Subacromial spacer implantation: an alternative to arthroscopic superior capsular reconstruction. A systematic review
AbstractIntroductionThis systematic review evaluated and compared the use of a subacromial spacer implantation (SSI) with arthroscopic superior capsular repair (ASCR) in the management of massive irreparable rotator cuff tears (MIRCTs) with an assessment of clinical and imaging outcomes.Sources of dataThis systematic review was carried out following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched in PubMed, Medline and Embase database literature using the keywords ‘subacromial spacer’, ‘subacromial balloon’, ‘subacromial device’, ‘arthroscopy’, ‘superior caps...
Source: British Medical Bulletin - July 2, 2021 Category: General Medicine Source Type: research
Ethics of ICU triage during COVID-19 and Psychological factors associated with inflammatory bowel disease
(Source: British Medical Bulletin)
Source: British Medical Bulletin - June 10, 2021 Category: General Medicine Source Type: research
Capsular repair vs capsulectomy in total hip arthroplasty
AbstractBackgroundA major complication of total hip arthroplasty is dislocation. The hip joint capsule can be incised and repaired, or can be excised.Sources of dataWe performed a systematic review of the literature following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines focusing on capsular repair and capsulectomy.Areas of agreementWe identified 31 articles (17 272 patients). Capsular repair produced a lower blood loss (465.2 vs 709.2 ml), and the procedure lasted 102.5 vs 96.08 min in patients who underwent capsulectomy. The patients undergoing capsulectomy experienced a disloca...
Source: British Medical Bulletin - May 31, 2021 Category: General Medicine Source Type: research
Psychological factors associated with inflammatory bowel disease
AbstractBackgroundBoth depression and anxiety are identified as significant experiences in inflammatory bowel disease (IBD); whether these are a consequence of the disease or an active contributor to the disease remains controversial. This review aimed to identify and critique recent evidence regarding mental health in IBD.Sources of dataPubmedⓇ, OvidⓇ, EmbaseⓇ, EBSCO PsychInfo and Google-Scholar were searched within the last 5 years (2016–2020).Areas of agreementOverall, both depression and anxiety affect disease activity, relapse and healthcare utilization.Areas of controversyThere is some controversy on whethe...
Source: British Medical Bulletin - May 31, 2021 Category: General Medicine Source Type: research
Ethics of ICU triage during COVID-19
AbstractIntroductionThe coronavirus disease 2019 pandemic has placed intensive care units (ICU) triage at the center of bioethical discussions. National and international triage guidelines emerged from professional and governmental bodies and have led to controversial discussions about which criteria —e.g. medical prognosis, age, life-expectancy or quality of life—are ethically acceptable. The paper presents the main points of agreement and disagreement in triage protocols and reviews the ethical debate surrounding them.Sources of dataPublished articles, news articles, book chapters, ICU triage guidelines set out by pr...
Source: British Medical Bulletin - May 31, 2021 Category: General Medicine Source Type: research
High-fat diet, adipokines and low-grade inflammation are associated with disrupted tendon healing: a systematic review of preclinical studies
AbstractBackgroundThe aetiopathogenesis of tendinopathy is uncertain, but inflammation may play a role in the early phase of tendinopathy and in tendon healing response. We investigated the most up-to-date evidence about the association between obesity, high-fat diet and tendinopathy, focusing on the role of adipokines, inflammatory pathways and molecular changes.Sources of dataA systematic review was performed searching PubMed, Embase and Cochrane Library databases following the PRISMA guidelines. We included studies of any level of evidence published in peer-reviewed journals. The risk of bias (SIRCLE) was assessed, as w...
Source: British Medical Bulletin - May 28, 2021 Category: General Medicine Source Type: research
Failure and progression to total hip arthroplasty among the treatments for femoral head osteonecrosis: a Bayesian network meta-analysis
AbstractIntroductionOsteonecrosis of the femoral head (ONFH) often leads to secondary osteoarthritis and total hip arthroplasty.Source of dataRecent published literatures.Areas of agreementThere has been increasing focus on the early intervention in ONFH patients to preserve the native hip articulation, reduce pain and improve function.Areas of controversyEfficacy of surgical strategies for ONFH is debated. Several clinical studies showed controversial results, and the best treatment has not yet been clarified.Growing pointsTo provide an overview over current treatment options for ONFH compares their failure rates and conv...
Source: British Medical Bulletin - May 18, 2021 Category: General Medicine Source Type: research
Matrix-induced autologous chondrocyte implantation versus autologous matrix-induced chondrogenesis for chondral defects of the talus: a systematic review
AbstractIntroductionChondral defects of the talus are common and their treatment is challenging.Source of dataRecent published literatures.Areas of agreementMembrane-induced Autologous Chondrocyte Implantation (mACI) and Autologous Matrix-Induced Chondrogenesis (AMIC) have been proposed as management for chondral defects of the talus.Areas of controversyIt is debated whether AMIC provides greater outcomes compared to mACI for chondral regeneration. Several clinical studies showed controversial results, and the best treatment has not yet been clarified.Growing pointsTo investigate whether AMIC provide superior outcomes than...
