Colon capsule endoscopy polyp detection rate vs colonoscopy polyp detection rate: Systematic review and meta-analysis

BACKGROUND

Colon capsule endoscopy (CCE) is a modern, non-invasive method for large bowel visualization, offering a less invasive alternative to traditional colonoscopy (TC). While TC remains the gold standard for comprehensive large bowel assessment, including the detection and treatment of various conditions, the effectiveness of CCE in detecting polyps is less established.

AIM

To systematically review and compare the polyp detection rates (PDR) of CCE and TC.

METHODS

A systematic literature search was conducted using four scientific databases: CINAHL, MEDLINE via EBSCO, Cochrane Library, and MEDLINE/PubMed. A standardized search command was utilized to ensure consistency. Full papers were retrieved if they compared PDR between CCE and TC and involved patients over 18 years old. A meta-analysis was then conducted using the meta package in R software.

RESULTS

Initially, 339 articles were identified, with 128 duplicates and 15 non-English articles excluded, leaving 196 for screening. After further exclusions, 9 articles were included in the review. The meta-analysis revealed minimal differences in PDR between CCE and TC. The pooled PDR for TC was 0.61 (95%CI: 0.48–0.72), and for CCE, it was 0.61 (95%CI: 0.48–0.73). The overall comparison of the pooled PDR of both methods was 0.96 (95%CI: 0.90–1.02), indicating that CCE is non-inferior to TC.

CONCLUSION

CCE has emerged as a modern and safe diagnostic alternative to TC for polyp detection, demonstrating non-inferiority when compared to the conventional method.

Risk factors, manifestations, diagnosis and treatment of cholelithiasis in children

Cholelithiasis in children refers to cholelithiasis or choledocholithiasis in newborns, infants and adolescents, including a series of symptoms and complications related to stones. The incidence rate of cholelithiasis in children is far lower than that in adults. However, the detection rate of cholelithiasis in children has risen in recent years. The aetiology of cholelithiasis in children is complex, and the pathogenesis is still unclear. According to existing studies, cholelithiasis in children may be related to sex and hormones, obesity, drugs, haemolytic diseases, genetic factors, chemokines, abnormal biliary tract formation, ileal surgery, total parenteral nutrition and other factors. In addition, there is a large occurrence of idiopathic cholelithiasis in children with unknown aetiology. The clinical manifestations of cholelithiasis in children are not completely the same as those in adults, mainly due to the different ages and causes. At present, there is no consensus on the clinical treatment of cholelithiasis in children. Follow-up and observation, drug dissolution and surgical treatment are all treatment methods for children with cholelithiasis. This study reviewed the related literature reports of cholelithiasis in children and summarized the risk factors, clinical manifestations, diagnosis and treatment of cholelithiasis in children to improve the understanding, diagnosis, and treatment of cholelithiasis in children.

SARS-CoV-2 viral load in the upper respiratory tract and disease severity in COVID-19 patients

Due to the disease's broad clinical spectrum, it is currently unclear how to predict the future prognosis of patients at the time of diagnosis of coronavirus disease 2019 (COVID-19). Real-time reverse transcription-polymerase chain reaction (RT-PCR) is the gold standard molecular technique for diagnosing COVID-19. The number of amplification cycles necessary for the target genes to surpass a threshold level is represented by the RT-PCR cycle threshold (Ct) values. Ct values were thought to be an adequate proxy for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral load. A body of evidence suggests that SARS-CoV-2 viral load is a possible predictor of COVID-19 severity. The link between SARS-CoV-2 viral load and the likelihood of severe disease development in COVID-19 patients is not clearly elucidated. In this review, we describe the scientific data as well as the important findings from many clinical studies globally, emphasizing how viral load may be related to disease severity in COVID-19 patients. Most of the evidence points to the association of SARS-CoV-2 viral load and disease severity in these patients, and early anti-viral treatment will reduce the severe clinical outcomes.

