World journal of methodology最新文献

This editorial discusses recent advancements and ongoing challenges in diabetic retinopathy, as reviewed by Morya et al in their comprehensive analysis. In their review, Morya et al discussed the pathophysiology of diabetic retinopathy and explored novel treatment modalities. This editorial highlights the importance of these advancements and emphasizes the need for continued research and innovation for the enhanced management of diabetic retinopathy. It also reflects upon the implications of the authors' review findings for clinical practice and future research directions, underscoring the potential of emerging therapies for improving patient outcomes and providing a deeper understanding of disease mechanisms.

Microorganisms such as bacteria, fungi, viruses, parasites living in the human intestine constitute the human intestinal microbiota. Dysbiosis refers to compositional and quantitative changes that negatively affect healthy gut microbiota. In recent years, with the demonstration that many diseases are associated with dysbiosis, treatment strategies targeting the correction of dysbiosis in the treatment of these diseases have begun to be investigated. Faecal microbiota transplantation (FMT) is the process of transferring faeces from a healthy donor to another recipient in order to restore the gut microbiota and provide a therapeutic benefit. FMT studies have gained popularity after probiotic, prebiotic, symbiotic studies in the treatment of dysbiosis and related diseases. FMT has emerged as a potential new therapy in the treatment of allergic diseases as it is associated with the maintenance of intestinal microbiota and immunological balance (T helper 1/T helper 2 cells) and thus suppression of allergic responses. In this article, the definition, application, safety and use of FMT in allergic diseases will be discussed with current data.

In the practice of healthcare, patient-reported outcomes (PROs) and PRO measures (PROMs) are used as an attempt to observe the changes in complex clinical situations. They guide us in making decisions based on the evidence regarding patient care by recording the change in outcomes for a particular treatment to a given condition and finally to understand whether a patient will benefit from a particular treatment and to quantify the treatment effect. For any PROM to be usable in health care, we need it to be reliable, encapsulating the points of interest with the potential to detect any real change. Using structured outcome measures routinely in clinical practice helps the physician to understand the functional limitation of a patient that would otherwise not be clear in an office interview, and this allows the physician and patient to have a meaningful conversation as well as a customized plan for each patient. Having mentioned the rationale and the benefits of PROMs, understanding the quantification process is crucial before embarking on management decisions. A better interpretation of change needs to identify the treatment effect based on clinical relevance for a given condition. There are a multiple set of measurement indices to serve this effect and most of them are used interchangeably without clear demarcation on their differences. This article details the various quantification metrics used to evaluate the treatment effect using PROMs, their limitations and the scope of usage and implementation in clinical practice.

Background: Intrathecal bupivacaine is the traditional anesthetic drug used in spinal anesthesia for caesarean sections (CSs), but ropivacaine has emerged as a potential alternative. This meta-analysis compares the efficacy and safety of intrathecal hyperbaric bupivacaine vs hyperbaric ropivacaine for cesarean sections.

Aim: To systematically evaluate and compare the efficacy and safety of intrathecal hyperbaric bupivacaine and hyperbaric ropivacaine for spinal anesthesia in CSs.

Methods: A thorough search of electronic databases was carried out to find pertinent randomized controlled trials (RCTs) comparing intrathecal hyperbaric ropivacaine and hyperbaric bupivacaine during CSs. PubMed, Cochrane database, Google Scholar, and Scopus were searched, and papers from January 2000 to January 2024 were deemed eligible and filtered using predetermined inclusion and exclusion criteria. Studies were assessed for methodological quality, and data were extracted for time to adequate anesthesia (sensory and motor blockade), duration of sensory and motor block, hemodynamic changes and side effect profile. The standardized mean difference with 95%CI was used for continuous data. Dichotomous variables were assessed using the Mantel-Haenszel test and the random effect model to compute the odds ratio.

Results: Total 8 RCTs were selected from a pool of 119 search results for meta-analysis. The meta-analysis evaluated pooled effect sizes and assessed heterogeneity among the studies. The primary objective was to compare key outcomes to identify any significant variances in efficacy and safety profiles between two local anesthetics. The analysis revealed that the difference in the onset of sensory blockade between the two local anesthetics was statistically insignificant (P = 0.1586). However, the onset of motor blockade appeared to be faster with bupivacaine (P = 0.03589). Additionally, the regression of sensory and motor blockade occurred earlier in the ropivacaine group. Furthermore, the duration of the first analgesic effect was shorter with a significance level of P < 0.05. Regarding side effects profile, including hypotension, nausea, and shivering, the study did not observe any significant differences between the two groups.

Conclusion: This meta-analysis offers insights into the effectiveness and safety of hyperbaric bupivacaine vs ropivacaine for cesarean sections. Hyperbaric ropivacaine had a comparable safety profile and faster regression of sensory and motor blockade than hyperbaric bupivacaine, perhaps aiding early mobilization of parturient and facilitating mother-child bonding. Choosing ropivacaine may offer benefits beyond efficacy for cesarean section patients and short surgical procedures.

Appreciation of soft-tissue thickness (STT) at surgical sites is an increasingly recognized aspect of arthroplasty procedures as it may potentially impacting postoperative outcomes. Recent research has focused on the predictive value of preoperative STT measurements for complications following various forms of arthroplasty, particularly infections, across procedures such as total knee, hip, shoulder, and ankle replacements. Several studies have indicated that increased STT is associated with a higher risk of complications, including infection and wound healing issues. The assessment of STT before surgery could play a crucial role in identifying patients at a higher risk of complications and may be instrumental in guiding preoperative planning to optimize outcomes in arthroplasty procedures. Standardized measurement techniques and further research are essential to enhance the reliability and clinical utility of STT assessment for arthroplasty surgery.