Source: British Medical Bulletin - May 3, 2021 Category: General Medicine Source Type: research
An update on the role of anti-IL-12/IL23 agents in the management of inflammatory bowel disease
AbstractIntroductionThe aim of treatment in inflammatory bowel disease (IBD) is to control symptoms and suppress gut inflammation with minimal systemic side effects. A large proportion of patients are either primary non-responders or lose response to currently licensed therapies. The development of monoclonal antibodies, blocking interleukin (IL)-12 and IL-23 pathways are a promising therapeutic advance. We review the data on IL12/23 inhibitors and emerging data on IL-23 inhibition in IBD treatment.Sources of dataThis review is based on data published in peer-reviewed journals and clinical trials registry.Areas of agreemen...
Source: British Medical Bulletin - April 21, 2021 Category: General Medicine Source Type: research
Non-steroidal anti-inflammatory drugs and gabapentinoids for chronic lumbar pain: a Bayesian network meta-analysis of randomized controlled trials
AbstractIntroductionSeveral pharmacological therapies have been proposed for the management of chronic low back pain (LBP), but no consensus has been reached yet.Source of dataRecent published literatures identified accessing PubMed, Google scholar, Embase and Scopus.Areas of agreementExploring effective conservative alternatives to the surgical intervention is of especial interest.Areas of controversyThe efficacy and safety of non-steroidal anti-inflammatory drugs and gabapentinoids for chronic LBP are debated. Several clinical studies showed controversial results, and the most effective and safe class of drugs has not ye...
Source: British Medical Bulletin - April 21, 2021 Category: General Medicine Source Type: research
Prolotherapy for chronic low back pain: a review of literature
AbstractIntroductionLow back pain is common and imposes major societal burdens for patient suffering and costs. Prolotherapy injections are used for musculoskeletal conditions including tendinopathies, osteoarthritis and low back pain to enhance soft-tissue healing. This review aims to clarify the place of prolotherapy in chronic low back pain (CLBP).Sources of dataUsing multiple databases, a systematic search was performed to identify studies detailing the use of prolotherapy to manage CLBP. A total of 12 articles was included in the present work.Areas of agreementConsidering the level of evidence and the quality of the s...
Source: British Medical Bulletin - April 21, 2021 Category: General Medicine Source Type: research
Mindfulness-based interventions: an overall review
AbstractIntroductionThis is an overall review on mindfulness-based interventions (MBIs).Sources of dataWe identified studies in PubMed, EMBASE, CINAHL, PsycINFO, AMED, Web of Science and Google Scholar using keywords including ‘mindfulness’, ‘meditation’, and ‘review’, ‘meta-analysis’ or their variations.Areas of agreementMBIs are effective for improving many biopsychosocial conditions, including depression, anxiety, stress, insomnia, addiction, psychosis, pain, hypertension, weight control, cancer-related symptoms and prosocial behaviours. It is found to be beneficial in the healthcare settings, in schools...
Source: British Medical Bulletin - April 21, 2021 Category: General Medicine Source Type: research
Vaccination ethics and Repurposing approved drugs for cancer therapy
These important subjects have been chosen to have free online access. In addition, the Bulletin has a section to celebrate its amazing archive, (see end of ‘In this Issue’). The British Medical Bulletin (BMB), on its website, also has a fascinating section on the Nobel Prize winners who wrote for the Bulletin and went on to win the accolade. (Source: British Medical Bulletin)
Source: British Medical Bulletin - March 25, 2021 Category: General Medicine Source Type: research
Sedentary behaviour in the workplace: prevalence, health implications and interventions
AbstractIntroductionThis paper reviews the prevalence and health risks of excess sedentary behaviour in office workers, and the effectiveness of sedentary workplace interventions in a manner accessible to practitioners.Sources of dataA narrative review of empirical studies obtained from PubMed and Web of Science.Areas of agreementOffice workers are highly sedentary, increasing their risk of health problems. Interventions using individual, organisational and environmental level strategies can be effective for reducing workplace sitting.Areas of controversyThe effects of sedentary workplace interventions on health are incons...
Source: British Medical Bulletin - March 12, 2021 Category: General Medicine Source Type: research
The different phenotypes of COPD
AbstractBackgroundChronic obstructive pulmonary disease (COPD) is associated with significant morbidity and mortality. To improve the health status and reduce symptom burden, it is important to identify a group of patients with similar characteristics and prognosis, called clinical phenotypes. Herein we shall review the different phenotypes of COPD.Sources of dataKeywords (COPD, phenotype, acute exacerbation) search was conducted in PubMed, Google Scholar.Areas of agreementThose with raised blood eosinophil counts respond better to steroid therapy at stable state and exacerbation.Areas of controversyThere is no universally...
Source: British Medical Bulletin - March 10, 2021 Category: General Medicine Source Type: research