Post COVID-19 infection: Long-term effects on liver and kidneys

Coronavirus disease 2019 is a pandemic, which has affected millions of people across the globe in the year 2020. This disease is caused by a virus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), that belongs to the family of coronaviruses and primarily affects the respiratory system. This infection has a wide spectrum of clinical manifestations ranging from asymptomatic form to mild, moderate and severe forms depending upon the age, comorbidity and immunity of an affected individual. Hyper-inflammatory response due to SARS-CoV-2 adversely affect several internal organs. Besides lung injury, which is the main outcome of SARS-CoV-2 infection, it has been reported to adversely impact other organs including the liver and kidneys. SARS-CoV-2 virus can also have a direct adverse impact on liver as well as kidneys due to systemic inflammatory response or drug toxicity, leading to elevated levels of liver injury markers and acute kidney injury. Clinical outcomes of SARS-CoV-2 infection could be worse in patients suffering from pre-existing liver and kidney disease. So far, there have been several reports on the mechanism of liver and kidney injury during SARS-CoV-2 viral attack. However, the long-term impact of this infection on these organs is yet to be understood. This review summarizes the possible causes and effects of SARS-CoV-2 on the liver and kidneys during the infection and post recovery based on available literature.

Simulating the mind and applications – a theory-based chance for understanding psychic transformations in somatic symptom disorders

With the new category of somatic symptom disorder/bodily distress disorder in ICD-11, research into pathogenetic and therapeutic pathways is stimulated. By turning away from the definition of somatoform disorders as “the lack of something physical explaining everything”, this new classification might offer a way to put the focus on the individual patient’s psychodynamic balance and conflicts and their condensation in the symptom. Modelling and simulation have a long history in science to gain insight also into complex phenomena. Considering the evolution of precision medicine many different parameters are meanwhile operationalised and ready for consequent process research. Calculation models have to fit to the complexity of this disorder category. In an interdisciplinary discourse between computer and medical/psychoanalytic scientists a multilayer, fine grained calculation model is elaborated. Starting from a clinical case history, within iterative discussion, by acknowledging the demand for interdisciplinary synergy and cooperation in science, psychoanalytic theory served as the basis for computer-scientific information technique. A parallelisation with the Mealy model helped to establish a meaningful calculation possibility for further process research. How psychic transformations can be understood properly in order to provide meaningful treatments, the respective training, and to conduct appropriate process- and outcome-research is established in simulating the mind and applications.

Clinical outcomes of the omicron variant compared with previous SARS-CoV-2 variants; meta-analysis of current reports

BACKGROUND

Omicron (B.1.1.529) is a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variant of concern; however, there is no comprehensive analysis regarding clinical features, disease severity, or clinical outcomes of this variant.

AIM

To compare the clinical characteristics of infection with omicron and previous variants of SARS-CoV-2.

METHODS

We searched major international databases consisting ISI Web of Science, PubMed, Scopus, MedRxiv, and Reference Citation Analysis to collect the potential relevant documents. Finally, clinical features, e.g., death rate, intensive care unit (ICU) admission, length of hospitalization, and mechanical ventilation, of infection with SARS-CoV-2 omicron variant compared with previous variants were assessed using odds ratio and 95% confidence intervals by Comprehensive Meta-Analysis software version 2.2.

RESULTS

A total of 12 articles met our criteria. These investigated the clinical outcomes of infection with omicron variant compared with other variants such as alpha, beta and delta. Our results suggested that ICU admission, need for mechanical ventilation, and death rate were significantly lower for omicron than previous variants. In addition, the average length of hospitalization during the omicron wave was significantly shorter than for other variants.

CONCLUSION

The infectivity of omicron variant was higher than for previous variants due to several mutations, particularly in the spike protein. However, disease severity was mild to moderate compared previous variants.

