World journal of methodology最新文献

{"title":"Sacrum magnetic resonance imaging for low back and tail bone pain: A quality initiative to evaluate and improve imaging utility.","authors":"Samantha Castillo,&nbsp;Robert Joodi,&nbsp;L Errett Williams,&nbsp;Parham Pezeshk,&nbsp;Avneesh Chhabra","doi":"10.5662/wjm.v11.i4.110","DOIUrl":"https://doi.org/10.5662/wjm.v11.i4.110","url":null,"abstract":"<p><p>As quality and cost effectiveness become essential in clinical practice, an evidence-based evaluation of the utility of imaging orders becomes an important consideration for radiology's value in patient care. We report an institutional quality improvement project including a retrospective review of utility of sacrum magnetic resonance (MR) imaging for low back pain at our institution over a four-year period and follow-up results after physician education intervention. Sacral MR imaging for low back pain and tailbone pain were only positive for major findings in 2/98 (2%) cases, and no major changes in patient management related to imaging findings occurred over this period, resulting in almost $500000 cost without significant patient benefit. We distributed these results to the Family Medicine department and clinics that frequently placed this order. An approximately 83% drop in ordering rate occurred over the ensuing 3 mo follow-up period. Sacrum MR imaging for low back pain and tail bone pain has not been a cost-effective diagnostic tool at our institution. Physician education was a useful tool in reducing overutilization of this study, with a remarkable drop in such studies after sharing these findings with primary care physicians at the institution. In conclusion, sacrum MR imaging rarely elucidates the cause of low back/tail pain diagnosed in a primary care setting and is even less likely to result in major changes in management. The practice can be adopted in other institutions for the benefit of their patients and improve cost efficiency.</p>","PeriodicalId":23729,"journal":{"name":"World journal of methodology","volume":"11 4","pages":"110-115"},"PeriodicalIF":0.0,"publicationDate":"2021-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/19/1e/WJM-11-110.PMC8299904.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39255085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Looking into key bacterial proteins involved in gut dysbiosis.","authors":"Xin-Yu Zeng, Ming Li","doi":"10.5662/wjm.v11.i4.130","DOIUrl":"10.5662/wjm.v11.i4.130","url":null,"abstract":"<p><p>The gastrointestinal microbiota plays a pivotal role in health and has been linked to many diseases. With the rapid accumulation of pyrosequencing data of the bacterial composition, the causal-effect relationship between specific dysbiosis features and diseases is now being explored. The aim of this review is to describe the key functional bacterial proteins and antigens in the context of dysbiosis related-diseases. We subjectively classify the key functional proteins into two categories: Primary key proteins and secondary key proteins. The primary key proteins mainly act by themselves and include biofilm inhibitors, toxin degraders, oncogene degraders, adipose metabolism modulators, anti-inflammatory peptides, bacteriocins<i>,</i> host cell regulators, adhesion and invasion molecules, and intestinal barrier regulators. The secondary key proteins mainly act by eliciting host immune responses and include flagellin, outer membrane proteins, and other autoantibody-related antigens. Knowledge of key bacterial proteins is limited compared to the rich microbiome data. Understanding and focusing on these key proteins will pave the way for future mechanistic level cause-effect studies of gut dysbiosis and diseases.</p>","PeriodicalId":23729,"journal":{"name":"World journal of methodology","volume":"11 4","pages":"130-143"},"PeriodicalIF":0.0,"publicationDate":"2021-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f5/16/WJM-11-130.PMC8299906.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39254549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Delphi methodology in healthcare research: How to decide its appropriateness.","authors":"Prashant Nasa,&nbsp;Ravi Jain,&nbsp;Deven Juneja","doi":"10.5662/wjm.v11.i4.116","DOIUrl":"https://doi.org/10.5662/wjm.v11.i4.116","url":null,"abstract":"<p><p>The Delphi technique is a systematic process of forecasting using the collective opinion of panel members. The structured method of developing consensus among panel members using Delphi methodology has gained acceptance in diverse fields of medicine. The Delphi methods assumed a pivotal role in the last few decades to develop best practice guidance using collective intelligence where research is limited, ethically/logistically difficult or evidence is conflicting. However, the attempts to assess the quality standard of Delphi studies have reported significant variance, and details of the process followed are usually unclear. We recommend systematic quality tools for evaluation of Delphi methodology; identification of problem area of research, selection of panel, anonymity of panelists, controlled feedback, iterative Delphi rounds, consensus criteria, analysis of consensus, closing criteria, and stability of the results. Based on these nine qualitative evaluation points, we assessed the quality of Delphi studies in the medical field related to coronavirus disease 2019. There was inconsistency in reporting vital elements of Delphi methods such as identification of panel members, defining consensus, closing criteria for rounds, and presenting the results. We propose our evaluation points for researchers, medical journal editorial boards, and reviewers to evaluate the quality of the Delphi methods in healthcare research.