247 research outputs found
Comparative Risk of Serious Infections With Biologic and/or Immunosuppressive Therapy in Patients With Inflammatory Bowel Diseases: A Systematic Review and Meta-Analysis
No full textMagnitude and Kinetics of Decrease in Liver Stiffness After Anti-viral Therapy in Patients With Chronic Hepatitis C: A Systematic Review and Meta-analysis
No full textComparative accuracy of needle sizes and designs for EUS tissue sampling of solid pancreatic masses: a network meta-analysis
No full textBackground and Aims: Variable diagnostic performance of sampling techniques during EUS-guided tissue
acquisition of solid pancreatic masses based on needle type (FNA versus fine-needle biopsy [FNB]) and gauge
(19-gauge vs 22-gauge vs 25-gauge) has been reported. We performed a systematic review with network metaanalysis
to compare the diagnostic accuracy of EUS-guided techniques for sampling solid pancreatic masses.
Methods: Through a systematic literature review to November 2018, we identified 27 randomized controlled trials
(2711 patients) involving adults undergoing EUS-guided sampling of solid pancreatic masses that evaluated the
diagnostic performance of FNA and FNB needles based on needle gauge. The primary outcome was diagnostic
accuracy. Secondary outcomes were sample adequacy, histologic core procurement rate, and number of needle
passes. We performed pairwise and network meta-analyses and appraised the quality of evidence using GRADE
(Grading of Recommendations Assessment, Development and Evaluation) methodology.
Results: In the network meta-analysis, no specific EUS-guided tissue sampling technique was superior, based on
needle type (FNA vs FNB) or gauge (19-gauge vs 22-gauge vs 25-gauge) (low-quality evidence). Specifically, there
was no difference between 25-gauge FNA versus 22-gauge FNA (relative risk [RR], 1.03; 95% confidence interval
[CI], 0.91-1.17) and 22-gauge FNB versus 22-gauge FNA (RR, 1.03; 95% CI, 0.89-1.18) needles for diagnostic
accuracy, sample adequacy, and histologic core procurement. Findings were confirmed in sensitivity analysis
restricted to studies with no rapid on-site cytologic evaluation and no use of the fanning technique.
Conclusion: In a network meta-analysis, no specific EUS-guided tissue sampling technique was superior with
regard to diagnostic accuracy, sample adequacy, or histologic procurement rate for solid pancreatic masses,
with low confidence in estimate
TRATTAMENTO ROBOTIZZATO DELL’ARTO SUPERIORE NEI PAZIENTI CON EMIPARESI SPASTICA IN FASE CRONICA TRATTATI CON TOSSINA BOTULINICA TIPO A: CONFRONTO TRA END-EFFECTOR E ESOSCHELETRO
No full textL’utilizzo di dispositivi robotici per l’arto superiore in riabilitazione è supportato da numerose evidenze che mostrano come essi
possano migliorare la funzione e la forza dell’arto superiore e l’attività di vita quotidiana. Tuttavia ci sono poche evidenze sulla scelta del dispositivo più appropriato da utilizzare. Inoltre pochi studi hanno indagato l’efficacia del trattamento robotico per l’arto superiore associato all’impiego di tossina botulinica. L’obiettivo di questo studio osservazionale è quello di identificare le differenze tra end effector e esoscheletro nel migliorare la funzione dell’arto superiore nei pazienti affetti da emiparesi spastica sottoposti ad infiltrazione di tossina botulinica di tipo A in fase cronica
Sensor based assessment of turning during instrumented Timed Up and Go Test for quantifying mobility in chronic stroke patients
No full textBACKGROUND: Turning may be particularly challenging for stroke patients leading to decreased mobility and increased functional restriction. Timed up and go instrumentation using a simple technology in the clinical context could allow for the collection of both traditional and poten-tially more discriminatory variables in turning ability.AIM: Determine whether the speed turning metrics obtained by a single inertial sensor are suitable for differentiating between stroke patients with varying levels of mobility and disability.DESIGN: Cross-sectional study.SETTING: Outpatients setting.POPULATION: Chronic stroke patients.METHODS: A total of 48 chronic stroke patients and 23 healthy controls were included. Stroke patients were divided in two groups based on the total iTUG score: an impaired mobility (> 20 seconds) and an available mobility (<20 seconds) group. All subjects performed an instrumented Timed Up and Go (iTUG) wearing a single IMU sensor on the lower back. Time of subcomponents of the timed up and go test and kinematic parameters of turning were quantified. Other clinical outcomes were: 10 meters walk test, Functional Ambulation Categories Scale (FAC), the Rivermead Mobility Index (RMI), Modified Rankin Scale and the Saltin-Grimby Physical Activity Level Scale (SGPALS).RESULTS: There were significant differences (P<0.01) in iTUG phases and turning speeds among groups. Low to strong significant correlations were found between measures derived from the turning speeds and clinical measures. The area under the curve (AUC) of Receiver Operating Characteristic (ROC) turning speeds was demonstrated to be able to discriminate (AUC: 0.742-0.912) from available to impaired stroke patients.CONCLUSIONS: This study provides evidence that turning speeds during timed up and go test are accurate measures of mobility and capable of discriminating stroke patients with impaired mobility from those with normal mobility. CLINICAL REHABILITATION IMPACT: The turning metrics are related to impairment and mobility in chronic stroke patients; hence they are important to include during clinical evaluation and may assist in creating a customized strategy, assess potential treatments, and effectively organize recovery.(Cite this article as: Spina S, Facciorusso S, D'Ascanio MC, Morone G, Baricich A, Fiore P, et al. Sensor based assessment of turning during instru-mented Timed Up and Go Test for quantifying mobility in chronic stroke patients. Eur J Phys Rehabil Med 2023;59:6-13. DOI: 10.23736/S1973-9087.22.07647-X
Transcranial Direct Current Stimulation Combined with Botulinum Neurotoxin Type A Injections for Treatment of Upper Limb Intention Tremor in Multiple Sclerosis: A Case Report
No full textUpper limb intention tremor is a common cause of disability in multiple sclerosis (MS). Transcranial direct current stimulation (tDCS) is an emerging form of brain stimulation used to improve sensorimotor impairments in many neurological disorders. Here, we describe a combined therapeutic approach with botulinum neurotoxin type A (BoNT-A) and tDCS for the treatment of upper limb tremor in a patient with MS. We administered a cathodal tDCS 15 days after the injections of BoNT-A. Both post-injection and post-stimulation evaluation revealed a considerable improvement of the tremor. This approach positively affected the patient's activities of daily living. Our case report shows a safe and beneficial effect of tDCS in the treatment of action tremor in MS especially as a possible adjunctive synergic treatment with BoNT-A injections
Trans-arterial radioembolization in intermediate-advanced hepatocellular carcinoma: systematic review and meta-analyses
No full textStatin Use Decreases the Incidence of Hepatocellular Carcinoma: An Updated Meta-Analysis
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