Human uterus transplantation in focus
Introduction
Uterus transplantation (UTx) is introduced as the first treatment for absolute uterine factor infertility (AUFI), affecting 1:500 fertile aged women. This review presents potential patients, research and human UTx cases.
Sources of data
Published articles and our research experience.
Areas of agreement
The first UTx live births in 2014 established UTx as a possible treatment for AUFI. This was proceeded by 15 years of systematic research.
Areas of controversy
Is a deceased donor UTx as effective as the proven successful live donor UTx?.
Growing points
Human UTx trials will accumulate data on risks, effecti...
Source: British Medical Bulletin - March 8, 2016 Category: Journals (General) Authors: Dahm-Kähler, P., Diaz-Garcia, C., Brännström, M. Tags: Transplantation Articles Source Type: research
Human amniotic membrane grafts in therapy of chronic non-healing wounds
Background
Human amniotic membrane (HAM) has been embraced as a natural wound dressing almost exclusively in ophthalmology. Only recently, emergence of commercial HAM products prompted its use in growing range of indications, especially treatment of chronic non-healing wounds.
Sources of data
ClinicalTrials.gov database and International Clinical Trials Registry Platform searched with key words ‘human amniotic membrane’ and ‘chronic wounds’.
Areas of agreement
HAM can be successfully used as a natural wound dressing to promote healing.
Areas of controversy
It is still unclear, which preparation i...
Source: British Medical Bulletin - March 8, 2016 Category: Journals (General) Authors: Ilic, D., Vicovac, L., Nikolic, M., Lazic Ilic, E. Tags: Genetics Articles Source Type: research
Hormones and tendinopathies: the current evidence
Background
Tendinopathies negatively affect the quality of life of millions of people, but we still do not know the factors involved in the development of tendon conditions.
Sources of data
Published articles in English in PubMed and Google Scholar up to June 2015 about hormonal influence on tendinopathies onset. One hundred and two papers were included following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
Areas of agreement
In vitro and in vivo, tenocytes showed changes in their morphology and in their functional properties according to hormonal imbalances.
Areas of contr...
Source: British Medical Bulletin - March 8, 2016 Category: Journals (General) Authors: Oliva, F., Piccirilli, E., Berardi, A. C., Frizziero, A., Tarantino, U., Maffulli, N. Tags: Sports Medicine Articles Source Type: research
Regeneration techniques for bone-to-tendon and muscle-to-tendon interfaces reconstruction
Introduction
The complex structure of the bone–tendon and muscle–tendon junctions makes their reproduction for tissue engineering applications very difficult. Relatively few studies have investigated the characteristics of these regions from a tissue engineering view point.
Sources of data
PubMed, Thomson Reuters, Scopus and Google Scholar databases were searched using various combinations of the keywords ‘Tendon’, ‘Myotendinous junction’, ‘Osteotendinous junction’, ‘Tissue engineering’ and ‘Scaffold’.
Areas of agreement
The available studies can be ...
Source: British Medical Bulletin - March 8, 2016 Category: Journals (General) Authors: Baldino, L., Cardea, S., Maffulli, N., Reverchon, E. Tags: Sports Medicine Articles Source Type: research
The Ebola epidemic and public health response
Introduction
An unprecedented global effort has been required to tackle the Ebola outbreak in West Africa. In this paper, we describe the contribution of Public Health England (PHE) in West Africa and the UK.
Sources of data
Public Health England
Areas of agreement
The epidemic has been a humanitarian crisis for the three worst affected countries. PHE contributions have included expertise in outbreak control and microbiology services in West Africa, and UK preparedness for an imported case.
Areas of controversy
National and international systems require change to enhance the response to the next international public hea...
Source: British Medical Bulletin - March 8, 2016 Category: Journals (General) Authors: Moll, R., Reece, S., Cosford, P., Kessel, A. Tags: Public Health Medicine Articles Source Type: research
Bioethics meets Ebola: exploring the moral landscape
Introduction
The Ebola Virus Disease (EVD) outbreak in West Africa raised ethical issues about structural disadvantage; the duty to care of healthcare workers; the use and study of unregistered agents; the use of restrictive measures like mass quarantine and the importance of public trust.
Sources of data
WHO reports, literature on EVD and ethics.
Areas of agreement
The use of restrictive measures and the testing of unregistered agents is ethical if support for individuals or communities is provided.
Areas of controversy
Controversy exists over ethical trial design for the study of unregistered agents and over the limit...
Source: British Medical Bulletin - March 8, 2016 Category: Journals (General) Authors: Thompson, A. K. Tags: Ethics Articles Source Type: research
Editor's choice, Volume 117
(Source: British Medical Bulletin)
Source: British Medical Bulletin - March 8, 2016 Category: Journals (General) Authors: Vetter, N. Tags: Editor ' s choice Source Type: research
Editor's Note, Volume 116
(Source: British Medical Bulletin)
Source: British Medical Bulletin - December 9, 2015 Category: Journals (General) Tags: Articles Source Type: research
Endoscopic cubital tunnel release: a systematic review
Introduction
Theoretical advantages of endoscopic cubital tunnel release are the short incision, lower risk of nerve damage, reduced manipulation of the nerve and possible faster recovery.