</p>","PeriodicalId":23729,"journal":{"name":"World journal of methodology","volume":"11 4","pages":"116-129"},"PeriodicalIF":0.0,"publicationDate":"2021-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/92/4a/WJM-11-116.PMC8299905.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39255086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fascinating history of groin hernias: Comprehensive recognition of anatomy, classic considerations for herniorrhaphy, and current controversies in hernioplasty.","authors":"Tomohide Hori, Daiki Yasukawa","doi":"10.5662/wjm.v11.i4.160","DOIUrl":"10.5662/wjm.v11.i4.160","url":null,"abstract":"<p><p>Groin hernias include indirect inguinal, direct inguinal, femoral, obturator, and supravesical hernias. Here, we summarize historical turning points, anatomical recognition and surgical repairs. Groin hernias have a fascinating history in the fields of anatomy and surgery. The concept of tension-free repair is generally accepted among clinicians. Surgical repair with mesh is categorized as hernioplasty, while classic repair without mesh is considered herniorrhaphy. Although various surgical approaches have been developed, the surgical technique should be carefully chosen for each patient. Regarding as interesting history, crucial anatomy and important surgeries in the field of groin hernia, we here summarized them in detail, respectively. Points of debate are also reviewed; important points are shown using illustrations and schemas. We hope this systematic review is surgical guide for general surgeons including residents. Both a skillful technique and anatomical knowledge are indispensable for successful hernia surgery in the groin.</p>","PeriodicalId":23729,"journal":{"name":"World journal of methodology","volume":"11 4","pages":"160-186"},"PeriodicalIF":0.0,"publicationDate":"2021-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/27/16/WJM-11-160.PMC8299909.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39254551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Simplified figure to present direct and indirect comparisons: Revisiting the graph 10 years later.","authors":"Valeria Fadda,&nbsp;Laura Bartoli,&nbsp;Elisa Ferracane,&nbsp;Sabrina Trippoli,&nbsp;Andrea Messori","doi":"10.5662/wjm.v11.i4.228","DOIUrl":"https://doi.org/10.5662/wjm.v11.i4.228","url":null,"abstract":"<p><p>A \"simplified\" figure was proposed in 2011 to summarize the results of controlled trials that evaluate different treatments aimed at the same disease condition. The original criteria for classifying individual binary comparisons included superiority, inferiority and no significance difference; hence, they did not differentiate between no proof of difference <i>vs</i> proof of no difference. We updated the criteria employed in the original \"simplified\" figure in order to include this differentiation. A revised version of the simplified figure is proposed and described herein. An example of application is also presented. The example is focused on first-line treatments for paroxysmal atrial fibrillation. Three treatments (medical therapy, cryoballoon ablation, radiofrequency ablation) are compared with one another through direct and indirect comparisons.</p>","PeriodicalId":23729,"journal":{"name":"World journal of methodology","volume":"11 4","pages":"228-230"},"PeriodicalIF":0.0,"publicationDate":"2021-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/26/fc/WJM-11-228.PMC8299911.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39254556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tocilizumab as treatment for COVID-19: A systematic review and meta-analysis.","authors":"Fausto Petrelli, Sara Cherri, Michele Ghidini, Gianluca Perego, Antonio Ghidini, Alberto Zaniboni","doi":"10.5662/wjm.v11.i3.95","DOIUrl":"10.5662/wjm.v11.i3.95","url":null,"abstract":"<p><strong>Background: </strong>The majority of patients with coronavirus disease 2019 (COVID-19) have good prognoses, but some develop a critical illness that can lead to death. Evidence shows severe acute respiratory syndrome is closely related to the induced cytokine storm. Interleukin-6 is a key player; its role in systemic inflammation is well known.</p><p><strong>Aim: </strong>To evaluate the effect of tocilizumab (TCZ), an interleukin-6 receptor antagonist, on the outcomes for patients with COVID-19 pneumonia.