scholarly journals Innervation Patterns of the Pronator Teres Muscle and Their Possible Role in Neurotization: A Systematic Review of Cadaveric Studies

2021 ◽  
Vol 64 (2) ◽  
pp. 77-84
Author(s):  
Bhagath Kumar Potu ◽  
M. V. Ravishankar

Background: Contrary to the classic anatomical description, many recent studies have reported wide variations in branching patterns and location of motor branches that are supplying the pronator teres muscle. To understand these variations and their implications in surgical procedures of the nerve transfers, a systematic review was performed on the innervation of pronator teres muscle from cadaveric studies.Methods: A systematic literature search was performed in databases such as Medline, PubMed, Google Scholar, SciELO, ScienceDirect, Cochrane reviews and orthopedics textbooks using the search terms “pronator teres nerve branches”; AND “number” OR “location” OR “length” OR “diameter” yielded 545 article links. Articles were evaluated according to PRISMA guidelines. Results: A total of twenty cadaveric studies including 648 branches have registered 52.9% of two branch innervation pattern followed by 31.3%-single branch pattern; 13.5%-three branch pattern; 1.7%-four branch pattern, and 0.4%-five branch patterns, respectively. Of the 403 branches studied for their location in relation with the humeral intercondylar line, most branches were located distal to the line (50.3%), followed by 32.7% (proximal to it) and 16.8% at the line, respectively. The distance of branches located proximal and distal to humeral intercondylar line was in the range of 1.25–10 cm, and 1.1–7.5 cm, respectively. The mean length and diameter of nerves reported were 4.37 ± 2.43 cm, and 1.5 mm, respectively. Conclusions: Our data defined the morphometrics of nerve branches and they often met the required diameter for neurotization procedures. Our findings also demonstrated that the morphometrics, branching pattern and their location vary between populations and this information is very vital for surgeons during the nerve transfers.

Author(s):  
Ahmed S. Ali ◽  
Ekram A. Saied ◽  
Sharifa M. Theeban ◽  
Mazen M. Humayran ◽  
Assmaa Ahmed Shaker ◽  
...  

Background: Many publications discussed the potential role of medicinal plants in the management of COVID-19. However, clinical studies of the efficacy and safety of specified phytochemical(s) are limited. Objectives: To explore the pharmacological profile of specified compounds against COVID-19 Method: Systematic literature search of academic databases to explore specified phytochemicals for the management of COVID-19 using appropriate search terms. Rayyan software was used to organize 786 citations of which. 236 articles were included in this review. Results: Initially 70 compounds were identified to have a potential role in the management of COVID-19. In this review, 18 compounds were selected for further search Conclusion: In vitro anti-SARS-CoV-2activity has been demonstrated for a variety of natural compounds. However, preclinical research for most phytochemicals is scarce, and only a few compounds have been evaluated in clinical trials against COVID-19. A comprehensive pharmacological profile of these phytochemicals is urgently needed.


Author(s):  
Marco Guidi ◽  
Riccardo Luchetti ◽  
Inga Besmens ◽  
Esin Rothenfluh ◽  
Maurizio Calcagni

Abstract Background Wrist arthrolysis is a viable option in wrist stiffness and can be performed via open or arthroscopic techniques. Purpose The aim of the study is to describe and evaluate the available techniques of open and arthroscopic arthrolysis of the radiocarpal joint and the distal radio ulnar joint (DRUJ) in posttraumatic wrist stiffness. Methods A systematic literature search was performed in PubMed to identify studies reporting on open and arthroscopic wrist arthrolysis. Key words included “open wrist arthrolysis,” “arthroscopic wrist arthrolysis,” “post-traumatic wrist stiffness,” and “DRUJ arthrolysis.” Data were extracted independently by a pair of reviewers. Results Overall, 637 studies were identified; 13 additional articles were found through previous publications (total 650 articles). A total of 612 records resulted after duplicates was removed. Fourteen studies were selected and only eight respected the inclusions criteria. One study focused on volar open arthrolysis and four studies on arthroscopic arthrolysis of the radiocarpal joint; two studies reported on open arthrolysis and two studies on arthroscopic DRUJ arthrolysis. Range of motion following open and arthroscopic wrist arthrolysis improved in all studies. Conclusion Both arthroscopic and open arthrolysis can lead to similar and satisfactory results in radiocarpal joint and DRUJ stiffness.. Level of Evidence This is a level 3a study.