Graphical abstracts (GAs) are emerging as a pivotal tool in medical literature, enhancing the dissemination and comprehension of complex clinical data through visual summaries. This editorial highlights the significant advantages of GAs, including improved clarity, increased reader engagement, and enhanced visibility of research findings. By transforming intricate scientific data into accessible visual formats, these abstracts facilitate quick and effective knowledge transfer, crucial in clinical decision-making and patient care. However, challenges such as potential data misrepresentation due to oversimplification, the skill gap in graphic design among researchers, and the lack of standardized creation guidelines pose barriers to their widespread adoption. Additionally, while software such as Adobe Illustrator, BioRender, and Canva are commonly employed to create these visuals, not all researchers may be proficient in their use. To address these issues, we recommend that academic journals establish clear guidelines and provide necessary design training to researchers. This proactive approach will ensure the creation of high-quality GAs, promote their standardization, and expand their use in clinical reporting, ultimately benefiting the medical community and improving healthcare outcomes.

Background: Central retinal artery occlusion (CRAO) is a potentially blinding disease, and hyperbaric oxygen therapy (HBOT) is becoming increasingly popular with the support of scientific evidence. Despite the presence of various acute management measures, there is no clear evidence on the gold standard treatment for CRAO.

Aim: To identify factors and imaging parameters associated with good visual outcome, which guide ophthalmologists in the triage of CRAO patients for HBOT.

Methods: Patients who suffered from CRAO and had a symptom onset ≤ 6 h were recruited for a course of HBOT in a tertiary hospital after failing bedside treatment. Patient demographics, onset time, CRAO eye parameters, and past medical history were prospectively collected. Visual outcomes after HBOT were also analyzed.

Results: A total of 26 patients were included; the female-to-male ratio was 1:1.6, and the mean age was 67.5 years ± 13.3 years (range 44-89 years). The mean duration of follow-up and mean visual acuity (VA) improvement were 10.0 mo ± 5.3 mo and 0.48 logarithm of minimal angle of resolution (logMAR) ± 0.57 logMAR (approximately 9 letters in ETDRS) (P = 0.0001, Z = -3.67), respectively. The 1 mm zone of central macular thickness (CMT) on optical coherence tomography was not associated with VA changes (P = 0.119); however, the 1-to-3 mm circular rim of CMT was fairly associated (P = 0.02, Spearman's coefficient = 0.45). Complete retinal perfusion time during fundus fluorescein angiography (FFA) was moderately associated (P = 0.01, Spearman's coefficient = 0.58) with visual outcome.

Conclusion: A thinner 1-to-3 mm circular rim of CMT, but not the central 1 mm zone, is associated with better visual outcome. A shorter perfusion delay on FFA is also associated with better visual outcome.

During dental examinations and treatments, many dentists are using magnification to improve their vision. The dental operating microscope serves as the most effective tool for this purpose, enhancing the quality, longevity, and outcome of clinical work. This review will explore the latest research and data on the importance of magnification devices in dentistry, including diagnostic methods, treatment options and ergonomics in specialities such as restorative dentistry, endodontics, pedodontics, periodontics, and prosthodontics. This review aims to provide insights into the optimal magnification for different clinical situations, the specific benefits of dental operating microscopes for each dental branch, and their limitations.

Nursing staff provides patient care in an occupational environment that often imposes challenges that affect significantly the musculoskeletal system. Work-related musculoskeletal disorders are common in nursing stuff and have a negative impact in their professional and daily activities. In the current editorial, the duties of nursing staff, the types of musculoskeletal disorders, the predisposing factors (including factors related to professional tasks/ergonomics and to working schedules, psychological, social and individual factors) and their impact on working ability and quality of life nursing staff are summarized and preventive measures are proposed.

Background: Epilepsy impacts millions of people, with many not responding to existing treatments. Some evidence links neuroinflammatory processes to epilepsy. Statins exhibit anti-inflammatory and neuroprotective properties, potentially offering antiepileptic effects.

Aim: To evaluate the anticonvulsant effects of rosuvastatin in animal models of epilepsy.

Methods: Ninety-six albino mice were divided into 16 groups. In the maximal electroshock seizure (MES) model, eight groups received intraperitoneal vehicle, carbamazepine, rosuvastatin, or a combination. Outcomes measured included seizure protection [tonic hind limb extension (THLE)], duration of THLE, seizure duration, and mortality. In the pentylenetetrazol (PTZ) model, eight groups were pretreated with vehicle, valproate, rosuvastatin, or a combination, with outcomes measured as seizure latency, seizure duration, and mortality.

Results: In the MES model, rosuvastatin exhibited protection against THLE in a small percentage of mice. Rosuvastatin shortens the duration of THLE in a dose-dependent manner. However, none of these were statistically significant compared to the control group. The combination of rosuvastatin 10 mg/kg with carbamazepine 4 mg/kg resulted in a significant reduction in seizure duration compared to the control group, better than carbamazepine alone at 4 mg/kg and 6 mg/kg. In the PTZ model, rosuvastatin alone showed no significant effects on latency, duration of seizure, or mortality. However, rosuvastatin 10 mg/kg combined with valproate 100 mg/kg significantly delayed the onset of seizures, seizure duration and mortality percentage, better than valproate alone at 100 mg/kg.

Conclusion: Rosuvastatin enhanced the anticonvulsant effects of carbamazepine and valproate. Further studies are required to explore the antiepileptic potential of rosuvastatin at various doses, durations, dosage forms, routes and models.