</p><p><strong>Methods: </strong>PubMed, EMBASE, SCOPUS, Web of Science, MedRxiv, Science Direct, and the Cochrane Library were searched from inception to 9^th June 2020 for observational or prospective studies reporting results of hospitalized adult patients with COVID-19 infection treated with TCZ. Effect sizes were reported as odds ratios (ORs) with 95% confidence intervals (CIs), and an OR less than 1 was associated with a better outcome in those treated with TCZ.</p><p><strong>Results: </strong>Overall 13476 patients (33 studies; <i>n</i> = 3264 received TCZ) with COVID-19 pneumonia and various degree of severity were included. Outcome was improved with TCZ. In the primary analysis (<i>n</i> = 19 studies reporting data), mortality was reduced in patients treated with TCZ (OR = 0.64, 95%CI: 0.47-0.87; <i>P</i> < 0.01). In 9 studies where risk of death with TCZ use was controlled for other variables mortality was reduced by 57% (OR = 0.43, 95%CI: 0.27-0.7; <i>P</i> < 0.01). Intensive care need (mechanical ventilation) was also reduced (OR = 0.36, 95%CI: 0.14-0.89; <i>P</i> = 0.02).</p><p><strong>Conclusion: </strong>In COVID-19-infected patients treated with TCZ, outcome may be improved compared to those not treated with TCZ.</p>","PeriodicalId":23729,"journal":{"name":"World journal of methodology","volume":"11 3","pages":"95-109"},"PeriodicalIF":0.0,"publicationDate":"2021-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/74/58/WJM-11-95.PMC8127418.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39011791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of lag screws and double Y-shaped miniplates in the fixation of anterior mandibular fractures.","authors":"Lydia Melek","doi":"10.5662/wjm.v11.i3.88","DOIUrl":"https://doi.org/10.5662/wjm.v11.i3.88","url":null,"abstract":"<p><strong>Background: </strong>Mandibular fractures constitute about 80.79% of maxillofacial injuries in Alexandria University, either as isolated mandibular fractures or as a part of panfacial fractures. The combination of symphyseal and parasymphyseal fractures represent 47.09% of the total mandibular fractures.</p><p><strong>Aim: </strong>To compare the effectiveness of lag screws <i>vs</i> double Y-shaped miniplates in the fixation of anterior mandibular fractures.</p><p><strong>Methods: </strong>This study is a prospective randomized controlled clinical trial, performed on sixteen patients with anterior mandibular fractures. Patients were divided equally into two groups, each consisting of eight patients. Group 1: Underwent open reduction and internal fixation using two lag screws. Group 2: Underwent open reduction and internal fixation using double Y-shaped plates. The following parameters were assessed: operating time in minutes, pain using a visual analog scale, edema, surgical wound healing for signs and symptoms of infection, occlusion status and stability, maximal mouth opening, and sensory nerve function. Cone beam computed tomography was performed at 3 and 6 mo to measure bone density and assess the progression of fracture healing.</p><p><strong>Results: </strong>The study included 13 males (81.3%) and 3 females (18.8%) aged 26 to 45 years (mean age was 35.69 ± 6.01 years). The cause of trauma was road traffic accidents in 10 patients (62.5%), interpersonal violence in 3 patients (18.8%) and other causes in 3 patients (18.8%). The fractures comprised 10 parasymphyseal fractures (62.5%) and 6 symphyseal fractures (37.5%). The values of all parameters were comparable in both groups with no statistically significant difference except for the mean bone density at 3 mo postoperatively which was 946.38 ± 66.29 in group 1 and 830.36 ± 95.53 in group 2 (<i>P</i> = 0.015).</p><p><strong>Conclusion: </strong>Both lag screws and double Y-shaped miniplates provide favorable means of fixation for mandibular fractures in the anterior region. Fractures fixed with lag screws show greater mean bone density at 3 mo post-operation, indicative of higher primary stability and faster early bone healing. Further studies with larger sample sizes are required to verify these conclusions.</p>","PeriodicalId":23729,"journal":{"name":"World journal of methodology","volume":"11 3","pages":"88-94"},"PeriodicalIF":0.0,"publicationDate":"2021-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/45/05/WJM-11-88.PMC8127419.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39011790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bowel intussusception in adult: Prevalence, diagnostic tools and therapy.","authors":"Francesco Panzera,&nbsp;Beatrice Di Venere,&nbsp;Marina Rizzi,&nbsp;Assunta Biscaglia,&nbsp;Carlos Alberto Praticò,&nbsp;Gennaro Nasti,&nbsp;Andrea Mardighian,&nbsp;Thiago Franchi Nunes,&nbsp;Riccardo Inchingolo","doi":"10.5662/wjm.v11.i3.81","DOIUrl":"https://doi.org/10.5662/wjm.v11.i3.81","url":null,"abstract":"<p><p>Intussusception is defined as invagination of one segment of the bowel into an immediately adjacent segment. The intussusception refers to the proximal segment that invaginates into the distal segment, or the intussusception (recipient segment). Intussusception, more common occur in the small bowel and rarely involve only the large bowel. In direct contrast to pediatric etiologies, adult intussusception is associated with an identifiable cause in almost all the symptomatic cases while the idiopathic causes are extremely rare. As there are many common causes of acute abdomen, intussusception should be considered when more frequent etiologies have been ruled out. In this review, we discuss the symptoms, location, etiology, characteristics, diagnostic methods and treatment strategies of this rare and enigmatic clinical entity in adult.