Prediabetes and cardiovascular complications study: Highlights on gestational diabetes, self-management and primary health care

International collaboration on the prediabetes and cardiovascular complications study started in 2013. In 2017, a reflection was reported. Incompleteness of documentation and screening of antenatal cases for gestational diabetes mellitus (GDM) was concerning. Hence, further observations have been made that warrant an update. The objective of this review is to highlight gaps between clinical knowledge and practice in GDM, diabetes self-management and primary health care (PHC) for rural dwellers. We followed a descriptive field notes method. Antenatal records of patients screened for GDM with incomplete documentation were examined to determine incompleteness of data in those that also met the criteria for GDM risk assessment. Experiences on development of a diabetes register and education and notes on behavioural change wheel were also reviewed. Other data included cross-sectional evaluation of activities of daily living at two private hospitals. Up to 29% had high GDM risk factors, which fulfilled selection criteria for laboratory screening. Demographic data was complete in all women; however, incomplete documentation was observed with as much as 98% of basic data. High levels of physical activity were found in the population, and health lectures proved effective in food choices. The workforce need for diabetes care seems underestimated, but this may be better understood with reactivation of PHC services. The observations highlight behavioural change wheel issues on GDM and PHC services that need concerted focus. Two proposals are to advance the use of a ‘risk assessment and screening sheet’ for GDM screening and enlightenment of stakeholders on the central hub role of PHC in diabetes management.

Alcohol consumption and the risk of Barrett’s esophagus: A meta-analysis

AIM: To evaluate the possible association between alcohol consumption and Barrett’s esophagus (BE).

METHODS: We performed a systematic literature search of multiple online electronic databases. Inclusion criteria entailed studies about alcohol and BE. Meta-analysis was conducted to evaluate odds ratio (OR) and 95%CIs for the association between alcohol consumption and BE.

RESULTS: Twenty studies comprising 4758 patients with BE were included in the meta-analysis. The risk of BE in patients with alcohol consumption was increased compared with control groups (OR = 1.01; 95%CI: 1.00-1.02), especially in case-control and cohort, European and Asian, and hospital studies, but there was a decreased risk of BE associated with alcohol consumption from American studies (OR = 0.86; 95%CI: 0.77-0.96). At the same time, there was no significant association between BE and alcohol consumption in community studies (OR = 0.97; 95%CI: 0.84-1.12) and the type of alcohol (wine, beer and liquor) studies.

CONCLUSION: Our meta-analysis found that alcohol consumption was associated with an increased risk of BE, especially for European and Asian drinkers.

Early immune response in post endoscopic retrograde cholangiopancreatography pancreatitis as a model for acute pancreatitis

This opinion review summarizes comparison of clinical presentation and immunology of post-endoscopic pancreatitis and acute pancreatitis (AP) of other etiology. The rationale for this topic was found in studies that mention differences in clinical presentation between these entities, stating that severe form of AP after endoscopic retrograde cholangiopancreatography was more severe than AP of other etiology. Found difference in clinical presentation may have a background in different immunology that needs to be further investigated.

Relationship between apolipoprotein E gene polymorphism and total cholesterol level in patients with kidney diseases

AIM: To evaluate the association between apolipoprotein E (apoE) gene polymorphism and total cholesterol (TC) level in patients with kidney diseases.

METHODS: A predefined literature search was performed to collect data from the electronic databases of PubMed, Embase and the Cochrane Library and eligible relevant studies reporting the association of apoE gene polymorphism with TC level in patients with kidney diseases were recruited for meta-analysis.

RESULTS: Twenty-one studies were identified for the analysis of association between apoE gene polymorphism and TC level in patients with kidney disease. Subjects with E3E4 had a higher TC than those with E3E3 [weighted mean differences (WMD) = 2.14, P = 0.01] and subjects with E2E3 had a lower TC than those with E3E3 (WMD = -1.93, P = 0.01). Subjects with ε2 had a lower TC than those with ε3 (ε2 vs ε3: WMD = -1.23, P = 0.002; ε2 vs ε4: WMD = -2.77, P ﹤0.0001) and subjects with 3 had a lower TC than those with 4 (WMD = -0.79, P = 0.03).

CONCLUSION: Subjects with apoE E3E4 and ε4 had a higher TC level and subjects with apoE E2E3 and ε2 had a higher TC level in patients with kidney disease. However, more well-designed studies should be performed in the future to confirm these findings.

Different methods of acupuncture for relief of pain due to liver cancer: A network meta-analysis

BACKGROUND

Pain in the liver is a common symptom of liver cancer in late stages, and the pain incidence rate exceeds 50%[1]. In serious cancer pain, morphine and other major analgesics have been commonly administrated for clinical treatments, and their effects are accurate, but with a high incidence of side effects, such as nausea, vomiting, constipation, and other conditions. Acupuncture is a traditional Chinese medicine therapy. There have been many randomized controlled trials addressing the safety and usefulness of different methods of acupuncture in alleviating liver cancer pain. However, which of these methods is the most effective method is still unclear.