Cancers ◽  
2021 ◽  
Vol 13 (15) ◽  
pp. 3872
Author(s):  
Małgorzata Styczewska ◽  
Małgorzata A. Krawczyk ◽  
Ines B. Brecht ◽  
Konrad Haug ◽  
Ewa Iżycka-Świeszewska ◽  
...  

Melanotic Neuroectodermal Tumor of Infancy (MNTI) is a very rare pediatric neoplasm of neural crest origin. In most cases, it develops in infants as a localized tumor of the maxilla, and surgery is usually curative. In less than 10% of patients with inoperable, metastatic or persistently recurring MNTI, chemotherapy (CHT) may be considered; however, its role is still unclear. The aim of our study was to assess the efficacy of CHT in children with large, inoperable, metastatic and/or recurrent MNTI. Four such infants, treated with CHT in Polish and German centers of pediatric oncology, were presented. Additionally, a systematic literature search of the PubMed/MEDLINE, Scopus and Web of Science databases was performed, yielding 38 similar cases within the last 42 years. Neoadjuvant CHT, based mainly on the protocols for neuroblastoma, was often effective, allowing for complete delayed surgery in most cases. However, the role of adjuvant CHT in preventing recurrences after incomplete resection of MNTI remains unclear. Disseminated inoperable MNTI was almost universally associated with poor response to CHT and unfavorable outcome. Further investigations to elaborate standards of management in patients with inoperable, metastatic or persistently recurring MNTIs are necessary to improve outcomes.


Neurosurgery ◽  
2021 ◽  
Author(s):  
Kenny Yat Hong Kwan ◽  
J Naresh-Babu ◽  
Wilco Jacobs ◽  
Marinus de Kleuver ◽  
David W Polly ◽  
...  

Abstract BACKGROUND Existing adult spinal deformity (ASD) classification systems are based on radiological parameters but management of ASD patients requires a holistic approach. A comprehensive clinically oriented patient profile and classification of ASD that can guide decision-making and correlate with patient outcomes is lacking. OBJECTIVE To perform a systematic review to determine the purpose, characteristic, and methodological quality of classification systems currently used in ASD. METHODS A systematic literature search was conducted in MEDLINE, EMBASE, CINAHL, and Web of Science for literature published between January 2000 and October 2018. From the included studies, list of classification systems, their methodological measurement properties, and correlation with treatment outcomes were analyzed. RESULTS Out of 4470 screened references, 163 were included, and 54 different classification systems for ASD were identified. The most commonly used was the Scoliosis Research Society-Schwab classification system. A total of 35 classifications were based on radiological parameters, and no correlation was found between any classification system levels with patient-related outcomes. Limited evidence of limited quality was available on methodological quality of the classification systems. For studies that reported the data, intraobserver and interobserver reliability were good (kappa = 0.8). CONCLUSION This systematic literature search revealed that current classification systems in clinical use neither include a comprehensive set of dimensions relevant to decision-making nor did they correlate with outcomes. A classification system comprising a core set of patient-related, radiological, and etiological characteristics relevant to the management of ASD is needed.


Author(s):  
Xiaorong Mao ◽  
Olivia WM Fung ◽  
Xiuying Hu ◽  
Alice Yuen Loke

Abstract Disasters can cause long-lasting damage to survivors and rescue workers. Some rescue workers suffer negative physical and psychological consequences, while others do not. Thus, it is of value to fully understand the characteristics of rescuers who have not been affected by rescue activities. Resilience refers to the ability or capacity to cope with adversity. The aim of this review is to explore and identify the characteristics of resilience among rescue workers. A systematic literature search was conducted of seven electronic databases from inception to May 2019, using keywords and medical subject heading terms related to the resilience of rescuers. Hand searches and searches of leading authors were also performed. A total of 31 articles were eligible for review. Six domains were identified to characterize the resilience of rescuers namely, demographic and physical characteristics, personality traits, coping strategies, perceived resources, being equipped with special skills for disaster rescue, and having less adverse consequences from exposure to disaster. Researchers and disaster managers can take note of these characteristics to comprehensively understand the ‘positive concept’ of resilience. This enhanced understanding of ‘positive resilience’ can in turn be used to develop a framework to assess and establish interventions, and consequently to improve the psychological wellbeing of rescuers after disaster rescue efforts.