</p>","PeriodicalId":23729,"journal":{"name":"World journal of methodology","volume":"11 3","pages":"81-87"},"PeriodicalIF":0.0,"publicationDate":"2021-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6e/89/WJM-11-81.PMC8127421.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39011909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rationalising animal research synthesis in orthopaedic literature.","authors":"Konstantinos Tsikopoulos,&nbsp;Konstantinos Sidiropoulos,&nbsp;Dimitrios Kitridis,&nbsp;Lorenzo Drago,&nbsp;Rakesh Ebnezar,&nbsp;David Lavalette","doi":"10.5662/wjm.v11.i3.75","DOIUrl":"https://doi.org/10.5662/wjm.v11.i3.75","url":null,"abstract":"<p><p>Systematic reviews in orthopaedic literature are frequently criticised for offering inconsistent conclusions. On top of that, high-quality randomized human evidence on crucial orthopaedic topics is more often than not lacking. In this situation, pooling animal literature could offer an excellent insight into unanswered critical clinical questions, thus potentially improving healthcare. In this paper, we sought to present the rationale and basic principles governing meta-analysis of animal research. More specifically, we elaborated on the available evidence-based methods to achieve a scientifically sound animal data synthesis. In addition, we discussed result interpretation, strength of recommendations and clinical implications based on the results of these meta-analytic modalities.</p>","PeriodicalId":23729,"journal":{"name":"World journal of methodology","volume":"11 3","pages":"75-80"},"PeriodicalIF":0.0,"publicationDate":"2021-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/84/1c/WJM-11-75.PMC8127423.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39011908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Concise review of stereotactic irradiation for pediatric glial neoplasms: Current concepts and future directions.","authors":"Omer Sager,&nbsp;Ferrat Dincoglan,&nbsp;Selcuk Demiral,&nbsp;Bora Uysal,&nbsp;Hakan Gamsiz,&nbsp;Onurhan Colak,&nbsp;Fatih Ozcan,&nbsp;Esin Gundem,&nbsp;Yelda Elcim,&nbsp;Bahar Dirican,&nbsp;Murat Beyzadeoglu","doi":"10.5662/wjm.v11.i3.61","DOIUrl":"https://doi.org/10.5662/wjm.v11.i3.61","url":null,"abstract":"<p><p>Brain tumors, which are among the most common solid tumors in childhood, remain a leading cause of cancer-related mortality in pediatric population. Gliomas, which may be broadly categorized as low grade glioma and high grade glioma, account for the majority of brain tumors in children. Expectant management, surgery, radiation therapy (RT), chemotherapy, targeted therapy or combinations of these modalities may be used for management of pediatric gliomas. Several patient, tumor and treatment-related characteristics including age, lesion size, grade, location, phenotypic and genotypic features, symptomatology, predicted outcomes and toxicity profile of available therapeutic options should be considered in decision making for optimal treatment. Management of pediatric gliomas poses a formidable challenge to the physicians due to concerns about treatment induced toxicity. Adverse effects of therapy may include neurological deficits, hemiparesis, dysphagia, ataxia, spasticity, endocrine sequelae, neurocognitive and communication impairment, deterioration in quality of life, adverse socioeconomic consequences, and secondary cancers. Nevertheless, improved understanding of molecular pathology and technological advancements may pave the way for progress in management of pediatric glial neoplasms. Multidisciplinary management with close collaboration of disciplines including pediatric oncology, surgery, and radiation oncology is warranted to achieve optimal therapeutic outcomes. In the context of RT, stereotactic irradiation is a viable treatment modality for several central nervous system disorders and brain tumors. Considering the importance of minimizing adverse effects of irradiation, radiosurgery has attracted great attention for clinical applications in both adults and children. Radiosurgical applications offer great potential for improving the toxicity profile of radiation delivery by focused and precise targeting of well-defined tumors under stereotactic immobilization and image guidance. Herein, we provide a concise review of stereotactic irradiation for pediatric glial neoplasms in light of the literature.</p>","PeriodicalId":23729,"journal":{"name":"World journal of methodology","volume":"11 3","pages":"61-74"},"PeriodicalIF":0.0,"publicationDate":"2021-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/82/6b/WJM-11-61.PMC8127424.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39011907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}