AIM

To compare the effectiveness of different acupuncture methods for alleviating pain due to liver cancer.

METHODS

Eligible studies were retrieved from eight databases (the Cochrane Library, PubMed, EMBASE, Medline, CNKI, CBM, Chongqing VIP, and Wan Fang Database) up to March 31, 2021 and screened based on the established inclusion and exclusion criteria. The quality of the include studies was evaluated. Stata software was applied for statistical analyses. Publication bias of the included studies was also determined. Finally, the network meta-analysis was carried out to evaluate the efficacy of acupuncture methods for relief of pain due to liver cancer.

RESULTS

A total of eight randomized controlled trials were included in the network meta-analysis. Eight trials (covering 5 treatments and 734 patients) provided data suitable for analysis. Most trials focused on short-term effects and many were classed as being of poor quality with a high risk of bias, commonly associated with lack of blinding (which was sometimes impossible to achieve). End of treatment results showed that four interventions, including wrist-ankle acupuncture, triple puncture and remaining needle acupuncture, Tian Yuan acupuncture, and block acupuncture, produced a statistically significant reduction in pain when compared with the three-step analgesic ladder therapy. The surface under the cumulative ranking sorting results showed that triple puncture and remaining needle acupuncture had a relatively high effective rate.

CONCLUSION

The network meta-analysis results indicate that the overall effectiveness of triple puncture and remaining needle acupuncture is better than the other therapies.

Operative vs nonoperative treatment of displaced intra-articular calcaneal fracture: A meta-analysis of randomized controlled trials

AIM: To investigate clinical efficacy of displaced intra-articular calcaneal fracture (DIACF) following operation and nonoperation.

METHODS: Literature search was performed of PubMed and Cochrane Library by two independent authors to identify randomized controlled trials (RCTs) comparing operative vs nonoperative treatment of DIACF from inception to December 31^st, 2013. RCT quality was evaluated by the modified Jadad scale. Dichotomous variables were pooled using risk ratios by review manager 5.3 software. Fixed-effects or random-effects models were adopted with P > 0.05 or P≤ 0.05 for heterogeneity tests, respectively.

RESULTS: Eight RCTs comprising 767 cases met inclusion criteria. Results revealed that more surgically treated patients could resume pre-injury job (P = 0.006). No statistical differences were found between the two groups in residual pain (P = 0.33), shoe fitting problems (P = 0.07), limited walking distance (P = 0.56) or secondary late arthrodesis (P = 0.38). However, operative treatment was associated with a higher complication rate (P = 0.003). Subgroup analyses of specific complications revealed that except for a higher risk of superficial wound problems (P < 0.0001) in operative group, the two groups had similar complication rate in deep wound infection (P = 0.34), compartment syndrome (P = 0.46), thromboembolism (P = 0.32), reflex sympathetic dystrophy (P = 0.51) or traumatic arthritis secondary to DIACF (P = 0.43).

CONCLUSION: Current evidence demonstrates that compared with operative treatment, conservative treatment of DIACF lead to similar clinical outcomes regarding residual pain, shoe fitting, walking distance and secondary subtalar arthrodesis but a significantly lower complication rate.

Decision-tree analysis for cost-effective management of solitary pulmonary nodules in China

AIM: To analyze the cost-effectiveness of the diagnosis of solitary pulmonary nodule (SPN) in China.

METHODS: Decision analysis models were constructed to assess the cost-effectiveness of four strategies for the management of SPN: computed tomography (CT) alone, CT plus CT-guided automated cutting needle biopsy (ACNB), CT plus positron emission tomography/computed tomography (PET/CT), CT plus diffusion-weighted magnetic resonance imaging (DWI) plus PET/CT.