Author(s):  
Julio Vaquerizo-Serrano ◽  
Gonzalo Salazar de Pablo ◽  
Jatinder Singh ◽  
Paramala Santosh

AbstractPsychotic experiences can occur in autism spectrum disorders (ASD). Some of the ASD individuals with these experiences may fulfil Clinical High-Risk for Psychosis (CHR-P) criteria. A systematic literature search was performed to review the information on ASD and CHR-P. A meta-analysis of the proportion of CHR-P in ASD was conducted. The systematic review included 13 studies. The mean age of ASD individuals across the included studies was 11.09 years. The Attenuated Psychosis Syndrome subgroup was the most frequently reported. Four studies were meta-analysed, showing that 11.6% of CHR-P individuals have an ASD diagnosis. Symptoms of prodromal psychosis may be present in individuals with ASD. The transition from CHR-P to psychosis is not affected by ASD.


2021 ◽  
Vol 11 (4) ◽  
pp. 1903
Author(s):  
Adrian Kahn ◽  
Shlomo Matalon ◽  
Rahaf Bassam Salem ◽  
Lazar Kats ◽  
Liat Chaushu ◽  
...  

This study aimed to characterize the demographic and clinical features of underreported surgical ciliated cysts developing after sinus floor augmentation, based on a series of cases from our files and a systematic review of the literature. A series of five cases (four patients) of microscopically confirmed surgical ciliated cysts following sinus floor augmentation procedures from our files are described. A systematic literature search (1991–2020) with strict clinical-, radiological- and microscopic-based exclusion and inclusion criteria was performed to detect additional similar cases. The systematic review revealed only five cases that fulfilled the inclusion criteria. Altogether, surgical ciliated cysts associated with sinus floor augmentation have been rarely reported in the literature, and have not been characterized either demographically or clinically. Graft materials were diverse, implants were placed simultaneously, or up to two years post-augmentation. The associated surgical ciliated cysts developed between 0.5 and 10 years post-augmentation. Although limited in its extent, this study is the first series to characterize possible underreported sequelae of surgical ciliated cysts associated with sinus floor augmentation. It emphasizes the need for long post-operative follow-up and confirmation of lesion by microscopic examination.


2019 ◽  
Vol 16 (1) ◽  
Author(s):  
Isabel Martinez-Tejada ◽  
Alexander Arum ◽  
Jens E. Wilhjelm ◽  
Marianne Juhler ◽  
Morten Andresen

Abstract Background Although B waves were introduced as a concept in the analysis of intracranial pressure (ICP) recordings nearly 60 years ago, there is still a lack consensus on precise definitions, terminology, amplitude, frequency or origin. Several competing terms exist, addressing either their probable physiological origin or their physical characteristics. To better understand B wave characteristics and ease their detection, a literature review was carried out. Methods A systematic review protocol including search strategy and eligibility criteria was prepared in advance. A literature search was carried out using PubMed/MEDLINE, with the following search terms: B waves + review filter, slow waves + review filter, ICP B waves, slow ICP waves, slow vasogenic waves, Lundberg B waves, MOCAIP. Results In total, 19 different terms were found, B waves being the most common. These terminologies appear to be interchangeable and seem to be used indiscriminately, with some papers using more than five different terms. Definitions and etiologies are still unclear, which makes systematic and standardized detection difficult. Conclusions Two future lines of action are available for automating macro-pattern identification in ICP signals: achieving strict agreement on morphological characteristics of “traditional” B waveforms, or starting a new with a fresh computerized approach for recognition of new clinically relevant patterns.


2020 ◽  
Vol 33 (Supplement_1) ◽  
Author(s):  
A Rita ◽  
E Pinto ◽  
L Pomba ◽  
F Tolin ◽  
G Mattara ◽  
...  

