Medicina
-
Review Meta Analysis
Effect of the BiZact™ Low-Temperature Dissecting Device on Intra- and Postoperative Morbidities Related to Tonsillectomy-A Systematic Review and Meta-Analysis.
Background and Objectives: We investigated the effects of using a BiZact™ device for tonsillectomy on operating time, intraoperative blood loss, postoperative bleeding rate, and pain through a meta-analysis of the relevant literature. Materials and Methods: We reviewed studies retrieved from the databases of PubMed, SCOPUS, Google Scholar, Embase, Web of Science, and Cochrane up to March 2024. The results were analyzed following PRISMA guidelines. ⋯ Postoperative pain on day 1 (SMD -0.0885, 95%CI [-0.4368; 0.2598], I2 = 98.9%), day 3 (SMD -0.2118, 95%CI [-0.6110; 0.1873], I2 = 99.5%), and later than day 7 (SMD 0.0924, 95%CI [-0.2491; 0.4338], I2 = 98.6%) in the treatment group was not significantly reduced relative to the control group. When compared to the control group, BiZact™ did not reduce the incidence of secondary postoperative bleeding control in the operation room (OR 0.5711, 95%CI [0.2476; 1.3173], I2 = 32.1%), primary bleeding (OR 0.4514, 95%CI [0.0568; 3.5894], I2 = 0.0%), or all postoperative bleeding events (OR 0.8117, 95%CI [0.5796; 1.1368], I2 = 26.3%). Conclusions: This study demonstrated that using the BiZact™ device for tonsillectomy significantly decreased the operative time but could not effectively reduce intraoperative bleeding or postoperative pain and bleeding.
-
Observational Study
Intensive Care Management of Severe Hyponatraemia-An Observational Study.
Background and Subject: Hyponatraemia is a common electrolyte disorder. For patients with severe hyponatraemia, intensive care unit (ICU) admission may be required. This will enable close monitoring and allow safe management of sodium levels effectively. ⋯ No difference was identified between the normal and overcorrected cohorts for ICU/hospital length of stay or mortality. Conclusions: In some patients with severe hyponatraemia, overcorrection is inevitable to avoid symptoms such as seizures and arrhythmias, and consequently, we highlight the key factors associated with overcorrection. Overall, we identified that overcorrection was common and concordant with the current literature.
-
Review Case Reports
Anatomical Variations of the Jugular Bulb: A Critical and Comprehensive Review.
Background and Objectives: The jugular bulb (JB) is the uppermost part of the internal jugular vein receiving the sigmoid sinus. The aim of the present research is to aid the comprehension of the JB, its abnormalities, and surrounding structures for improving both academic and surgical awareness. Materials and Methods: Various studies on this topic were critically reviewed. ⋯ Another case describes a dehiscent JB with a hypotympanic air cell protruding into it, further highlighting the variability of this condition. Conclusions: It is necessary to proceed with caution when observing abnormal morphological characteristics of the JB. Preoperative assessment of each case is essential for optimal outcomes.
-
Over the past two decades, the use of tumor necrosis factor alpha (TNF-α) inhibitors has significantly improved the treatment of patients with immune-mediated inflammatory diseases. Firstly, introduced for rheumatoid arthritis, these inhibitors are currently approved and used for a variety of conditions, including ankylosing spondylitis, Crohn's disease, juvenile idiopathic arthritis, psoriasis, psoriatic arthritis, ulcerative colitis, and chronic uveitis. ⋯ The present review collects data from multiple studies to evaluate the incidence and the relationship between TNF-α inhibitors and neurological side effects and to explore the potential underlying mechanisms of this association. Moreover, it highlights the importance of patient selection, particularly in the case of individuals with a history of demyelinating diseases, raises awareness for clinicians, and calls for ongoing research that will improve TNF-α targeting strategies and offer safer and more effective therapeutic options.
-
Background and Objectives: Rheumatoid arthritis (RA) patients experience sarcopenia and decreased muscle mass and handgrip strength, leading to decreased quality of life and disability. The prevalence of RA varies across regions. This study aimed to evaluate the factors associated with RA in Croatian regional centres and explore correlations between clinical parameters and muscle strength. ⋯ The negative predictors are the use of conventional synthetic disease-modifying anti-rheumatic drugs, the use of biological disease-modifying anti-rheumatic drugs, the number of tender joints, the number of swollen joints, the estimated sedimentation rate, the C-reactive protein, the disease activity score, the parameters of the EQ5D, and being prescribed with three or more medications. In the male RA participants, significant predictors of muscle strength are only weight, height, and anxiety/depression difficulties, according to the EQ5D. Conclusions: This study showed correlations between muscle strength and the parameters of disease activity, inflammation parameters, health-related quality of life, therapy, and exercise in the female RA participants in Croatia.