RESULTS: The prevalence of lung cancer among SPN discovered in the clinical setting was approximately 50%. The CT plus ACNB strategy had higher diagnostic accuracies (87% vs 81%), with a cost saving of ￥1945 RMB per patient, and reducing unnecessary thoracotomy by 16.5%; this was associated with a 4.5% missed diagnosis rate. CT plus DWI plus PET/CT strategy also had higher accuracies (95% vs 81%), with a cost saving of ￥590 RMB per patient, and reducing unnecessary thoracotomy by 13.5%; this was accompanied by 0.3% missed diagnosis rate. CT plus PET strategy is cost effective at a prevalence rate of 0-34%, but there was a larger prevalence range of lung cancer for CT plus ACNB strategy (from 0 to 0.6) and CT plus DWI plus PET/CT strategy(from 0 to 0.64).

CONCLUSION: CT plus DWI plus PET/CT strategy was cost-effective, and had a higher accuracy accompanied by a lower missed diagnosis rate than CT plus ACNB strategy.

Ankle injuries in athletes: A review of the literature

Ankle injuries are commonplace in the athletic population, with lateral ligament sprains accounting for the majority of them. The medial ligament complex, the distal tibiofibular syndesmosis as well as any of the bones that constitute the ankle joint can also be injured. Typical mechanisms of injury include inversion-plantarflexion and external rotation on a supinated, dorsiflexed or pronated foot. Lesions of the ankle present with similar symptoms of pain, swelling and tenderness. Therefore, a thorough history and physical examination must be obtained to make the correct diagnosis. This is especially critical for athletes as certain injuries can lead to termination of their career if not treated accurately on time. Imaging may be useful in some cases to confirm or rule out differential diagnoses. Most injuries can be managed conservatively using the Protection, Rest, Ice, Compression and Elevation protocol followed by a comprehensive rehabilitation programme. Surgery is reserved for grade III ligament tears that are refractory to initial non-operative treatment and displaced fractures that are unlikely to unite without surgical intervention. The objective of this review is to discuss the common ankle injuries encountered in the athletic population and the approaches to their diagnosis and management.

Non-invasive diagnosis of Crohn’s disease: All that glitters is not gold

Crohn’s disease (CD) is associated with occurrence of inflammation in the digestive tract. Diagnosing intestinal bowel diseases can be difficult because bowel disease can be tricky as it does not have unique symptoms. Endoscopy and histopathological tests play a crucial role in the diagnosis and management of inflammatory bowel diseases. Various techniques can be used to diagnose CD. Nevertheless, the diagnosis of CD mostly requires having patients in the hospital. During the SARS-CoV-2 pandemic, that might not be very feasible, as minimizing contact is essential, but can an alternative diagnosis technique be enough to provide a definitive diagnosis?

Incidence and predictors of hypocalcemia in end-stage renal disease patients on denosumab therapy: A systematic review and meta-analysis

BACKGROUND

Denosumab inhibits the receptor activator of nuclear factor kappa-ligand. It markedly increases bone mineral density and has been proven to reduce the risk of fractures. However, numerous adverse effects, notably hypocalcemia, are prevalent in patients with end-stage renal disease (ESRD).

AIM

To analyze the incidence and predictors of hypocalcemia caused by denosumab compared to control in patients with ESRD.

METHODS

We conducted this study in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. PubMed, Scopus, Cochrane Central, and EMBASE were systematically searched from inception through March 2024. All original studies investigating the effects of denosumab on patients with ESRD compared to control were extracted. The primary outcomes of our study were the incidence of mild, severe, and very severe hypocalcemia. Secondary outcomes included serum levels of intact parathyroid hormone, calcium, and phosphate. The results were pooled and analyzed using a random-effects model.

RESULTS

Seven articles comprising 3240 patients were included in our study. Patients treated with denosumab had a significantly increased incidence of mild hypocalcemia [risk ratio (RR): 2.79; 95% confidence interval (CI): 0.99-7.91; P = 0.05; I² = 37%] and of very severe hypocalcemia (RR: 9.58; 95%CI: 1.58-57.98; P = 0.01; I² = 49%). However, an increase in the occurrence of severe hypocalcemia was non-significant (RR: 4.23; 95%CI: 0.47-38.34; P = 0.20; I² = 96%). Alternatively, denosumab showed a significant decrease in serum intact parathyroid hormone [mean difference (MD): -433.20, 95%CI: -775.12 to -91.28, I² = 98%, P= 0.01], while there was a non-significant decrease in phosphate (MD: -0.47, 95%CI: -1.35 to 0.41, I² = 88%, P = 0.30) and calcium levels (MD: -0.33, 95%CI: -0.95 to 0.29, I² = 94%, P = 0.29).