Abstract   Oesophagectomy is associated with high morbidity. One of the postoperative complication observed after esophageal resection is Post Operative Delirium (POD), a psychiatric disease caused by major surgical stress and pharmacological treatments. POD can jeopardize patient healing-process since patients are not collaborative to perioperative care but also because they can harm themselves. Thus the aim of this systematic review was to identify POD factors and its effective management in patients undergone oesophagectomy for oesophageal/oesophagogastric-junction cancer. Methods A comprehensive systematic literature search was conducted using PubMed, Cochrane Library, Scopus, psycINFO and psycARTICLES in order to identify all articles published until January 2020. The following combinations of terms were used for the search strategy: neoplasm; esophagus; gastro-esophageal junction; oesophagectomy; delirium. The following inclusion criteria were set: full article published in English; patients with esophageal cancer undergone oesophagectomy; POD observed. Two researchers independently selected studies matching the inclusion criteria. Duplicate studies, non-relevant topic, data from abstracts or unpublished were excluded. Any disagreements between the researchers’ evaluation concerning inclusion of studies were resolved by consensus. Results Of 235 studies yielded by systematic literature search, 21 met inclusion criteria. POD incidence was observed between 3 and 38% of patients and was precursor of other complications in 1/3 of POD patients. Preoperative risk factors were older age, cerebrovascular disease and pulmonary disfunction. Anxiety and depression resulted predisposing factors. Perioperative risk factors were duration of surgery, ICU length of stay, colloids infusion and blood transfusion. Open-surgery seemed to influence POD more than minimally-invasive and robotic surgery. Interventions identified to treat POD were pharmacological (prophylactic haloperidol, insomnia treatment) and behavioral (patient reorientation by family involvement, bright-light therapy, early mobilization). Conclusion This systematic review identified preoperative, intraoperative and postoperative risk factors of POD after oesophagectomy. No standardized prevention nor treatment of POD was identified. POD impacts patients’ ability in perceiving postoperative symptoms. The difficulty in communicating with health professionals may lead to delay the diagnosis of others complications and prolong hospital stay. Therefore further trials are required to assess efficacy of different POD treatments aimed to enhance postoperative management.


2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Andreas Pregernig ◽  
Mattia Müller ◽  
Ulrike Held ◽  
Beatrice Beck-Schimmer

Abstract Background Angiopoietin-1 (Ang-1) and 2 (Ang-2), high mobility group box 1 (HMGB1), soluble receptor for advanced glycation endproducts (sRAGE), soluble triggering receptor expressed on myeloid cells 1 (sTREM1), and soluble urokinase-type plasminogen activator receptor (suPAR) have shown promising results for predicting all-cause mortality in critical care patients. The aim of our systematic review and meta-analysis was to assess the prognostic value of these biomarkers for mortality in adult patients with sepsis. Methods A systematic literature search of the MEDLINE, PubMed, EMBASE, and Cochrane Library databases, for articles in English published from 01.01.1990 onwards, was conducted. The systematic review focused exclusively on observational studies of adult patients with sepsis, any randomized trials were excluded. For the meta-analysis, only studies which provide biomarker concentrations within 24 h of admission in sepsis survivors and nonsurvivors were included. Results are presented as pooled mean differences (MD) between nonsurvivors and survivors with 95% confidence interval for each of the six biomarkers. Studies not included in the quantitative analysis were narratively summarized. The risk of bias was assessed in all included studies using the Quality in Prognosis Studies (QUIPS) tool. Results The systematic literature search retrieved 2285 articles. In total, we included 44 studies in the qualitative analysis, of which 28 were included in the meta-analysis. The pooled mean differences in biomarker concentration (nonsurvivors − survivors), measured at onset of sepsis, are listed as follows: (1) Ang-1: − 2.9 ng/ml (95% CI − 4.1 to − 1.7, p < 0.01); (2) Ang-2: 4.9 ng/ml (95% CI 2.6 to 7.1, p < 0.01); (3) HMGB1: 1.2 ng/ml (95% CI 0.0 to 2.4, p = 0.05); (4) sRAGE: 1003 pg/ml (95% CI 628 to 1377, p < 0.01); (5) sTREM-1: 87 pg/ml (95% CI 2 to 171, p = 0.04); (6) suPAR: 5.2 ng/ml (95% CI 4.5 to 6.0, p < 0.01). Conclusions Ang-1, Ang-2, and suPAR provide beneficial prognostic information about mortality in adult patients with sepsis. The further development of standardized assays and the assessment of their performance when included in panels with other biomarkers may be recommended. Trial registration This study was recorded on PROSPERO, prospective register of systematic reviews, under the registration ID: CRD42018081226


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