reconstruction (SCR), and rehabilitation programs were included in the study. Though there was variability, the definition of pseudoparalysis was active forward elevation (AFE) less than 90° with preserved passive range of motion (ROM). Reversal of pseudoparalysis was defined as restoration of AFE greater than 90°. The overall rate of reversal of pseudoparalysis across studies was similar for RTSA (96% ± 17%) and SCR (94% ± 3%). However, there was a difference in average improvement in AFE for RTSA (56° ± 11°) and SCR (106° ± 20°). A progressive rehabilitation program described improvements in a single study with 82% reversal of pseudoparalysis. Conclusion The available Level IV evidence suggests that RTSA and SCR reliably reverse pseudoparalysis in most patients with massive, irreparable rotator cuff tears. However, the dissimilar improvements in ROM suggest that a more consistent definition of pseudoparalysis is warranted. Future randomized controlled trials are needed to determine the best treatment approach for patients with massive irreparable rotator cuff tears.

The pyramidal lobe is an important feature of thyroid gland anatomy that is often neglected in preoperative imaging and thyroid surgery. The aim of this review is to assess the frequency of the pyramidal lobe as well as its clinical importance. The search was conducted using the Medline database (1946 to February 2020). The key words of our search were “thyroid pyramidal lobe”. The inclusion criteria specified the availability of abstracts or full-text articles in English. Out of 101 search results, 50 articles were relevant and were included in this study. The prevalence of the pyramidal lobe in recent surgical and cadaveric studies varies between 12% – 65%. Identification rates in preoperative imaging are insufficient (ultrasonography accuracy: 80.3% – 83.7%, computed tomography accuracy: 92.6%). Ultrasonography appears less diagnostically accurate (accuracy: 82.1% – 87.5%) compared to computed tomography. The pyramidal lobe is commonly involved in thyroid pathology, especially in cancer and diffuse thyroid diseases, like Graves’ disease and multinodular goiter. The pyramidal lobe is a normal component of thyroid anatomy. Intraoperative pyramidal lobe identification and resection is mandatory, in order to prevent disease recurrence.

Simulation plays a pivotal role in neurosurgical training by allowing trainees to develop the requisite expertise to enhance patient safety. Several models have been used for simulation purposes. Non-living animal models offer a range of benefits, including affordability, availability, biological texture, and a comparable similarity to human anatomy. In this paper, we review the available literature on the use of non-living animals in neurosurgical simulation training. We aim to answer the following questions: (1) what animals have been used so far, (2) what neurosurgical approaches have been simulated, (3) what were the trainee tasks, and (4) what was the experience of the authors with these models. A search of the PubMed Medline database was performed to identify studies that examined the use of non-living animals in cranial neurosurgical simulation between 1990 and 2020. Our initial search yielded a total of 70 results. After careful screening, we included 22 articles for qualitative analysis. We compared the reports in terms of the (1) animal used, (2) type of surgery, and (3) trainee tasks. All articles were published between 2003 and 2019. These simulations were performed on three types of animals, namely sheep, cow, and swine. All authors designed specific, task-oriented approaches and concluded that the models used were adequate for replicating the surgical approaches. Simulation on non-living animal heads has recently gained popularity in the field of neurosurgical training. Non-living animal models are an increasingly attractive option for cranial neurosurgical simulation training. These models enable the acquisition and refinement of surgical skills, with the added benefits of accessibility and cost-effectiveness. To date, 16 different microneurosurgical cranial approaches have been replicated on three non-living animal models, including sheep, cows, and swine. This review summarizes the experience reported with the use of non-living animal models as alternative laboratory tools for cranial neurosurgical training, with particular attention to the set of tasks that could be performed on them.

Background Retro-hepatic inferior vena cava (RHIVC) injuries resulting from blunt or penetrating abdominal trauma are rare but devastating events that remain a considerable challenge to even the most experienced doctors, which continue to carry a considerable mortality. Aim To establish a better understanding of the management of RHIVC injuries and to identify any adjuncts or operative methods that were associated with an increased survival. Methods A systematic review of the MEDLINE database was conducted using Medical Search Headings and exploded keywords and phrases. Studies were screened and subjected to inclusion/exclusion criteria. Data were extracted in a methodical manner collecting population demographics, morbidity, mortality and operative intervention, where provided. Operative strategies were compared and discussed. Results An initial search identified 483 articles. Following duplicate removal and abstract screening, 85 full-text articles were assessed with 25 meeting the desired criteria and were, therefore, included in the systematic review. Key operative strategies and complications were identified and discussed. Conclusion The wide variety of operative interventions in the management of RHIVC liver injuries described attest to the increased efforts to improve outcomes. The overall improvement in mortality can be noted since the earlier descriptions reported mortality approaching 100% compared to the 52% reported in this review. An algorithm has been proposed based on these findings and our experiences for the management of RHIVC injuries.