CONCLUSION

Our study demonstrated that denosumab is significantly associated with mild and very severe hypocalcemia in patients with ESRD making it necessary to detect and prevent this side effect of treatment.

Robot-assisted vs laparoscopy-assisted gastrectomy for gastric cancer: A meta-analysis based on 3518 subjects

AIM: To compare the short-term clinical outcomes of robot-assisted gastrectomy (RAG) with laparoscopy-assisted gastrectomy (LAG) in gastric cancer patients.

METHODS: Articles were identified through a literature search of Pubmed, EMBASE, Scopus, Web of Science, Chinese National Knowledge Infrastructure and the Cochrane Library. Weighted mean differences (WMDs) and odds ratios (ORs) were selected as effect sizes for quantitative variables and qualitative variables, respectively. And 95%CIs were also calculated.

RESULTS: A total of 13 studies with 3518 patients were included. RAG was associated with longer operative time (WMD = 46.26 min, 95%CI: 31.89-60.63, P < 0.00001), less blood loss [WMD = -37.19 mL, 95%CI: -60.16-(-14.23), P = 0.002] and shorter postoperative hospital stay [WMD = -0.65 d, 95%CI: -1.24-(-0.05), P = 0.03] than LAG. No significant difference in the numbers of retrieved lymph nodes was found between the two groups (WMD = 1.46, 95%CI: -0.19-3.10, P = 0.08). There was no significant difference in mortality (OR = 1.55, 95%CI: 0.49-4.94, P = 0.45), overall complications (OR = 1.00, 95%CI: 0.80-1.26, P = 0.98), anastomosis leakage (OR = 1.02, 95%CI: 0.62-1.65, P = 0.95) and anastomosis stenosis rates (OR = 0.54, 95%CI: 0.18-1.57, P = 0.25).

CONCLUSION: RAG is effective and safe in the treatment of gastric cancer. RAG is a promising alternative to laparoscopic surgery. Long-term randomized controlled studies with large scale and improved designs are needed to further evaluate the long-term outcomes.

Is Pilates an effective tool for the management of kinesiophobia in musculoskeletal disorders?

BACKGROUND

Kinesiophobia is a common condition often manifested in patients with musculoskeletal disorders within the process of rehabilitation. Recently, the literature has been investigating whether Pilates could contribute to the management of kinesiophobia in various musculoskeletal disorders. However, aggregated data regarding its effectiveness are absent from literature.

AIM

To evaluate recordings of the Pilates method in kinesiophobia related to musculoskeletal disorders.

METHODS

PubMed, ScienceDirect, Scopus and Pedro databases were all scrutinized for randomized controlled trials, by two or more intervention groups, where at least one group received a Pilates-based intervention and which had been conducted in patients aged 18-65 years with musculoskeletal disorders, having assessed at least one outcome related to kinesiophobia. The systematic review was based on the PRISMA guidelines.

RESULTS

We have identified five studies, with a total of 366 patients with musculoskeletal disorders. Three of them showed that a Pilates-based intervention by either mat or equipment can combat kinesiophobia in patients with musculoskeletal conditions, while another showed that Pilates exercises with equipment may have better long-term effects on kinesiophobia compared to Pilates mat.

CONCLUSION

Overall, a strong level of research evidence has been amassed for the Pilates intervention as well as a moderate level of research evidence for the effectiveness of equipment-based Pilates in reducing kinesiophobia in patients with musculoskeletal disorders. While the underlying mechanisms driving such a result remain unknown, it appears that Pilates can influence both biological and psychological factors in musculoskeletal disorders, thus resulting in the management of kinesiophobic behaviours.

