BackgroundHidradenitis suppurativa (HS) can be a severe condition that impacts patients’ health and quality of life. One aspect that can be impaired is sexual health, with many patients suffering from sexual dysfunction (SD). There are numerous articles describing this association.ObjectiveWe sought to synthesize and analyze the recent available evidence on HS and SD.MethodsA systematic review was conducted. Three medical databases were used: Medline, Embase, and Cochrane. All types of epidemiological articles were included, while reviews, guidelines, protocols, conference abstracts, and case report articles were excluded. This review covers the past eight years.ResultsTwelve studies were included for review, with the most common study design being cross-sectional. Most studies involved surveys and questionnaires, with some using control groups to compare results. SD affected roughly half of patients with HS, and was found more frequently in women. Comorbidities included psychological conditions, such as depression and low self-esteem, as well as metabolic and cardiovascular diseases.ConclusionHS is significantly associated with sexual health issues, including SD in women and erectile dysfunction in men. 相似文献
The association between inadequate glycemic control and surgical site infection (SSI) following total joint arthroplasty (TJA) remains unclear. The aim of this study is to assess the relationship between perioperative glycemic control and the risk for SSI, mainly periprosthetic joint infection.
Methods
We searched OVID-MEDLINE, Embase, and Web of Science from inception up to June 2017. The main independent variable was glycemic control as defined by glycated hemoglobin (HbA1C) or perioperative glucose values. The main outcome was SSI. Publication year, location, study design, sample population (size, age, gender), procedure, glycemic control assessment, infection outcome, results, confounders, and limitations were assessed. Studies included in the meta-analysis had stratified glycemic control using a distinct HbA1C cut-off.
Results
Seventeen studies were included in this study. Meta-analysis of 10 studies suggested that elevated HbA1C levels were associated with a higher risk of SSI after TJA (pooled odds ratio 1.49, 95% confidence interval 0.94-2.37, P = .09) with significant heterogeneity between studies (I2 = 81.32%, P < .0001). In a subgroup analysis of studies considering HbA1C with a cut-off of 7% as uncontrolled, this association was no longer noticed (P = .50). All 5 studies that specifically assessed for SSI and perioperative hyperglycemia showed a significant association, which was usually attenuated after adjusting for covariates.
Conclusion
Inadequate glycemic control was associated with increased risk for SSI after TJA. However, the optimal HbA1C threshold remains contentious. Pooled data does not support the conventional 7% cut-off for risk stratification. Future studies should examine new markers for determining adequate glycemic control. 相似文献
Objective: To examine N-acetylcysteine’s (NAC’s) renoprotective effect in adult cardiac surgeryMethods: PubMed, Ovid Medline, and Embase were searched for randomized controlled trials published between January 1990 and May 2021 that investigated the effect of NAC in preventing acute kidney injury (AKI) in patients undergoing cardiac surgery. The inclusion criterion was studies that assessed the effect of NAC in comparison to placebo by measuring the incidence of AKI.Results: Overall meta-analytic estimates of all 10 included trials showed that NAC did not have a significant effect (odds ratio [OR]: 0.84, 95% confidence interval [CI]: 0.64–1.10) on AKI. Further subgroup analysis did not show a significant benefit of NAC in preventing AKI.Conclusion: This meta-analysis suggests that NAC does not have a significant effect in reducing the incidence of AKI. However, there is notable heterogeneity among the included studies that could possibly account for the non-significant effect observed. It is worth noting that only one trial administered NAC high dosages perioperatively, and it is the only included trial to show a significant benefit in reducing the incidence of AKI (OR: 0.30, 95% CI: 0.11–0.81). Further studies on this dosage and duration of administration should be conducted to best elucidate the effect of administering NAC. 相似文献
Transforaminal lumbar interbody fusion (TLIF) is the treatment of choice for lumbar spinal stenosis and spondylolisthesis. The procedure can be performed through a traditional open approach (O-TLIF) or through minimally invasive techniques (MI-TLIF). Spinal surgeries in obese patients can pose risks, including increased rates of infection and thromboembolic events.
Questions/Purposes
We sought to systematically review the literature on the differences between MI-TLIF and O-TLIF in the obese patient in terms of complication rate, functional outcomes, blood loss, and length of hospital stay.
Methods
We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to systematically search PubMed, Embase, Web of Science, and the Cochrane Library for studies published through February 2019 and identified those comparing the outcomes of O-TLIF and MI-TLIF in obese patients. The primary outcome was complication rate (total, infections, dural tears); secondary outcomes were blood loss, length of hospital stay, and functional scores. Two authors independently reviewed the studies using the Newcastle-Ottawa Scale, and data were pooled using the Mantel-Haenszel random-effects model.
Results
In the sample of 430 patients, the average age was 53.5 years, there were 153 men and 203 women, and the average body mass index was 33.6. Complications were significantly higher in O-TLIF than in MI-TLIF (OR?=?0.420 [95% CI: 0.199, 0.887]; I2?=?45.20%). No difference was detected between the two groups for visual analog scale back pain scores and Oswestry Disability Index scores between the pre-operative and last follow-up visits (SMD?=?–0.034 [95% CI –0.695, 0.627]; I2?=?62.14% and SMD?=?0.617 [95% CI: –1.082, 2.316]; I2?=?25%, respectively). Blood loss was significantly lower in MI-TLIF compared to O-TLIF (SMD?=?–426.736 [95% CI: –490.720, –362.752]; I2?=?70.53%), as was the duration of hospital stay (SMD?=?–1.079 [95% CI: –1.591, –0.208]; I2?=?84.3%).
Conclusion
MI-TLIF has equivalent efficacy to O-TLIF in obese patients at long-term follow-up. In addition, complication rate, blood loss, and length of hospital stay were lower in MI-TLIF than in O-TLIF.
World Journal of Surgery - With the global prevalence of liver cirrhosis rising, this systematic review aimed to define the perioperative risk of mortality in these patients following... 相似文献
The hypermobility theory of the first ray is the reason for the popularization of procedures such as the modified Lapidus procedure involving arthrodesis of the first tarsal–metatarsal joint for correction of hallux valgus deformity. Although many studies have involved motion of the first ray in hallux valgus patients, the presence and clinical significance of hypermobility in the first ray remains controversial. We performed a systematic review and meta-analysis to evaluate the difference in the first ray range of motion between patients with or without hallux valgus deformity. The databases used for the present review included Ovid EMBASE, Ovid MEDLINE, CINAHL, and the Cochrane Database. We searched for comparative studies that had evaluated the motion of the first ray in patients with or without hallux valgus. After screening for inclusion and exclusion criteria, we identified 3 studies that were relevant to our study question. All 3 studies showed more first ray motion in the hallux valgus group. Our quantitative synthesis showed a mean difference in the range of motion of the first ray of 3.62 mm (95% confidence interval 2.26 to 4.98) between those with and without hallux valgus deformity. Thus, we found statistically significantly increased first ray motion in patients with hallux valgus deformity compared with those without hallux valgus deformity. However, the clinical significance of this small amount of increased sagittal plane motion as a response to or a cause of hallux valgus remains unanswered. 相似文献