Sources of data
We systematically searched Medline (PubMed), Web of Science and Scopus databases using the following keywords: ‘endoscopic ulnar nerve’, ‘endoscopic cubital nerve’, ‘endoscopic ulnar compression’ and ‘endoscopic ulnar neuropathy’. Twenty-one studies were included in this review. The quality of the studies was assessed using the Coleman Methodological Score.
Areas of agreem...
Source: British Medical Bulletin - December 9, 2015 Category: Journals (General) Authors: Smeraglia, F., Del Buono, A., Maffulli, N. Tags: Sports Medicine Articles Source Type: research
The development of urban community health centres for strengthening primary care in China: a systematic literature review
Introduction
This review outlines the development of China's primary care system, with implications for improving equitable health care.
Sources of data
Government documents, official statistics, and recent literature identified through systematic searches performed on NCBI PubMed.
Areas of agreement
Community health centres (CHCs) are being developed as the major primary care provider in urban China, with laudable achievements. The road towards a strong primary care-led system is promising but challenging.
Areas of controversy
The effectiveness in improving equitable care through the expansion of primary care workforce...
Source: British Medical Bulletin - December 9, 2015 Category: Journals (General) Authors: Wang, H. H. X., Wang, J. J., Wong, S. Y. S., Wong, M. C. S., Mercer, S. W., Griffiths, S. M. Tags: Public Health Medicine Articles Source Type: research
Efficacy and safety of extracorporeal shock wave therapy for orthopedic conditions: a systematic review on studies listed in the PEDro database
Background
Extracorporeal shock wave therapy (ESWT) is an effective and safe non-invasive treatment option for tendon and other pathologies of the musculoskeletal system.
Sources of data
This systematic review used data derived from the Physiotherapy Evidence Database (PEDro; www.pedro.org.au, 23 October 2015, date last accessed).
Areas of agreement
ESWT is effective and safe. An optimum treatment protocol for ESWT appears to be three treatment sessions at 1-week intervals, with 2000 impulses per session and the highest energy flux density the patient can tolerate.
Areas of controversy
The distinction between radial ESW...
Source: British Medical Bulletin - December 9, 2015 Category: Journals (General) Authors: Schmitz, C., Csaszar, N. B. M., Milz, S., Schieker, M., Maffulli, N., Rompe, J.-D., Furia, J. P. Tags: Articles Source Type: research
Antibiotic resistance: what, why, where, when and how?
Background
Antibiotic resistance is a threat to the effective prevention and treatment of an ever-increasing range of infections caused by bacteria, parasites, viruses and fungi.
Sources of data
Peer-reviewed journal articles, governmental and professional society publications.
Areas of agreement and controversy
There is consensus about the development and spread of antibiotic resistance, the reasons for the development of antibiotic resistance and the clinical impact. There is more debate about the most appropriate way of tackling this increasing problem.
Growing points
This review discusses a number of initiatives (lo...
Source: British Medical Bulletin - December 9, 2015 Category: Journals (General) Authors: Sabtu, N., Enoch, D. A., Brown, N. M. Tags: Infectious Diseases Articles Source Type: research
Microfracture produces inferior outcomes to other cartilage repair techniques in chondral injuries in the paediatric knee
Introduction
Chondral injuries are becoming increasingly common in the paediatric knee. First line surgical therapy is usually microfracture (MF), but the emergence of alternative techniques raises the question of what is the optimal treatment in paediatric patients.
Sources of data
A comprehensive search of PubMed, OVID, Web of Science, SportDiscus and Cochrane databases was performed using the key words ‘autologous chondrocyte implantation, MF, mosaicplasty, juvenile, paediatric’.
Areas of agreement
Each technique demonstrated a significant post-surgical improvement in clinical outcome scores. However, MF d...
Source: British Medical Bulletin - December 9, 2015 Category: Journals (General) Authors: Chawla, A., Twycross-Lewis, R., Maffulli, N. Tags: Sports Medicine Articles Source Type: research
New paradigms in hepatitis B management: only diamonds are forever
Introduction
The hepatitis B virus (HBV) causes chronic hepatitis B (CHB) in ~350 million people worldwide who have an increased risk of end-stage liver disease and/or hepatocellular carcinoma.
Sources of data
Several peer-reviewed papers featuring new approaches to anti-HBV management. Additionally, we also reviewed recent abstract presentations at international congresses.
Areas of agreement
There has been great progress in CHB therapy with the development of standard and pegylated interferon (i.e. PEG-IFN) as well as nucleos/tide analogs (NAs). IFN has both antiviral and immunomodulatory effects and through immune-med...
Source: British Medical Bulletin - December 9, 2015 Category: Journals (General) Authors: Coffin, C. S., Lee, S. S. Tags: Cardiovascular Disease Articles Source Type: research
Eradication of tetanus
Introduction
The causative agent of tetanus, Clostridium tetani is widespread in the environment throughout the world and cannot be eradicated. To reduce the number of cases of tetanus efforts are focussed on prevention using vaccination and post-exposure wound care.
Sources of data
Medline, Pubmed and Cochrane databases; World Health Organization and United Nations Children's Fund publications.
Areas of agreement
The maternal and neonatal tetanus elimination initiative has resulted in significant reductions in mortality from neonatal tetanus throughout the world.
Areas of controversy
Although there are few data availab...
Source: British Medical Bulletin - December 9, 2015 Category: Journals (General) Authors: Thwaites, C. L., Loan, H. T. Tags: Infectious Diseases Articles Source Type: research