Role of transcranial magnetic stimulation in the management of trichotillomania: A systematic review

BACKGROUND

Trichotillomania is a challenging to treat psychiatric disorder, with limited evidence for pharmacotherapy. Treatment typically involves medication, cognitive behavioral therapy, and behavioral interventions. Recently, transcranial magnetic stimulation (TMS) has emerged as a potential treatment strategy.

AIM

To assess the role of TMS in treating trichotillomania.

METHODS

A systematic search using specific terms was done in PubMed and Scopus databases for articles published until May 17, 2024, related to trichotillomania and TMS. The search included randomized controlled trials, open-label studies, case series, case reports, and retrospective chart reviews, following the Preferred Items for Systematic Reviews and Meta-Analysis guideline.

RESULTS

We identified 32 articles (6 in PubMed and 26 in Scopus). After removing duplicates and articles that did not meet the selection criteria, we conducted a final analysis of four articles. These included one retrospective study, two case series, and one case study, with a total of 22 patients diagnosed with trichotillomania enrolled across all four studies. The brain areas targeted were the supplementary motor area (SMA), pre-SMA, and left dorsolateral prefrontal cortex. The studies reported an improvement in the severity of symptoms of trichotillomania in the majority of patients with negligible side effects. Nevertheless, it is important to note that the existing studies are mostly of low to moderate quality.

CONCLUSION

Early evidence suggests repetitive TMS and accelerated continuous theta burst stimulation can help treat trichotillomania adjunctively to other treatments.

Bibliometric analysis of original studies on stereoelectroencephalography from 1990 to 2023

BACKGROUND

Stereoelectroencephalography (SEEG) is a minimally invasive preoperative evaluation of drug-resistant focal epilepsies. Increasing preclinical data show that SEEG has tremendous diagnostic and therapeutic value for epilepsy. There are currently many studies on SEEG.

AIM

To summarize the development and application of SEEG.

METHODS

We conducted a bibliometric analysis of research on SEEG from 2019 to 2023. We obtained publications on SEEG from the Web of Science Core Collection (WoSCC) database. Excel, VOSviewer, and CiteSpace were responsible for the analyses. A variety of bibliographic elements were collected, including annual publications, authors, countries/regions, journals, keywords, etc.

RESULTS

A total of 691 publications were included in this study. Professor Fabrice Bartolomei of Timone Hospital in France was the most productive and influential author in the field of SEEG, whereas the authors from the United States were the leaders in general. In addition, we found that deep learning and source localization in SEEG have been popular in recent years.

CONCLUSION

This study provides a comprehensive analysis of SEEG research and highlights the growing interest in SEEG and its deep learning and source localization.

Maintaining the metabolic homeostasis of Helicobacter pylori through chronic hyperglycemia in diabetes mellitus: A hypothesis

Helicobacter pylori (H. pylori) infection occurs in almost half of the world's population, most of whom are merely carriers of this microorganism. H. pylori is shown to be detected more frequently in patients with diabetes mellitus (DM) than in the general population, which is accompanied by a significantly increased risk of developing H. pylori-associated diseases. In addition, eradication therapy shows a low efficiency for H. pylori infection in patients with DM. There is a relationship between the level of chronic hyperglycemia and a higher detection rate of H. pylori as well as a lower efficiency of eradication therapy in patients with DM. The exact mechanisms of these phenomena are unknown. The authors make a hypothesis that explains the relationship between chronic hyperglycemia and the increased detection rate of H. pylori, as well as the mechanisms contributing to the improved survival of this bacterium in patients with DM during eradication therapy.

Difference in incidence of developing hepatocellular carcinoma between hepatitis B virus-and hepatitis C virus-infected patients

BACKGROUND

It is generally accepted that the incidence of hepatocellular carcinoma (HCC) in hepatitis C virus (HCV)-associated patients is higher than that in hepatitis B virus (HBV)-associated patients. The reason why this difference in the incidence of HCC occurs in patients with HBV and HCV infections remains unclear. We report the possibility that the contributing power of inflammation, which is the main risk factor for developing HCC, may be different with HBV and HCV infections.

AIM

To investigate this, we surveyed the hazard ratio of inflammation for HCC development which was identified by serum alanine aminotransferase (ALT) levels between patients with HBV and HCV infections.

METHODS

The PubMed database was searched (2001-2021) for studies published in English regarding the incidence of HCC identifying 8924 HBV-and 7376 HCV- infected patients. From these studies, interferon-treated patients with both HBV and HCV infections were excluded. Furthermore, in HBV patients, those administered nucleos(t)ide analogues were excluded, and in HCV patients, those administered direct acting antivirals were also excluded. Studies citing hazard ratios of HCC regarding inflammation (serum elevated alanine aminotransferase levels) were selected. Finally, there were 14 studies of HBV- infected patients and 8 studies of HCV-infected patients. We calculated the hazard ratio in patients in an inflammatory state (serum ALT levels were above the normal range).

RESULTS

In the 14 studies of HBV patients, the average hazard ratio (HR) of elevated ALT for developing HCC was 2.74 [1.98-3.77] and that in the 8 studies of HCV-infected patients was 5.51 [3.08-9.83]. The HR of inflammation for HCC development in HCV-associated liver diseases is about twice that in HBV-associated liver diseases. HR in HCV-infected patients was significantly (P = 0.0391) higher than that in HBV-infected patients. In hepatitis B patients, the abnormal range adopted was 28-45 IU/L, and in hepatitis C patients, it was 20-50 IU/L. It was demonstrated that the abnormal ALT levels adopted in hepatitis B and C patients were very similar in this series.

CONCLUSION

The difference in the incidence of HCC development between HBV and HCV patients may depend on the difference in the hazard risk of ALT between HBV and HCV infections.

Newer developments in viral hepatitis: Looking beyond hepatotropic viruses

Viral hepatitis in the entirety of its clinical spectrum is vast and most discussion are often restricted to hepatotropic viral infections, including hepatitis virus (A to E). With the advent of more advanced diagnostic techniques, it has now become possible to diagnose patients with non-hepatotropic viral infection in patients with hepatitis. Majority of these viruses belong to the Herpes family, with characteristic feature of latency. With the increase in the rate of liver transplantation globally, especially for the indication of acute hepatitis, it becomes even more relevant to identify non hepatotropic viral infection as the primary hepatic insult. Immunosuppression post-transplant is an established cause of reactivation of a number of viral infections that could then indirectly cause hepatic injury. Antiviral agents may be utilized for treatment of most of these infections, although data supporting their role is derived primarily from case reports. There are no current guidelines to manage patients suspected to have viral hepatitis secondary to non-hepatotropic viral infection, a gap that needs to be addressed. In this review article, the authors analyze the common non hepatotropic viral infections contributing to viral hepatitis, with emphasis on recent advances on diagnosis, management and role of liver transplantation.

Russian clinical research policy does not guarantee results availability

AIM: To investigate results availability from clinical studies enrolling Russian subjects and Russian clinical research policy.

METHODS: We analyzed Russian legislation and ethical regulations about drug and devices approval, clinical research registration and the results availability. In August 2012, we searched International Clinical Trials Registry Platform and clinicaltrials.gov to find all registered studies that had an investigational site in the territory of the Russian Federation. To find publication status, we searched the PubMed and Scirus bibliographical databases with trial registration number to find journal publications of the registered studies.

RESULTS: We identified 2062 registered research protocols comprising 2017 international and 45 protocols sponsored by the Russian funding agencies. The number of the studies enrolling Russian subjects increased dramatically from three studies in 2002 to 252 studies in 2012. Most studies (92%) were funded exclusively by industry, were interventions (94.6%), examined drugs (87%) and enrolled exclusively adults (86%) of both genders (89%). Only 383 (19%) of multinational studies and two (4.4%) of exclusively Russian studies were published. Posting of patient outcomes was available for 16% of the trials that recruited trial participants in the Russian territory including one study funded exclusively by Russian sponsors. Investigators terminated 99 studies of 38111 participants and did not provide the results in clinicaltrials.gov or in published manuscripts. Federal laws require clinical study registration and conflict of interest disclosure. However, routine monitoring of compliance to clinical research policy is not available.

CONCLUSION: Russian legislation does not guarantee the availability of clinical research results. Russian legislation should mandate transparent evidence- based market approval of the drugs and devices.